Choosing a Midwife for your Birth: Types, Skills, & Background

As the journey to welcoming a new life unfolds, many expectant mothers are exploring different options for maternity care. One increasingly popular choice is midwifery, a woman-centered approach to childbirth that emphasizes minimizing technological interventions while focusing on the physical, psychological, and social well-being of the mother. This holistic model of care has been shown to produce some of the best outcomes for both mothers and infants globally. If you’re considering a midwife, understanding the different types and what they offer is essential for making the right choice for your birth experience.

What is Midwifery?

Midwifery is a model of care that prioritizes the natural processes of childbirth while supporting the emotional and physical needs of the mother. This approach is utilized around the world and has been associated with excellent maternal and infant outcomes. Midwives provide hands-on assistance during labor and delivery and offer postpartum support to help new families transition smoothly.

Types of Midwives

Midwifery isn’t a one-size-fits-all practice. There are several types of midwives, each with varying levels of training and scope of practice:

Original Midwife

Original Midwives, are Midwives who practices from their roots and sometimes receive experience through their lineage or real life training. Being a midwife was not a certified or licensed practice for thousands of years and did not deem necessary until the early 20's by a group of people who had an agenda to demonize and take over the birthing process for their own selfish and weird desires. Original Midwives do not go the certified route and typically receive their training through self-study and apprenticeships for these very reasons. They often assist with home births and have experience in carrying for the mother and child during pregnancy.

• They offer regular routine checkups

• Offer natural health and wellness tips

• Connect you with other healthcare providers when necessary

• Assist in the birthing process

• Offer postpartum care up to 6 weeks

Their role can include providing emotional and physical support as well. However if complications arise, necessary transfer to a hospital may be needed. Due to the Original Midwives not being registered with the government they are not allowed the same privileges to practice within the Healthcare system. However they still may act as a support to you in the hospital assuming a doula role.

Certified Midwife (CM)

Certified Midwives (CMs) offer similar services to CNMs but may have a different scope of practice depending on state regulations. CMs provide comprehensive care throughout childbirth, including prenatal, intrapartum, and postpartum care. Their duties often include:

• Conducting physical exams and ordering laboratory tests

• Assisting with labor and delivery

• Offering contraceptive counseling

The recognition and authorization for CMs vary by state, so it's essential to check local regulations to understand their scope of practice in your area.

Certified Professional Midwife (CPM)

Certified Professional Midwives (CPMs) specialize in providing care during home births or other non-hospital settings. Their scope of practice includes:

• Providing hands-on support during pregnancy, labor, and birth

• Offering maternal and well-baby care for up to 6-8 weeks postpartum

• Conducting assessments and administering medications as permitted by state law

CPMs often work in states with specific protections or regulations for their practice, such as Missouri, Maine, and Mississippi.

Direct-Entry Midwife

Direct-Entry Midwives enter the field without a prior nursing background. They receive training through programs or apprenticeships and may hold various certifications. Their focus is often on providing care in home settings, and their scope of practice can vary widely depending on their education and experience.Certified Nurse-Midwife (CNM)

Certified Nurse-Midwives (CNMs) are advanced practice registered nurses with extensive training in midwifery. They offer a holistic approach to childbirth, emphasizing natural techniques and minimal technological intervention. CNMs work collaboratively with other healthcare professionals, including doctors, social workers, and dietitians, to provide comprehensive care. Their roles include:

• Monitoring the mother and fetus during labor

• Assessing labor progress and managing complications

• Assisting with pain management and performing necessary procedures

• Providing prenatal and postpartum care

• Educating new parents on infant care and breastfeeding

CNMs are employed in hospitals, clinics, birthing centers, health departments, and private practices, where they offer a blend of traditional and modern medical care.

What Does a Midwife Do?

Midwives, depending on their certification and scope of practice, can offer a range of services. Certified midwives and CNMs provide comprehensive care, including:

• Prenatal assessments and education

• Support during labor and delivery

• Postpartum care and education

• Assistance with breastfeeding

Lay midwives may focus on more supportive roles such as massages, breathing exercises, and help during delivery outside of hospital settings.

High-Risk Pregnancies and Midwifery Care

Midwives can also care for high-risk pregnancies, including those involving older mothers, multiple pregnancies, or pre-existing medical conditions. In such cases, midwives often work in conjunction with obstetricians and other specialists to ensure comprehensive care. They continue to play a critical role in managing the overall care plan, even if the pregnancy requires specialized medical interventions.

Midwifery in Numbers

Midwifery has seen significant growth in the U.S. In fact, the number of midwife-attended births has more than doubled since 1991. As of 2018, there were 11 obstetricians and 4 midwives per 1,000 live births in the U.S., compared to New Zealand’s impressive ratio of 8 obstetricians and 46 midwives per 1,000 live births. The majority of midwives in the U.S. are Certified Nurse-Midwives, with over 12,655 active CNMs reported in 2019.

Conclusion

Choosing a midwife involves understanding the different types of midwives and their respective roles. Whether you opt for a CNM, CM, CPM, or a lay midwife, each brings unique skills and approaches to childbirth. Consider your needs, preferences, and the regulations in your area to make the best choice for your birthing experience. Midwifery offers a nurturing, supportive, and holistic approach to childbirth that many families find deeply rewarding.