HCA Midwest Health - July 01, 2022
by Katie J. Lorand, Certified Nurse-Midwife, Midwest Women’s Healthcare Specialists

Midwifery has existed for centuries—and, although the practice is anything but old-fashioned, many misperceptions persist. For example, a midwife is not a free-spirited woman with no formal education who delivers babies only in a home setting. The Certified Nurse-Midwife and Certified Midwife are an important part of today’s healthcare landscape and receive certification through rigorous education.

According to the National Center for Health Statistics, Certified Nurse-Midwives (CNM) and Certified Midwives (CM) attended 332,107 births in 2014. This represents 12.1 percent of all vaginal births, or 8.3 percent of total U.S. births. Since 1989, the first year that statistics were available, CNMs/CMs have accounted for more than 90 percent of all midwife-attended births.

As the region’s largest network of CNMs, HCA Midwest Health was also the Kansas City’s region first hospital system to offer midwifery services more than 20 years ago.

Certified Nurse-Midwives—like Katie Lorand, who has practiced midwifery since 1997— do much more to support women’s health than just birth babies. Beyond working with patients to develop a customized birth plan, CNMs like Lorand offer women education, prevention and annual checkups and exams throughout the different stages of their lives.

Lorand’s greatest joy as a CNM is building those life-long trusting, authentic relationships with women and their families.

“It’s important to understand exactly what midwifery is and isn’t,” Lorand says. “In addition to giving birth to healthy babies, women need to make informed decisions about their health and well-being.”

Here are eight common midwifery myths that Lorand has encountered over the years—and the facts.

MYTH: Nurse-Midwives Don’t Have Formal Education


Nurse-midwives are registered nurses who pursue graduate level education in nurse-midwifery, with either master’s or Ph.D. degrees as an endpoint. In addition, all nurse-midwives go through continuing education in women’s health throughout their careers.

MYTH: Nurse-Midwives Only Deliver at Home


Although there are nurse-midwives who perform home births, more than 90 percent of CNMs and CMs deliver in hospitals, where they have access to highly specialized care like neonatal intensive care units, ready availability of physician colleagues and other technology, should the need arise.

MYTH: Nurse-Midwives and Obstetricians Don’t See Eye-To-Eye


There’s a false assumption in both the medical and broader community that nurse-midwives and obstetricians compete with one another. The reality: Nurse-midwives focus on collaboration with the OB-GYNs who celebrate and support them. “They recognize we have a unique skill set that benefits our patients. Our relationship is symbiotic, not competitive,” Lorand explains. “We depend on them for advice, especially in complex, high-risk situations.”

MYTH: Nurse-Midwives Don’t Have Access to Technology


Many CNMs and CMS are in hospital settings where they can access all the benefits of a labor floor when appropriate, along with lab tests and imaging,” Lorand says.

MYTH: If I Choose a Midwife, I Can’t Have an Epidural or Any Pain Medication During Labor


CNMs and CMs can order and provide the same medications for labor pain that physicians provide their patients. “All options are open,” Lorand says. “We advocate for women designing their own birth plans and making decisions that work for them for the best possible birth experience.

MYTH: Nurse-Midwives Only Take Care of Low-Risk Women


Although CNMs and CMs specialize in taking care of healthy women with healthy pregnancies, they also work with women who have moderate-risk pregnancies and those that develop complications, using collaboration and co-management with physician colleagues.

MYTH: Nurse-Midwives Offer a Lower Level of Care Than a Traditional Ob-Gyn


Women who go to a CNM or CM can expect to receive a comparable level of care. Recent research indicates that states with a higher percentage of deliveries by nurse-midwives have better birth outcomes.

MYTH: Nurse-Midwives Exclusively See Patients for Pregnancy


Female adolescents through post-menopausal women are cared for by nurse-midwives like Lorand, who provide well-woman care, uncomplicated gynecologic care, birth control, PAP smears, STD testing, testing care for the menopausal transition and more.