With a master’s degree in nurse-midwifery, one of the highest-paying master’s degrees, you will qualify as an advanced practice registered nurse, also called an APRN. Certified Nurse-Midwives (CNMs) have the same level of advanced education and clinical training as nurse practitioners, another kind of APRN. As such, they’re qualified – and, in most states, authorized – to work in independent practice providing care to women, including but not limited to pregnant women, the American College of Nurse-Midwives reported. Some of the tests midwives may order include ultrasound imaging tests and blood and urine tests.
How the Services of Nurse Midwives Compare to Those of Physicians
Nurse midwives are not medical doctors, and they don’t have a medical school education. However, they do have a graduate-level education that includes a great deal of clinical training, in addition to having a nursing background. Nurse midwives generally perform the same health care services for low-risk pregnant women that a physician, such as an obstetrician, would perform. They also provide primary care services and general reproductive care, or gynecological care, services.
However, nurse midwives are not surgeons, and they do not perform C-sections births or gynecological surgeries. Instead, they may collaborate with the physicians who perform surgeries. Generally, nurse midwives come from a background that focuses less on the diagnosis and treatment of disease and more on holistic patient care. When a patient presents with a disease that is out of a nurse midwife’s scope of practice to manage, such as serious pregnancy complications, the midwife may work with a physician in a support capacity or refer the patient to the doctor.
Although midwife-only care isn’t appropriate for high-risk pregnancies, women who prefer the holistic approach and emotional support that a nurse midwife brings may choose a collaboration between an obstetrician and a midwife throughout maternity and labor.
Ultrasound Imaging of the Growing Baby
An ultrasound, or a sonogram, is a type of imaging test often performed at different points throughout a pregnancy to assess the baby’s growth and development. In an ultrasound, high-frequency soundwaves that are painlessly applied to the body using an instrument called a transducer create an image of the inside of the body. Sonograms in pregnancy are usually performed on the abdomen, allowing for a view of the baby growing inside the uterus.
Early on, an ultrasound may be performed to make sure the fetus is growing correctly in the uterus and that it is not an ectopic pregnancy, or a non-viable pregnancy in which the embryo has implanted in a place where it cannot grow safely. The ultrasound may show the heart rate of the tiny fetus. Ultrasounds performed later in the pregnancy may be done to screen for signs of genetic abnormalities and to check the baby’s anatomy, which may include determining the baby’s sex. In the case of certain complications, ultrasounds may be used to guide interventions – performed by specialized doctors – performed on babies while they are still growing in the womb.
An ultrasound can be used to determine how far along a pregnancy is, learn whether the mother is carrying multiple babies, check that the fetus is growing normally and identify abnormalities and complications, such as too much or too little embryonic fluid.
Blood and Urine Tests
As the baby grows, the mother’s body changes, too. Blood and urine tests can tell providers a lot about the health of the pregnant woman as well as the baby she is carrying. Like obstetricians, nurse midwives recommend routine blood and urine tests at different points during the pregnancy. Giving a urine sample may be a regular part of pregnant patients’ prenatal appointments, just like measuring weight and blood pressure.
Most pregnant women will undergo a glucose screening test that can identify a complication called gestational diabetes. Other blood and urine tests, such as the 24-hour urine collection, are done if the midwife suspects that the patient is developing complications like preeclampsia, which may require closer observation, earlier delivery of the baby and a transfer of the patient’s care to a physician with experience managing pregnancy complications.
Nurse midwives don’t only care for pregnant women. As reproductive and primary care providers, they order tests such as diagnostic imaging of masses found during breast or pelvic exams and routine bloodwork and urine tests to accompany annual wellness exams.