HCA Midwest Health - October 08, 2015
by Jaime Thompson, CNM, Certified Nurse Midwife, Specialists in Women’s Care

When it comes to the time-honored practice of these healthcare providers, there is much more modern fact than outdated fiction.

Chances are, like many people, your perception of midwifery (a practice that’s been around for centuries) is old-fashioned. If a free-spirited woman who delivers babies in a home setting and has no formal education comes to mind when you think of midwifery, think again. Modern midwives, who go through rigorous education and certification, are an important part of the healthcare landscape—and do much more than just birth babies.

But let’s start at the beginning, the momentous occasion of birth. According to the National Center for Health Statistics, Certified Nurse-Midwives (CNM) and Certified Midwives (CM) attended 320,983 births in 2013, or 92 percent of midwife-attended births. This number represents 12 percent of all vaginal births, or 8.2 percent of total U.S. births. And CNMs/CMs account for more than 90 percent of all midwife-attended births since 1989, the first year that CNM/CM statistics were made available.

Beyond working with patients to develop a birth plan, CNMs and CMs offer women education, prevention and annual checkups and exams.

Casey Fleischman had to go to Hawaii to learn firsthand her misconceptions about midwives. “It has nothing to do with giving birth in a bathtub in your living room and everything to do with a personalized birth plan and overall health,” Fleischmann, who is married to a career Army man, says. “Midwives are hip, modern, cool.”

Fleischmann and her husband were stationed in Oahu in 2012 when she became pregnant with their first child. “Word on the street was that midwifery was the best option at the military base hospital,” Fleischmann recalls. “It was very competitive to even get an appointment with one of the seven midwives because they were so popular.”

If a free-spirited woman who delivers babies in a home setting and has no formal education comes to mind when you think of midwifery, think again. Modern midwives, who go through rigorous education and certification, are an important part of the healthcare landscape—and do much more than just birth babies.

After conducting her own research, Fleischmann made an appointment with a midwife. Months later she gave birth to her son—and became a forever-fan of midwifery. “I had a beautiful, natural birth,” Fleischmann says, “with the comfort of knowing that I had immediate access to physicians and technology if there were any complications.”

When the couple transferred to Fort Leavenworth, Kansas in 2013, Fleischmann started looking for a healthcare provider. “I wanted a midwife for my overall care, not just for birthing babies,” she says. “I found Jaime Thompson, a Certified Nurse Midwife, at Specialists in Women’s Care at Overland Park Regional Medical Center.”

Fleischmann, like many women who have discovered modern midwifery is a good fit for their lifetime healthcare needs and are champions and advocates, recommend research is integral to understanding the practice.

“Understand exactly what midwifery is and isn’t,” she says. “Make informed decisions. And be prepared to fall in love with the discipline of midwifery. There’s nothing like it.”

Here are the six most common myths of midwifery—and the facts.

MYTH: Midwives only focus on pregnancy and delivering babies.
FACT: Although it’s true that the majority of midwives attend births, the modern midwife enjoys a much broader scope of practice than in the past and builds long-term relationships with patients, often from the first pelvic exam beyond menopause. They get to know a woman’s medical history, which helps in decision-making, treating gynecologic conditions and maintaining a lifetime of health.

MYTH: Midwives are only allowed to deliver babies in a home setting.
FACT: According to the American College of Nurse Midwives, 98 percent of midwife-attended births occur in hospitals. In addition, there are midwives who assist women in giving birth at home or at a freestanding birth center.

MYTH: Midwives don’t allow pain medication or epidurals during birth.
FACT: One of the midwife’s goals is to improve the patient experience and to ensure all needs are met, which includes encouraging a woman and her partner to develop a birth plan, proven to help create a more positive birth experience and improve communication with their providers. Birth plans allow caregivers to understand expectant parents in terms of their emotional and physical expectations and reflect values, hopes and dreams for the birth process, as well as an attitude of collaboration and trust between expectant parents and their care team. And while plans can include dos and don’ts—such as pain medication vs. non-pharmaceutical options like acupressure, massage and hydrotherapy, it’s important to understand that, if there are changes in a woman’s health or environment, a different game plan before and during labor may be necessary.

MYTH: Midwives aren’t formally educated.
FACT: Certified Nurse-Midwives are registered nurses—most with master’s degrees—who have completed an accredited graduate program and passed a national certifying exam. Training involves obstetrics and gynecology, well-woman primary care and newborn care. A midwife is a low-risk pregnancy specialist, while an OB-GYN receives surgical and high-risk care.

MYTH: Midwives and obstetricians don’t see eye-to-eye.
FACT: Most pregnancies and births are normal, without complications. Part of a midwife’s training an education involves both respect for the normal births and high-risk situations that require a physician consultation. Most midwives practice collaboratively with an OB-GYN, especially when a C-section is necessary or other circumstances arise.

MYTH; Midwives don’t have access to technology.
FACT: Certified Nurse-Midwives have full access to state-of-the art technology and ultrasound, etc. Additionally, laboratory and x-ray services are also readily available for convenient and efficient care.

tags: midwifery , t4b