The term midwife, derived from the Anglo Saxon word, “mit wif”, meaning “with woman,” was first recorded in 1300. Written accounts dating to the 2nd century confirm the role of midwives in the birthing process.
Midwifery is quite possibily the oldest profession on the planet, as women have been helping women to give birth since the dawn of humankind. Modern midwives provide care to women during normal pregnancies and deliveries and collaborate with and or refer to obstetricians or other physicians if health complications develop or the pregnancy becomes high-risk.
A Midwife is…
…a trained professional who offers expert care, education, counseling, and support to a woman and her newborn during the childbearing cycle. The midwife works with each woman and her family to identify their unique physical, social and emotional needs. In addition, many midwives provide well-woman gynecological care and family planning services. Midwives know how to watch for and identify potential or actual complications, and they can provide emergency treatment until additional assistance is available.
What do Midwives do?
- prenatal care that promotes informed decision-making;
- choice of birth place;
- education and counseling;
- labor support, birth and postpartum care;
- support for bonding;
- examination and evaluation of the newborn;
- breastfeeding support;
- counseling in early parenting; and
- well-woman care.
Midwifery Care: Midwives are experts on normal birth; obstetricians are experts on difficult or surgical births. The division of responsibility between two strong and respected professions creates the best conditions for optimal birth care.
Midwifery care is cost effective, midwifery fees are typically less than fees for comparable services provided by physicians; midwifery care saves money without sacrificing quality or safety.
Midwives provide personalized care
Women want more than technological care during pregnancy and birth. Midwives encourage participation by family members and provide continuous support during labor and birth.
Midwives trust the birth process
and affirm each individual
woman’s ability to give birth.
Midwives encourage informed choice
Midwives encourage women and their families to take an active part in their own health care. Pregnancy is an ideal time to educate mothers about nutrition, healthful birth practices breastfeeding and infant care.
Midwifery care offers choice of birth place
Midwives practice in homes and birth centers. Midwives support the right of the parents to choose the birth place that best suits their needs.
Midwifery care makes a difference.
Midwives worldwide have an excellent record of safety with numerous studies associating midwifery care with excellent outcomes. In five nations with the lowest infant mortality and lowest rates of technological intervention, midwives attend 70% of all births without a physician in the birth room.
Midwifery in the United States
Midwives are recognized throughout the world as the most appropriate maternity care provider for most women. Midwifery licensure and scope of practice in the United States is regulated by individual state laws. The following categories of professional midwives are recognized in the United States.
Direct-Entry Midwives “Direct-entry” midwives, who are licensed in some states, are not required to become nurses before training to be midwives. The Midwifery Education and Accreditation Council (MEAC) is currently accrediting direct-entry midwifery educational programs and apprenticeships in the United States. Direct-entry midwives’ legal status varies according to state, and they practice most often in birth centers and in homes. Currently in the state of Oregon licensure is optional, some midwives choose to become both certified and licensed and some chose to remain unlicensed. A licensed midwife is a LDM an unlicensed midwife is a DEM, some midwives are both LDM or DEMs and CPMs.
Certified Professional Midwives (CPMs) may gain their midwifery education through a variety of routes. They must have their midwifery skills and experience evaluated through the North American Registry of Midwives (NARM) certification process and pass the NARM Written Examination and Skills Assessment. The legal status of these nationally credentialed direct-entry midwives varies from state to state. In some of the states where they are also individually licensed, midwives’ services are reimbursable through Medicaid and private insurance carriers.
Certified Nurse-Midwives Certified Nurse-Midwives (CNMs) are educated in both nursing and midwifery. After attending an educational program accredited by the American College of Nurse-Midwives Certification Council (ACC), they must pass the ACC examination and can be licensed in the individual states in which they practice. CNMs practice most often in hospitals and birth centers. CNMs are often trained by obstetricians or physicians and often must practice under a obstetrician in a hospital setting. Most CNMs do not attend home births.
Source: “What is a Midwife” pamphlet written by Ina May Gaskin