About

The Midwife

The modern midwife is a health care professional who provides holistic health care to the childbearing woman and her newborn. She combines traditional skills and modern health care techniques to safeguard normal childbirth and ensure prompt recognition and referral of complications. She encourages parents to take an active role in their birth experience. The midwife maintains liaisons with physicians and other health care providers, since she sees their skills as complementary to her own.

Midwives Model of CareTM

The Midwives Model of Care is based on the fact that pregnancy and birth are normal life events. The Midwives Model of Care includes:

  • Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle;
  • Providing individualized education, counseling and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
  • Minimizing technological interventions; and
  • Identifying and referring women who require obstetrical attention.

The application of this model has been proven to reduce the incidence of birth injury, trauma, and cesarean section.
Copyright © 1996-2001, Midwifery Task Force All Rights Reserved

General Information About Midwifery

From www.gamidwifery.org

Direct-entry midwives (DEMs) practice legally in approximately 34 states, with licensure available in 20 states. Direct-entry midwives are  independent practitioners educated in the discipline of midwifery through self-study, apprenticeship, formal midwifery school, or a college- or university-based program distinct from the discipline of nursing. A direct-entry midwife is trained to provide care to healthy women and newborns throughout the childbearing cycle primarily in out-of-hospital settings.

States that provide licensure for DEMs vary in their requirements. Most require the midwife be certified through The North American Registry of Midwives (NARM) as a Certified Professional Midwife (CPM), although some still have their own requirements in place. All states which credential (or license) DEMs, with the exception of New York, use the NARM Written Exam as their state licensing exam.

Efforts are underway in many states to make the CPM credential the basis of licensure, or a route to licensure for direct-entry midwives who practice predominantly in out-of-hospital settings. The CPM credential was created in 1994 by and for midwives. It recognizes a broad range of educational pathways, is competency based, and requires out-of-hospital birth experience. Practice is based on the Midwives Model of Care. For more information about the CPM, go to the mission statement of the North American Registry of Midwives or contact them via email.

Certified nurse-midwives (CNMs) are licensed health care practitioners educated in the two disciplines of nursing and midwifery. They provide primary health care to women of childbearing age including: prenatal care, labor and delivery care, care after birth, gynecological exams, newborn care, assistance with family planning decisions, preconception care, menopausal management and counseling in health maintenance and disease prevention. The CNM practices within a health care system that provides for consultation, collaborative management or referral as indicated by the health status of the client. This collegial relationship with physicians allows many hospital-based CNMs the ability to care for women with a wide variety of risk factors and obstetrical needs. While the majority of CNMs deliver in hospital settings, some CNMs also work with low-risk clients independently in birth center or homebirth practices. CNMs now deliver 9% of all babies born in the US.

The majority of CNMs are educated in programs within institutions of higher education leading to a Masters Degree, and this has become the current standard of nurse-midwifery education. CNMs are certified through the American College of Midwives Certification Council (ACC) and practice legally in all states.

Midwifery in the World

Midwifery has existed since the beginning of history and has continued as a well-established tradition in most countries. Midwives still deliver 80% of the babies born in the world today. Midwives in industrialized countries record some of the lowest infant mortality rates in the world.

Midwifery in the United States

Early in the 20th century, physician-attended hospital birth became the standard method of maternity care in the United States. However, the professional midwife is making a comeback in this country, and midwives now practice widely in hospitals, birth centers and homes. In November 1994, the North American Registry of Midwives (NARM) established national certification for midwives as Certified Professional Midwives. In many progressive health care settings, midwives and physicians work together to give childbearing women the best of both disciplines. See The History of Midwifery and Childbirth in America: A Time Line as a resource to understanding the bigger picture of midwifery in through the history of the United States.

Did you know?

  • The US ranks 25th internationally in infant mortality (National Center for Health Statistics, 1993)baby.jpg
  • All the European countries with perinatal and infant mortality rates lower than that of the United States use midwives as the sole birth attendant for at least 70% of all births. (Suarez, S.H.; Midwifery is Not the Practice of Medicine, Yale Journal of Law and Feminism 5, 2 1993)
  • The average cost of an uncomplicated physician-attended hospital birth in Ohio is more than $5,000, with a cesarean delivery costing $12,000 or more (for those without insurance). The total cost of midwife-attended home birth is less than $3000, and the chance of a midwife’s client needing a cesarean is less than 4 percent.
  • Some insurance companies will cover midwife-attended home birth.
  • Midwives are the most cost effective and appropriate primary care givers for all childbearing women in all instances and in all settings. (World Health Organization Report on Health Promotion and Birth, 1986)
  • Today, only 6% of US births are attended by midwives. (National Center for Health Statistics, 1995)
  • Midwives provide excellent personalized care, with each visit averaging 45-60 minutes and including nutritional counseling, in addition to the usual tests and analyses. Midwives emphasize the responsibility of the mother to lead a healthy lifestyle, and continuously apply risk screening criteria to ensure that only those women determined to be low-risk proceed with plans for a midwife-attended home birth.
  • Many Ohio families desire to have an unhampered, family-centered birth at home, whether for personal, religious, cultural, or economic reasons.