Historically, midwives in the United States emerged in the 1920s, though they have been practicing around the world for thousands of years. These types of midwives were usually women in rural communities who had been taught to assist with birthing, but they were not doctors or formally trained medical professionals. Today, however, midwifery has moved far beyond its roots. If they choose, modern families can use the services of certified nurse-midwives and direct-entry midwives to aid in the birth of their babies.
A certified nurse-midwife is a registered nurse who has completed additional training in the care of women of all ages, including pregnant women. Services offered by nurse-midwives include primary care, gynecologic care, family planning services, care during preconception and pregnancy, and childbirth and postpartum care. Additionally, nurse-midwives can assist mothers in breastfeeding and care for healthy newborns during the first 28 days of life. After passing a certification exam, nurse-midwives can practice anywhere in the US and are frequently found in a hospital or medical office setting, often working alongside obstetricians.
A direct-entry midwife, on the other hand, does not have a background in nursing but has pursued additional education to earn certification as a midwife, often including self-study and an apprenticeship. Midwife training can take three years or more. They are typically found outside of a hospital setting, either in a woman’s home or in a birthing center. Midwives as the sole deliverer of a baby are restricted to certain states. If you’re considering using a midwife, check your state’s certification requirements and investigate local midwives to find the best match for your family.
Women often choose midwives as their caregivers because of philosophical preferences. Midwives tend to favor less medical intervention during birth when it’s appropriate, focusing on natural delivery and methods of treatment. Midwives are frequently called upon for planned home deliveries. Some women feel they can form a more personal relationship with their midwife than their doctor. In addition, the costs associated with midwives are lower than obstetrics or delivery by a medical doctor. Studies have even shown that mothers have fewer recovery complications with midwives due to the lower number of interventions that are performed.
Direct-entry midwives and nurse-midwives are not appropriate for every situation. Women who have high-risk pregnancies are typically not advised to use a midwife unless they are closely working alongside an obstetrician to provide care. Additionally, women who require cesarean sections or who have underlying health issues should normally be under the care of a medical doctor. Finally, if your baby is likely to need medical intervention immediately after birth, including premature babies, obstetric care and delivery in a hospital would be the safer choice.
Reviewed by Dr. Jen Lincoln, December 2018
- Midwives are professional caregivers trained to help women deliver their babies.
- A nurse-midwife is a registered nurse who has also completed additional training in the care of woman, including pregnant women.
- Midwives are often the choice for women who want to deliver their babies at home or in a birthing center.
- Women with high-risk pregnancies are usually advised to deliver their babies in a hospital under the care of a physician.
I used a certified nurse-midwife or CNM in Alabama because direct-entry midwife or CPM are illegal there. Luckily I moved to Florida for my 2nd birth and used a wonder CPM for a home birth. I really enjoyed having the choice or where and how to give birth. My baby and I were both low risk and for us the home birth was easier and allowed for a great bonding experience for the whole family.