What is a midwife?
Certified Nurse Midwives (CNM) are highly skilled professionals who have received formal training in primary care and women’s health from a nationally accredited program through the American College of Nurse-Midwives (ACME). They receive their certification through the American Colleges of Nurse-Midwives (ACNM). The midwives on staff here at CHI Health are Certified Nurse Midwives.
There are other types of midwives
They have a bachelor’s degree in a field other than nursing and have graduated from a graduate level midwifery education program accredited by the ACME. They take the same certification exam as the Certified Nurse Midwife. They can practice in the same settings and receive the same preparation as the CNM’s to safely prescribe a full range of substances, medications, treatments, including pain control medications.
Certified Professional Midwife
They are midwives who provide care to woman outside the hospital –birthing centers or home. They prepare for a certification exam through the North American Registry of Midwives (NARM). They are not able to prescribe most medications. Their training involves either apprenticeship training alone or an accredited formal education program.
Other midwife-(lay Midwives)
The State of Nebraska prohibits this type of practice.
What is the difference between a midwife and a doula?
A doula is chosen by the expectant mother to work with her and her family during labor to provide uninterrupted physical and emotional support. They can be an integral part of the labor team. A midwife has the same goal, but in addition to that, is responsible for monitoring the health of mom and baby during labor. They will also provide the mother information about her progress; give her options or advice related to her labor, discussing medical decisions as needed and deliver her baby.
What services do CNMs provide?
They provide prenatal, birth, postpartum and normal newborn care. They can also provide routine gynecological care.
Explain the relationship midwives and physicians have
There is a practice agreement between CNM’s and physicians. They participate in collaborative management and will complete a referral for high risk situations, ie; abnormal presentations, c-section. The CNM’s will often be first assist during a c-section and continue to be present for continuity of care after the delivery.
Are patients under the care of a midwife not able to have an epidural?
No, Midwives listen to women and what choices they want to make. If an epidural is something the expectant mother has a strong desire for, they will honor that request.
What about other interventions such as IV’s, Episiotomies, continuous fetal monitoring and tubs?
Each intervention is evaluated on its own merit as the midwife assesses how to provide safe care. There are indications for each of these measures. Communications will occur with the patient and the medical team to determine the need for these. Most midwives favor an approach to pregnancy, labor and birth that is based on normal, bodily processes rather than on the use of medical procedures; an approach that is strongly supported by current research.
What role will the midwife have after delivery?
They will maintain continuity of care and follow the postpartum mom through her hospital stay. The newborn needing a circumcision will have this performed by the practice agreement physician or the newborn provider.