Who are midwives, and what do they do?
Midwives are qualified healthcare providers who assist women through pregnancy, labor, and delivery in a house, clinic, hospital, or birthing center. Midwives have extensive knowledge to help women make their journey of pregnancy and childbirth more natural and holistic.
Midwives help women even before they get pregnant by providing routine prepartum care through pap smears, pelvic exams, breast examinations, screening for vaginal and sexually transmitted infections, means of birth control, and counseling on conceiving. During pregnancy, midwives help women maintain their physical and emotional health by giving them routine gynecological examinations. They educate women on diet, exercise, and medications to help with the smooth pregnancy progression. They train to detect the first signs of complications and make timely referrals to the right specialists. Midwives also help women create a birth plan, keeping their preferences and wishes in mind.
During labor, midwives help women by offering emotional support and delivering babies with low-risk pregnancies. Post-delivery, they help mothers with breastfeeding and also provide quality infant care.
What are the types of midwives?
Depending on the levels of their training and credentials, the different types of midwives in the US include certified nurse-midwives (CNMs), certified midwives (CMs), certified professional midwives (CPMs), and unlicensed or lay midwives.
CNMs complete a graduate degree in midwifery after finishing nursing school. They are allowed to practice at homes, hospitals, and birthing centers in all 50 states in the US. The American Midwifery Certification Board provides board certification to CNMs in the US. The educational background for CMs is an undergraduate degree in an area other than nursing and a master's degree in midwifery. Like CNMs, they hold certification from the American Midwifery Certification Board and possess the authority to prescribe medications. Still, they are only permitted to practice in a limited number of states in the US. CPMs, on the other hand, can't prescribe drugs, and the US board certifying them is the North American Registry of Midwives. Unlicensed or lay midwives need formal training or certification in midwifery. They provide their services exclusively at home and receive training through self-study and apprenticeship.
Are there any benefits and risks to getting help from a midwife?
Midwives help women go through labor without external medications or epidurals. By guiding women on exercises and diet throughout pregnancy and childbirth, midwives reduce the need for induced labor and assisted delivery. By following a natural approach, they decrease the chances of a cesarean section and thus directly help reduce perineal tears and delivery costs. Their services indirectly help reduce preterm births and infant mortality rates. Post delivery, they assist mothers with breastfeeding, so more mothers under the care of a midwife are more likely to go for breastfeeding and give their children the start of a healthy life.
However, a midwife alone is not qualified to deal with delivery and its complications if the pregnancy is high-risk. Some scenarios include if the expectant mother is delivering multiple babies, has been diagnosed with diabetes or high blood pressure, and has a history of seizures or high-risk pregnancies. In such cases, a collaboration between midwives, OB-GYNs, and perinatologists is advisable.
What are the potential risks associated with having a midwife?
Midwives collaborate with OB/GYNs, maternal-fetal medicine specialists, and other healthcare providers to minimize risks in their care. Choose a midwife practicing in a hospital for childbirth if you have concerns about delivery. This approach can provide the safety net you seek in case complications arise.
How do midwives differ from OB-GYNs and doulas?
Midwives are different from OB-GYNs and doulas in terms of education and services. While midwives either come from a nursing background or have a degree from an accredited midwifery program, OB-GYNs are medical doctors who specialize in obstetrics and gynecology after finishing medical school. On the other hand, doulas have no medical training and only act as informational and emotional guides to women during labor and delivery.
Regarding services, OB-GYNs are qualified to diagnose and treat all complications that arise during pregnancy and delivery. Doulas are only eligible to help pregnant women manage their contractions with stretches and ice chips. Midwives stand in the middle of this spectrum because, while they have no training to deal with high-risk pregnancies or delivery complications, they have the deep knowledge to help women have a more relaxed and natural birthing experience. Under the guidance of OB-GYNs and other birthing professionals, midwives can also participate in labor and delivery.
Is choosing a midwife better than choosing an OB/GYN?
The decision depends on personal preference. Some individuals lean toward midwives, while others prefer OB/GYNs. Midwives are generally better for low-risk pregnancies, which are common in the United States. Here are some benefits associated with choosing a midwife:
- A lower likelihood of needing induction or assisted delivery
- Reduced risk of cesarean section
- Decreased reliance on epidurals or medication
- Lower incidence of severe perineal tears (third and fourth-degree)
- More options for home births, offering greater flexibility
- Enhanced control over your care and birthing experience
Do midwives perform cesarean sections?
Midwives do not perform cesarean sections themselves, but they can assist during the procedure. If a cesarean section is necessary, a collaborating physician will take over the care.
Do midwives administer epidurals?
While some midwives can prescribe epidurals, they do not administer them. Instead, midwives collaborate with anesthesiologists or certified registered nurse anesthetists (CRNAs) who are qualified to provide epidurals. These anesthesia providers are generally available in hospital settings.
How do you choose a midwife?
To select the best home birth midwife near you, commence by seeking recommendations from your doctor or OB. Additionally, it's wise to consult friends who have previously engaged with a midwife to gain insights into their experiences and potential recommendations.
Irrespective of your chosen caregiver, prioritizing confidence and comfort in your provider is paramount. The following inquiries will aid you in identifying the ideal midwife:
- What certifications does the midwife hold?
- Does the state license them?
- Does the midwife have affiliations with a medical practice, hospital, or birthing center?
