Demystifying Midwives

Contributed by Risa Klein, CNM, OB/GYN NP, M.S.

You’re newly pregnant and it’s time to find the right health care provider to take care of you and your gestating baby. Or perhaps this is your second or third pregnancy and you feel it’s time for a new provider. You’ve heard about midwives and want to know more about what they do, and any benefits that you could experience if you hire one. Here’s the scoop on working with a Certified Nurse Midwife (CNM) or Certified Midwife (CM). 

To start, midwives are independent health care providers, focusing particularly on common primary care issues, family planning, gynecologic needs of women, pregnancy, childbirth, the postpartum period and care of the newborn. Certified nurse-midwives (CNM) and certified midwives (CM) practice in accord with the Standards for the Practice of Midwifery, as defined by the American College of Nurse-Midwives. A certified nurse-midwife is educated in the two disciplines of nursing and midwifery. Midwives have received their master’s degree and some have gone onto receive their PhD. They are licensed by their individual states, and have prescription privileges. Midwives attend to women in birth at home, in birthing centers, or on labor and delivery floor hospital settings. 

What’s the difference between a midwife and an OB/GYN? Midwives work with healthy, low risk women and babies. They screen women carefully to uncover any health challenges that may prevent a woman from working with her.  If a women or her baby develops a high risk health issue during the course of the pregnancy which is outside the scope of the midwifery model of care, referrals are made to the appropriate health care specialists. Midwives co-manage women in many of these situations and consult and collaborate with obstetricians and perinatologists. Midwives do not take care of women who have high risk medical issues such as Diabetes, Heart and Liver Disease and some auto immune disorders. They do not perform cesarean sections although some midwives have training to first assist at c sections.

Midwives pride themselves on establishing close relationships of trust with their clients. Philosophically, midwives do not see birth as an illness nor see birth as something ‘to fix.’ Midwives have a holistic view of the process of birth, so childbirth feels more organic and natural for women when they receive guidance from a midwife who speaks with gratitude of birth coming from within, rather than from forces outside of us. Midwives spend a significant amount of time helping women learn how to stay healthy and low risk during the course of their pregnancies by making sure their client’s specific needs and questions are met. Nutrition is a powerful tool to keep mom and baby healthy and is the foundation of a healthy pregnancy and birth. Emotional support is another benefit of the midwifery model of care with time given to look at an overview of your life, health, job, family histories, and how they all may impact your pregnancy and birth outcome. 

Midwives can work with women for a VBAC (vaginal birth after cesarean section,) and also twin pregnancies with physician co management.  Can I get an epidural with a midwife?  Yes, unless you will deliver at home. There are several other forms of pain management you can also choose from in the hospital.  If a c section is medially needed, your midwife is with you during the procedure. Breastfeeding is encouraged by midwives and the first latch on after birth is taught with great care. The American College of Midwives website,, can provide you with more information about midwives and where you can find one in your city. Midwifery care is reimbursed by most health insurance companies.

If you want to learn more, sign up for Risa’s free class Thursday, October 20th at 6:30 at our New York City store.

Risa Klein is a highly experienced private practice CNM, M.S. She practices on the upper east side of Manhattan. She brings her home birth approach to her office and hospital practice with privileges at Mt. Sinai West’s birthing center and L&D floor. She promotes Peaceful Pregnancy, Empowered Birth, Individualized Care. She is in the process of writing her first book., http://www.ourmomentoftruth. com



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