A midwife is someone who is trained to care for women with low-risk pregnancies and those who are expecting normal deliveries. Midwives help more than 300,000 women give birth each year in the US; most births take place in hospitals, but some occur in birthing centers or at home. A midwife’s education stresses that pregnancy and birth are normal, healthy events, not potential medical emergencies.
A midwife may:
- help facilitate a natural childbirth
- spend more time with you than a medical doctor during prenatal visits
- work in collaboration with a physician
- be part of a labor and delivery team
- associated with a local hospital
- provide vaginal exams or fetal heart-rate monitoring
- help minimize medical interventions, such as induced labor, C-sections, and episiotomies
- stay with you during your entire labor and delivery
- handle an emergency transfer to a hospital if there are problems during a home birth
- provide postpartum care, including breastfeeding support
- provide well-woman care outside the realm of pregnancy and childbirth, including family planning and annual gynecological exams
- set up payment plans or sliding fees, or accept insurance plans, including Medicaid
A midwife will not:
- care for you if you have a preexisting medical condition, such as diabetes or epilepsy
- perform a C-section birth
- deliver a child with forceps or vacuum
- use medical interventions such as electronic fetal monitoring or epidurals without a doctor’s supervision
Midwives and home births
If you are planning to deliver your baby at home, here are some questions to ask your potential midwife.
- How do you handle problems during labor?
- When would we go to the hospital?
- What drugs and equipment do you use in the home?
- Do you have a formal agreement with an obstetrician/gynecologist to provide care if problems occur?
- Which hospital will I be transported to if a problem occurs during labor?
- Would you stay with me if we transfer?
- Are you trained in newborn resuscitation?
Certified nurse-midwives (CNMs) are licensed healthcare providers educated in nursing and midwifery. Certified midwives (CMs) are licensed healthcare providers educated in midwifery. Both have graduated from college, have passed a national exam, and have completed an accredited program of the American College of Nurse Midwives.
How does a doula help?
There are two types of doulas: A birth doula is a private support coach who can assist before and during labor. A postpartum doula can provide hands-on help at home, such as cooking and cleaning and caring for your baby. Some offer both types of services. Studies show that doulas can help reduce:
- the time spent in labor
- the need for pain medication
- complications during birth
- the rate of postpartum depression, and they also boost baby-mommy bonding
Think you’d like to hire a doula?
Ask potential doulas these questions:
- Why did you decide to become a doula? (Does this doula’s personality and approach mesh with your own?)
- How many births have you attended? How long have you been practicing? (Ask for referrals.)
- Are you available around my due date? Do you have a back-up on call? (Consider meeting and interviewing the back-up.)
- When will you arrive—from labor’s first at-home pangs or when I meet you at the hospital or birth center? Do you offer any special services? (Some may provide massage, photography, aromatherapy, or other unique services—such as writing your birth story.)
- What do you think of medication during birth? Would you support both medicated and non-medicated births? What’s your fee? (Your doula’s services may be reimbursable under your healthcare plan, or she might offer a payment plan or sliding-scale fees.)
- Which hospitals and birth centers have you worked in? Have you worked with my midwife or physician before? What type of pre-labor and post-labor support do you provide? Do you offer labor simulation exercises or help with breastfeeding and baby care? (You want answers to all of these questions.)
Where can you find a doula?
You can find a doula through word-of-mouth recommendations from other moms, njfamily.com/directories, and at the website for Doulas of North America, dona.org.
Erin Bernard-Benson is a freelance writer and mom who lives in New Jersey.