is a Midwife?
by Stacy Stich
of the most holy, natural, energizing (and
painful) experiences a woman accomplishes
in her lifetime is nurturing her unborn
child. To feel it grow and move within her
own body and then to give birth to another
human soul is the quintessential expression
of spirituality. And, it is unique to females
(at least human ones).
It is the hope and philosophy of Midwives
to provide personal, loving, educated and
competent obstetric and gynecological care
to all women. This not only includes the
hands on facet but also the emotional and
supportive aspects. They listen and hear
their patients. They empathize and understand
the plight women go through.
As a consumer of health care, it is imperative
that you be educated to the profession of
Midwifery. The misconceptions that plague
this profession need to be eradicated. It
is equally important that you understand
this non-physician profession as the health
care system as we know it is rapidly changing.
Inherent in these changes will be the catapulting
of non-physician professionals into an arena
that used to be reserved only for the physician.
It is already a legislative issue to slate
Midwives as primary care providers.
A Certified Nurse Midwife is licensed and
registered by a State Board of Midwifery.
In order to obtain these credentials a person
must complete a nursing program and then
continue with graduate studies specifically
in the field of Midwifery. Midwifery education
consists of the complete knowledge of the
female reproductive system. They are taught
to diagnose and treat (including writing
prescriptions). After their schooling, a
graduate Nurse Midwife must pass a national
exam (their "boards" if you will). Relative
to their role in the health care system,
they receive as stringent an education as
a physician only not in the medical school
tract. In fact, Ivy League schools such
as Columbia and Yale University have Midwifery
A Certified Nurse Midwife (CNM) is able
to care for the essentially healthy women
for her obstetrical and gynecological care.
She can render complete prenatal, intrapartum
and post partum care as well as the diagnosis
and treatment of the many common gynecological
problems that affect women. In fact, Midwives
manage women in all areas of their OB/GYN
health including annual exams, pap smears,
birth control, hormone replacement, infertility,
and, of course, all aspects of pregnancy
Midwives do not do surgery and they do not
manage high risk problems. They work within
a collegial relationship with a physician
with whom she can consult or refer a patient.
By law, a Midwife must have a physician
to back her up.
Once a person receives their credentials,
their personal style can take many forms.
The most well known are the Midwives who
do home births. In this environment, a Midwife
has the ability to assist a couple through
the birthing process in a natural and comfortable
milieu. It gives the Midwife the freedom
to implement a total non-interventionist
To the other extreme, and I believe the
least known form of practice, is the Midwife
who chooses to mainstream. They are educated
with the non-interventionist philosophy
and incorporate that core education with
a more expanded approach to providing care.
These Midwives work in hospital settings.
They can be employed in the Midwifery department
of a hospital, or like a physician, they
work in private practices and are privileged
to attend deliveries in the hospital.
Like the home birth Midwife, they utilize
such techniques as talking to, walking with,
massaging, medicating and showering the
laboring patient to help decrease her discomfort.
The hospital birth Midwife also has the
availability (when she needs to use them)
to benefit from modern technology such as
fetal monitors, ultrasound, lab analysis
and emergency equipment/personnel.
In the mid-path are Midwives that work in
birthing centers which incorporate the home
birth atmosphere with many of the hospital's
technology. The point is that Midwives are
professionals educated to assist a woman
in almost any environment the patient chooses.
No matter where a Midwife chooses to practice
they bring with them compassion, interest
and sensitivity combined with an educated,
professional expertise. If you would like
further information in regard to Midwifery
practice or if you would like to locate
a Midwife in your area, please call the
American College of Nurse Midwives (ACNM)
in Washington D.C. at (202) 728-9860.
Note: OB/GYN Nurse Practitioners are also
professionals educated in providing complete
health care to women. They do not attend
Written by Stacey
AMERICAN COLLEGE OF NURSE-MIDWIVES