You may have heard of a midwife from a friend or perhaps from a recent binge of “Call The Midwife” on Netflix, but do you know what midwives actually do?
Editor’s note: This article was updated from an earlier version posted in December 2019.
You may have heard of a midwife from a friend or perhaps from a recent binge of “Call The Midwife” on Netflix. It’s one of the fastest-growing women’s health practices, but there are also some misconceptions the general public has about what exactly midwives do.
According to Dr. Laniece A. Coleman, director of the Midwifery Program at Thomas Jefferson University Hospital, some of those misconceptions include that they’re only involved in monitoring home births or that midwives do not have a formalized education.
“In actuality, 95% of midwives in the U.S. attend births in hospitals,” Dr. Coleman explains. “Our goal is to partner with our clients to provide support, education and resources so they are empowered to make informed choices that are most in line with their goals and values. We in turn advocate for their choices within the bounds of safety.”
Midwives see people throughout their entire lives, from puberty, through pregnancy, to menopause, and beyond.
So should you see a midwife? Read on for what you need to know.
Who are Midwives?
There are several types of midwives, all with varying levels of training. At Jefferson Health, for example, all of the midwives are certified nurse-midwives. This means they have received a Master’s degree in nursing with specialized training and certification in midwifery. They can conduct pap smears, breast exams and annual check-ups. Midwives can also prescribe birth control and provide health promotion counseling.
Some of the techniques that midwives have implemented for some time that have recently become more mainstream, along with evidence to support their use, include delayed cord clamping, skin-to-skin contact and use of exercise balls and peanut balls.
“We are comfortable using low-intervention care techniques, like optimal positioning for physiologic labor and birth, and we are also trained to use technology and initiate emergency procedures when appropriate,” says Coleman. “We also know when a patient should be referred to one of our physician colleagues.”
At Jefferson, midwives practice alongside obstetricians and gynecologists to make that referral process easier.
We want to make people experts in their own health and we recognize our clients as the leaders of their healthcare teams.
Is a Midwife Right for You?
For women without a complex health history who are interested in understanding and driving their healthcare decisions, a midwife might be the perfect fit.
“We want to make people experts in their own health and we recognize our clients as the leaders of their healthcare teams,” says Dr. Coleman.
Midwives also work to change the perception of developmental changes, which can sometimes be treated like abnormalities.
“We view changes like puberty, pregnancy, childbirth and menopause as normal developmental milestones, rather than health conditions,” she continued. “Sometimes no- or minimal-intervention treatment techniques, coping methods and education are enough to navigate these changes, but if they go beyond our scope of practice, we collaborate with our physician colleagues.”
On the other hand, women with complex, chronic health issues or complications during pregnancy may benefit more from an OB-GYN’s oversight. They are able to use a full menu of technologies, procedures and medications.
“We are all connected and work in the same department,” says Dr. Coleman, “So even if the client develops a condition and leaves our scope of care, we are still available to them to provide education and emotional support.”
Finding a Midwife
Care from a midwife will be covered by insurance, just like a traditional OB-GYN visit. Patients interested in care from a midwife do not require a referral from their primary care physician and can receive their annual check-up from that provider.
“Our goal is education, patient-centered care, autonomy and the right to decide what is in your own best interest—with the guidance of a highly-trained provider,” says Dr. Coleman. “But that team-based care is also really important to us. It’s great to have a well-established partner if complications arise.”