Are you a mother-to-be? Or are you getting ready to start a family? Then you've probably heard the term 'midwife'. This may be a new word for you. In Sri Lanka, we often use the term "midwife" to refer to a midwife. You know what " family health worker " means. These are also the health workers who help us during pregnancy, childbirth, and after birth. But there may be slight differences in their training and services. So, who are these midwives? What kind of services do they provide? Let's talk about all this in detail and simply today.
Who exactly is a midwife?
Simply put, a midwife is a health professional who is specially trained in pregnancy, childbirth, newborn care, and postpartum maternal health. Some midwives also provide general reproductive health services, such as pelvic exams , Pap tests , or counseling about birth control.
Midwives often view pregnancy and childbirth as a natural process . As such, they are more supportive of natural childbirth and related natural methods. If you want to give birth at home, or if you want to have as little medical intervention as possible, many people are inclined to choose a midwife.
But it is also important to remember that midwives are not usually physicians. That is, they do not have a medical degree like `MBBS`. However, they are often Obstetricians and Gynecologists (Ob/Gyns) work together in hospitals to provide you with any medical care you may need. If your pregnancy is low-risk or has only minor complications, it is best to seek the services of a midwife.
Pregnancy and childbirth are very personal experiences. You have every right to choose what kind of care you want. That's why it's important to know the differences between a midwife and an obstetrician/gynecologist (Ob/Gyn).
What does a midwife do? What services do they provide?
The services a midwife provides vary depending on their qualifications, certifications, education, and location. Certified Midwives and Certified Nurse Midwives (CNMs) in particular are able to provide the widest range of services. Midwives without certification can provide relatively few services.
You can get it from a midwife. Here are some health services:
- Prenatal appointments and regular health monitoring throughout pregnancy.
- Things like ultrasounds and blood tests required during pregnancy.
- Assistance during childbirth and care of the newborn .
- Postpartum care is the care of the mother's health after giving birth .
- Providing education on nutrition, lactation , fertility and other issues related to reproductive health.
- Advice on birth control and family planning .
- Pap tests and breast exams.
- Screening for Sexually Transmitted Infections (STIs) and other vaginal infections and diseases.
A certified nurse midwife (CNM) can work in hospitals, clinics, birth centers, or even in your own home. However, there are limited places where midwives without certification can work. It is best to find out what qualifications and licenses a midwife has before you choose one. It is also important to find out what the rules and regulations are for midwifery services at the hospital or birth center where you are planning to deliver your baby.
Are there different types of midwives?
Yes, there are several main types of midwives. Although these classifications are often relevant to foreign countries, it is good to be aware of them:
- Certified Nurse Midwives (CNMs): These are people who have completed nursing school and have a graduate degree in midwifery. In addition to prenatal care and childbirth, they can provide general reproductive health services, prescribe medications, order laboratory tests, and diagnose diseases. They are qualified to work in hospitals, homes, and birth centers. CNMs are certified by the American Midwifery Certification Board.
- Certified Midwives (CMs): These are midwives who have a master's degree in midwifery, but they have not completed nursing school. CMs' primary degree may be in a field other than nursing. They are also certified by the American Midwifery Certification Board, and they can also prescribe medications. However, CMs are licensed to practice in only a limited number of states (e.g., nine states in the United States).
- Certified Professional Midwives (CPMs): CPMs work primarily in birth centers or homes. They have completed training and are certified by the North American Registry of Midwives. CPMs are not licensed to practice in all states, and they cannot prescribe medications.
- Unlicensed or Lay Midwives: These midwives do not have a specific certification or license to practice. They may have entered the field through self-study or other training methods, perhaps through an apprenticeship. Unlicensed midwives mostly only work at home births.
Important: In Sri Lanka, we are most familiar with the term "Public Health Midwife (PHM)". They play a very important role in the government health system. It is important to understand that the above midwife classifications are often used internationally.
Are midwives doctors?
No, most midwives are not doctors. However, some do have advanced qualifications in nursing, such as doctorates in nursing practice. However, they are not MBBS graduates like Ob/Gyns.
What is the main difference between an obstetrician and gynecologist (Ob/Gyn) and a midwife?
The main differences between an Ob/Gyn and a midwife are in their educational background and the way they provide care.
Midwives often view pregnancy and childbirth as a very natural process . They see it as a normal part of life, not a medical condition that needs to be managed. Therefore, they prefer non-traditional, natural methods during labor and delivery. Those who are looking for a more relaxed, less stressful birth are more likely to choose a midwife.
