September 28, 2016
Midwives Provide Comprehensive Care for Women in Childbirth and Beyond
National Midwifery Week 2016 is October 2—8. This celebration was created by the American College of Nurse Midwives (ACNM) to recognize and heighten awareness of Midwifery across the nation. Assuring the health and wellbeing of a mother and her baby during pregnancy through delivery is one of the most important aspects of a certified nurse-midwife’s job. Midwives attend nearly 10 percent of all births in the United States.
A certified nurse-midwife (CNM), the standard of practice in Pennsylvania, has a degree in nursing along with advanced academic and clinical training to earn a specialized degree and also must pass a national certification examination offered by the American Midwifery Certification Board. Many CNMs begin their work as a nurse in the labor and delivery unit of a hospital, where they are inspired to continue their training to become certified.
Perhaps because “midwife” is a term that has been associated with childbirth through the ages, a job that was once handed down through informal training, there are common misconceptions about what a CNM can and will do, as well as where care is provided. Today, CNMs have clearly-defined medical and clinical training requirements.
The CNM is an advanced practice role, providing family-centered comprehensive care. He or she is a clinician, a patient advocate, as well as a skilled manager of care. Once a pregnancy is confirmed, CNMs can oversee all of the prenatal visits, while also attending the birth of a baby in the hospital. CNMs can order tests, prescribe medications, make referrals, and perform any of a range of peritoneal procedures, including an episiotomy. Working collaboratively with specialists, the CNM can manage high-risk pregnancies and assist during C-section procedures.
Although the midwives of long ago attended births in the home, as did doctors as well, 95 percent of deliveries overseen by CNMs today occur in the hospital, and three percent are in birthing centers. Just like other childbirth professionals, the CNM uses advanced monitoring equipment along with other medical devices and interventions to assure safety of mother and baby.
The CNM has a goal and philosophy to personalize the mother’s birth experience that includes options for pain management during delivery. During prenatal visits, the CNM educates the mother and her birth partner on varying approaches to childbirth, options for pain medication so the mother can consider her options and choose anything from local anesthesia to epidural, as well as natural pain relief methods.
The CNM works in partnership with his or her patient, and in collaboration with a variety of specialists, to assure a holistic approach. In Pennsylvania, care provided by a CNM is covered by most insurance companies.
Certified Nurse-Midwives along with Obstetrics/Gynecology specialists, family medicine physicians, lactation consultants and nursing administrators all provide comprehensive care for women and babies at Susquehanna Health. At Susquehanna Health, CNMs have been attending births for several decades.