Midwives: Who Are They and How Can They Help You?

Midwives help women with all stages of pregnancy and delivery. They provide prenatal care, assist with childbirth, provide postpartum care, and offer routine gynecological services. Nurse midwives emphasize prenatal education, answer questions, address concerns, and explain different birth options. According to the American College of Nurse-Midwives, there are approximately 6,200 practicing certified nurse midwives in the United States in 2006. The World Health Organization has endorsed midwifery as an approach to improving the health of women worldwide.

Types of Midwives

There are three types of midwives. Each are distinguished on the basis of their educational background and certification.

• Lay midwives are neither licensed nor certified. Their backgrounds are quite varied. If there are serious medical complications with a mother or baby, their ability to deal appropriately with the situation is limited. Since there is no licensure, there is no state board to oversee their conduct. Some of them have a very limited ability to prevent or handle emergencies.
• Certified midwives may be nurses or have other educational backgrounds. They receive their preparation through various means including correspondence courses, formal schooling, and apprenticeships and must pass a certifying examination. Some states license this type of midwife.
• Certified nurse midwives (CNM) have the most formal education. They complete their education to become a registered nurse and then pursue extra schooling in one of more than 40 advanced educational programs accredited by the American College of Nurse-Midwives. After completing their education, they must pass a certifying exam administered by the American College of Nurse-Midwives Certification Council, Inc. Most CNMs work in hospitals or birthing centers.

The remainder of this discussion focuses on certified nurse midwives, as this group has been shown to be effective, safe providers of care during pregnancy and delivery. They emphasize the natural aspects of pregnancy, labor, and delivery and generally provide high levels of patient support.