On the other hand, Obstetricians and Gynecologists (Ob/Gyns) are doctors who have received specialized training from a medical school. They can treat high-risk pregnancies and complications during childbirth. An Ob/Gyn can perform medical or surgical interventions that a midwife cannot.
But this doesn't mean that Ob/Gyn doctors won't provide you with personal support and friendly care, nor that they won't be open to alternative birthing methods. If you have any doubts about this, it's best to meet and talk to both a midwife and an Ob/Gyn to decide who best fits your personality and your expectations for pregnancy and childbirth.
Is a midwife better than an Ob/Gyn?
This is really a personal choice . Some people prefer midwives, others prefer Ob/Gyn doctors. A midwife is usually only recommended for low-risk pregnancies . In fact, most pregnancies in the world are low-risk.
Here are some of the benefits of choosing a midwife:
- Reduced chance of induction or assisted delivery.
- Decreased chance of delivering the baby by cesarean section (C-section) .
- Reduced use of painkillers such as epidurals .
- Reduced risk of third and fourth-degree perineal tears during childbirth.
- More flexibility for home births.
- You have more control and decision-making power over your care.
But remember, midwives are not usually trained to perform surgery. If your pregnancy or delivery is complicated or you are at high risk, your midwife will refer you to an Ob/Gyn.
Should I choose a midwife?
If you have a low-risk, normal pregnancy, and you're looking for a closer, more personal relationship with your healthcare provider, a midwife may be a good choice for you.
However, if you have a health condition that could cause complications during your pregnancy or delivery, it is best to have a close collaboration between your midwife and your obstetrician/gynecologist (Ob/Gyn). Some of these conditions include:
- High blood pressure
- Diabetes
- If you have had previous conditions such as seizures or convulsions.
- If previous pregnancies were high-risk.
- If you are expecting twins or multiples.
If you decide to choose a midwife, it's best to find one who is licensed and certified to work in your area.
Are there any risks in receiving services from a midwife?
In fact, midwives work closely with Ob/Gyn doctors, Maternal-fetal medicine specialists , and other healthcare providers to minimize the risks associated with your care.
If you have any fears or concerns about childbirth, it is generally recommended to work with a midwife who attends hospital births. This will provide you with greater security as you will be able to access the necessary medical facilities and specialist support quickly in the event of an emergency.
Are a midwife and a doula the same person?
Yes, these two are people who perform two completely different roles.
The word doula comes from the Greek word for "woman's helper." A doula is someone who is trained to provide emotional and physical support to a mother during labor and delivery. They can help you manage labor pains, bring you fluids, suggest positions to help you through labor, and encourage you.
But most importantly, a doula does not have medical training. The service they provide is purely psychological, emotional, and informational support, not medical care. A midwife provides medical care with medical training and qualifications.
Do midwives perform cesarean sections (C-sections)?
No, midwives cannot perform C-sections . However, they can assist with a C-section. If you need a C-section, a collaborating physician will take over that responsibility.
Do midwives give epidurals?
Some midwives (especially CNMs) can prescribe painkillers like epidurals , but they do not administer them. That is, they do not give injections. They do this in consultation with an anesthesiologist or a Certified Registered Nurse Anesthetist (CRNA) . These providers of anesthesia are usually only available in a hospital setting.
What questions should I ask before choosing a midwife?
Many people choose to talk to a midwife, conducting an interview, to make sure they are comfortable working with her. Here are some questions to consider before choosing a midwife:
- Where will I deliver my baby? (Hospital, birth center, or home?)
- What kind of training do you have? What are your certifications?
- How long have you worked as a midwife?
- How many births have you attended?
- What are your views and values regarding childbirth?
- What kind of tests do you do during pregnancy?
- Will my insurance cover the costs for this?
- Do you work with any Ob/Gyns in your area? If so, who are they?
Finally, things to remember (Take-Home Message)
A midwife is a valuable addition to your reproductive health team, especially during pregnancy and childbirth. They are great for low-risk pregnancies and births, or if you prefer a more natural approach to care.
However, not all midwives are the same . When you're looking for a midwife, be sure to check out her certifications, where she's licensed to practice, and whether she has a good relationship with a physician partner.
Whether you choose a midwife, an obstetrician/gynecologist (Ob/Gyn), or a combination of both, your healthcare providers will work together to provide the best possible outcome for you and your baby. We wish you a healthy, happy pregnancy and a safe birth!
` midwife, midwife, pregnancy care, childbirth, natural childbirth, Ob/Gyn, family health worker
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