For as long as women have been have been giving birth, there has typically been one or more persons present to assist. For thousands of years that person would typically have been a trusted, older female member of her family or a local woman with experience tending to women in childbirth.

In the United States before the mid-1800s, midwives attended the majority of births. When medicine in the U.S. became institutionalized on a wider scale in the mid- to late 1800s, physicians began attending approximately half of the total births.

When a series of medical reports recommending doctors instead of midwives was issued in 1912, and the use of anesthesia for birth was promoted, more women began entering the hospital for their deliveries. The use of midwives has declined steadily since then.

midwifery care

However, the rest of the world hasn’t followed that standard. In countries like the United Kingdom and France, midwives are tasked with the primary care of women with low-risk pregnancies. Physicians aren’t utilized unless there is a risk that warrants more specialized care.

For many women, the decision to choose a midwife over a physician may be a confusing one. We’ll take a look at what a midwife is and is not, as well as some of the reasons that more and more women are choosing to partner with a nurse midwife for their health care needs.

What is a Nurse Midwife?

In some instances there are a great many questions regarding what a nurse midwife is. These questions can be answered relatively simply.

A nurse midwife has received advanced training in women’s health, prenatal care, postnatal care and childbirth. Nurse midwives are licensed by the state in which they practice, and each state has different requirements related to what a nurse midwife can and cannot do.

In most cases, nurse midwives see to the general health of their patients, attend to women who have low risk pregnancies, and provide postnatal care to new mothers. Nurse midwives may practice in their own offices and some midwives work directly with obstetricians in a shared practice. Nurse midwives can attend births in hospitals or birthing centers and in some states they are licensed to attend home births.

Nurse midwives are able to prescribe medications for their patients and are authorized to order diagnostic tests. Nurse midwives are not permitted to perform surgical procedures.

Why Choose a Midwife?

For women whose pregnancies have been deemed low-risk, a midwife is, in many cases, the preferred birth attendant. A 2009 study which utilized CDC data showed that midwives currently assist in 8 percent of births in the United States.

In the state of Georgia that number is 18 percent, and New Mexico has the highest use of midwives in the U.S., with 24 percent of pregnant women under the care of a nurse midwife.

While the ultimate goal of a midwife and an obstetrician are the same, a healthy mother and baby, midwives tend to approach pregnancy and birth in a different manner. Midwives view the process of pregnancy and birth in a more holistic way and also focus on the social aspect of the situation.

Women who choose midwifery care are more likely to see the same practitioner throughout their pregnancy and delivery. Women who work with physicians might not be able to see their preferred doctor for each appointment, and that doctor might not be able to attend the birth, typically due to scheduling reasons.

Women who work with a midwife are less likely to give birth prematurely, more likely to adhere to their original birth plan, less likely to need an episiotomy, and less likely to need an epidural for pain. Additionally, while midwives are practitioners of medicine, they often are not as quick to use traditional medical interventions during childbirth.

Midwives use fewer instruments such as forceps or vacuum to hasten birth, and they are typically reluctant to use drugs to induce labor. Midwives also encourage women to be active participants in their birth, and allow women in labor to move about freely without restraining monitors.

Lastly, and perhaps the most encouraging aspect of the studies, women with low-risk pregnancies who work with a midwife are not more likely to require a cesarean section. In addition, the portion of the study that focused on women with high risk pregnancies indicated that they were also no more likely to require a caesarean section if they chose a midwife as their health care practitioner.

Even though the majority of births in the United States are still attended to by an obstetrician, experts believe that as women become more familiar with the idea of working with a midwife and the benefits that partnership offers they will begin to consider the option. While the choice of a caregiver during pregnancy is an important and very personal one, for many women a nurse midwife might be the best decision for them and their children.

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