- What is their standing in terms of reputation?
- Can they recount their experience, specifying the settings they have worked in, such as hospitals, birthing centers, or home births?
- What is the midwife's overarching approach to pregnancy care and delivery?
- How do they manage pain during the delivery process?
- Under what circumstances do they perform episiotomies, if at all?
- When might the midwife recommend medical interventions, like labor induction, epidurals, or C-sections?
- What is their contingency plan for out-of-hospital births in emergencies?
- Do they actively listen and provide clear explanations?
- Is your spouse or partner comfortable with the chosen midwife?
- Who covers for them during their absence?
- If another midwife or doula will be present at your delivery, can you meet them in advance?
- Does the midwife collaborate with an OB, and can you meet the OB?
- Is there a designated doctor for backup in case of complications or emergencies?
- Is the location of the midwife's office convenient for you?
- How are emergencies and after-hours calls managed?
- Does your insurance policy include coverage for the midwife's services?
Ensuring you have answers to these questions will facilitate an informed decision in selecting the most suitable midwife for your pregnancy care.
Four ways you can prepare your body for pregnancy
Are you planning to have a baby with your partner? Then, the first step you should take is to prepare your body for at least 3-6 months before you start trying to get pregnant. In addition to going to your provider for pre-conception counseling, you must make certain lifestyle modifications to get in the best shape for a healthy pregnancy. Here are four tips to help you get started:
- Start an exercise routine to manage your weight: Being overweight can increase the chances of gestational diabetes or hypertension. Similarly, underweight mothers may give birth to low-birth-weight babies. To avoid these issues, you must reach a healthy body weight before you conceive. Regular exercise can help you with optimal weight management. Moreover, it can improve fertility and strengthen your body for the demands of pregnancy and labor.
- Eat a balanced diet and take supplements: Consuming a healthy diet involving fresh fruits and vegetables, lean protein, whole grains, and low-fat dairy has many benefits for pregnancy. Good nutrition can help you achieve your ideal weight and build nutrient stores for fetal development after you conceive. For a healthy pregnancy, you must also take prenatal vitamins that contain iron, calcium, folic acid, and other essential vitamins.
- Quit smoking, alcohol, and drugs: Smoking, drinking alcohol, and using drugs can affect your fertility and significantly reduce your chances to conceive. Continuing these habits also poses risks for your baby, like low birth weight, premature birth, and developmental disorders. Therefore, it is advisable to quit any form of harmful addiction to prevent fertility and pregnancy complications.
- Manage your stress: Stress can make it challenging to enjoy intimacy with your partner and get pregnant. So, relax in different ways, such as going for nature walks, practicing deep breathing, taking a yoga class, and indulging in hobbies.
Finding the best home birth midwife near you in NYC
One of the best places to find licensed midwives practicing near you is by using the Zocdoc app. Zocdoc provides an easy-to-understand interface where you can research caregivers that best suit your needs. Once you open the Zocdoc website, you will see search boxes, and upon filling them with your details, the application will filter through its entire database and present you with midwives who meet your specific needs. The details include your location (home or office), zip code, symptoms or conditions, the date and time you would prefer to meet with a midwife, and current medical insurance. Once you see the curated results, you can gather more information by clicking on the midwives, as Zocdoc includes a detailed description for every home birth midwife near you listed on the website.
The descriptions in the midwives' profiles detail their educational background, years of training and certifications, affiliations and accreditation, years of work experience with special reference to any particular condition they have expertise with, and the places, days, and dates they provide consultations. The profile also includes information about the midwives' gender and their comfort in speaking languages. You can make in-person and online appointments with the best midwife near you using the Zocdoc application; the database is free to access.
While getting help from midwives is economical, several midwives also accept insurance plans as payment methods. Using Zocdoc, once you select your current medical insurance plan and policy from the drop-down menu, you will immediately know which midwives near you are on the internet.
If you want to find a provider who accepts your insurance, add your insurance information (your provider and plan) on the Zocdoc search. It will help you see in-network providers who accept your plan. When you search for providers on the Zocdoc app on your phone, upload a photo of your insurance card (this option is not available for vision or dental plans), and we will scan and display your insurance plan. It will help you find accurate results of qualified providers. Check out Zocdoc's patient help center for more information and solutions related to insurance.
All bookings on Zocdoc are fast, free, and secure!
Pregnancy-related statistics in New York
The New York State Department of Health published a report on its website titled "The New York State Report of Pregnancy-Associated Deaths in 2018." According to this report, in 2018, 41 women died within a year of being pregnant. Embolism, hemorrhage, and mental health conditions were the main reasons for the deaths of these women. Delivery by cesarean section was responsible for 1.7 times more deaths when compared to vaginal deliveries.
The March of Dimes Perinatal Data Center published childbirth-related statistics on its website for the year 2020. According to this report, in 2020, every 11 babies born in New York were preterm, and of every 12 babies born in New York were of lower than average birth weight. The infant mortality rate during the year in the state was 4.7, the number of infants who died for every 1,000 live births. Of all the kids born during this period, 75.2% had mothers who received adequate prenatal care during their pregnancies.
Sources
WebMD
Cleveland Clinic
American Pregnancy Association
March of Dimes[1]
March of Dimes[2]
New York State Department of Health
Johns Hopkins Medicine
Healthline
