Pregnant patients seeking medical care before, during and after the birth of their baby may want to take a closer look at Certified Nurse-Midwives (CNMs). These professionals are registered nurses who go to graduate school to earn a specialized advanced degree in nurse-midwifery, which happens to be one of the highest-paying master’s degrees. Nurse-midwives aren’t doctors, but they do deliver babies and provide care for expecting mothers. Some women prefer the birth experience a midwife provides over what a doctor provides, especially if their pregnancy is low risk, they favor a holistic approach to healthcare and they want to know that their provider has the formal training to keep them and their baby safe.
Your Pregnancy Is Low-Risk
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The number-one factor you need to weigh when considering whether to see a Certified Nurse-Midwife, rather than a doctor, for your maternity care needs is your level of risk. For a midwife to be the primary care provider managing your maternity care services, you generally need to have a low risk of complications.
For example, a midwife may not be qualified to lead your care team if you are of a certain age or weight, have diabetes or hypertension, or develop gestational diabetes, hypertension or preeclampsia during pregnancy. High-risk pregnancies should be overseen by a provider with a greater depth of knowledge of complications and disease treatment. These providers include doctors known as maternal-fetal medicine (MFM) specialists or high-risk obstetricians.
However, pregnant patients don’t always have to make an either-or choice between a midwife and a doctor. If you are a high-risk patient but you long for the midwife care experience, you may be able to choose a healthcare facility where Certified Nurse-Midwives collaborate with specialists in maternal-fetal medicine. This option allows you to safely integrate midwife care into your birthing experience.
Having a care team that includes providers from different perspectives, like nurse-midwifery and maternal-fetal medicine, can offer women who are high-risk or who develop pregnancy complications the best of both worlds and the safest, most empowering delivery.
You Prefer a Holistic Approach to Medical Care and Birth
For many women, having a “natural” birth is important. What constitutes a natural birth is open to interpretation, for some women meaning simply a vaginal delivery instead of a C-section and for others meaning no medical interventions, including anesthesia. Whatever a natural birth means to you, you’re more likely to get it under a midwife’s care. For example, midwives tend to value the autonomy of the mother in deciding what position feels natural to them for laboring and giving birth, according to Penn Medicine.
Holistic care often goes hand-in-hand with alternative and complementary medicine. While some obstetricians certainly have an appreciation for complementary medicine – especially when there’s some solid evidence to support these treatments – their training makes them more likely to prescribe drugs or a more traditional course of therapy. You might be happier having a nurse-midwife as your primary provider for prenatal care if you want to explore alternative methods of treating common pregnancy symptoms that don’t involve medication. If your ideal form of pain relief during labor is more along the lines of aromatherapy, massage, water immersion and hypnosis rather than an epidural, you might find that a midwife better matches your ideal birth plan.
An even bigger reason why patients may choose a midwife, rather than a doctor, to handle their maternity care is for the emotional support they provide. As part of their holistic approach to patient care, nurse-midwives emphasize whole-patient support and tend to make an extra effort to provide emotional as well as physical support, not only during labor but also during the postpartum period.
Patients should keep in mind that a nurse-midwife is still a healthcare provider, rather than a doula, whose job is solely to provide physical and emotional support. Some patients may choose to hire a doula for additional support who will work alongside their provider.
You Want the Peace of Mind of Having a Provider With Nursing and Clinical Experience
Medical interventions like C-sections, inductions, anesthesia, vacuums and forceps exist for a reason. If things with your pregnancy or your delivery were to go south, you want to know that your care provider knows what to do, even they aren’t the right professional to continue providing your care.
Patients receiving care under a Certified Nurse-Midwife, as opposed to a self-proclaimed lay midwife, can rest assured that their provider knows the warning signs of serious complications and when a situation is out of their scope of practice. Certified Nurse-Midwives are trained in evidence-based practice and a nursing model of patient care. They go through specialized graduate midwifery education programs that are comparable to those used to train other types of advanced practice registered nurses (APRNs), including nurse practitioners.
You might be surprised to learn that most Certified Nurse-Midwives work in hospitals. The American College of Nurse-Midwives reported that more than 94 percent of births attended by CNMs and Certified (non-nurse) Midwives took place in hospitals.
Additional Resources
What Does a Midwife Do That Is Different From a Doctor?