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What is a Midwife?
by Stacy Stich

One 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 programs.

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 and delivery.

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 philosophy.

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 deliveries.

Written by Stacey Stich


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