Oh boy. I have been avoiding this post for a while, but at last I will write it and be free. I want to be clear, and to the best of my (limited) ability convey my exact meaning. I am after all, a scientist with the hands and heart of a healer, Not a writer. Please keep my preface in mind as you read through this one, and stay with me.
If it is not clear yet to my readers, I will spell out for you my future plans. I am currently finishing up my sophomore year in a bachelorette nursing program. I want to focus on Labor and Delivery and well women/ family care. I intend to continue my education (with or without a break) to earn my DNP in Midwifery. This certification is often called CNM for short, which stands for Certified Nurse Midwife. Currently there is a change happening at the national level with education programs transitioning from masters level to doctoral nursing practice degrees. So, there will be midwives with either a Masters or a DNP in practice who are all equally qualified and talented care providers for sometime to come. I also want to take a moment to acknowledge that there are midwives in practice without a nursing background. These individuals are known as “Lay Midwives” and have a more limited scope of practice, but are still valuable and highly competent care providers.
The numbers of CNMs are growing, and recognition of the highly compassionate and case appropriate care CNMs are capable of giving is also growing. The evidence includes (but is not limited to) higher mother/family satisfaction rates, lower C-section rates, lower rates of prenatal and labor complications, and lower medical costs. I firmly believe that Midwifery practice is the future of standard well woman and obstetrical care. Midwives will be sought out first, and OB-Gyns will be used primarily for high risk and complicated patients instead of primary care. It is happening right now,but slowly changing. We should all be excited about this for many reasons. My own reasons could be perceived as biased. (I do want a job after all!) But we are not there YET.
As an assignment for my Nursing Care of Families course, I had the pleasure of attending one session of a child-birth preparation class. I was instantly thrown back to happy memories of the class my husband and I attended when we were awaiting the birth of our beloved daughter. I was asked to briefly introduce myself to the class, and said, “I am a nursing student at the University of Minnesota, and on a path to become a certified nurse midwife, and I am observing this class today for one of my classes. I am also a mother of 2.” Of course, my being there was of pretty limited interest to most of these parents. However, one sweet and sunny mother approached me on the break to say hi and chat. I was happy to engage in small talk and be excited with her about the upcoming delivery of her first baby. Then she started to inquire about my career path. “A midwife?” she asked. “Yes” I said with a smile, “I discovered with the births of my own babies that I am just really interested in the whole process and I felt a pull to be a midwife.” She told me that her husband and her had speculated about midwifery care, but decided that home birth just wasn’t for them. “Me neither.” I said. “Did you know that almost 90% of midwives deliver in hospital settings?” I asked. She was surprised. I told her that I was really glad she was happy with her OB, and that I had been pretty much happy with mine too. But I also encouraged her to take another look at Midwifery for future care. Then break was over. I have noted this surprise reaction in everyone from doctors and nurses to just about any one in the general population. I want EVERYONE to know that midwife are not ONLY home care providers.
I think it is important that the general public understand that midwives are not JUST private practice women all on their own running off to people’s homes to deliver babies in the middle of the night. They are both men and women (though the vast majority are women), and work with a variety of clients in a variety of settings and care for women from puberty throughout the life span. They are employed by physicians groups, multi disciplinary practices, hospitals, birth centers, and others. All though midwives tend to strive for “natural” births for their clients, their true focus is on patient centered care. CNMs have prescription privileges too. If that means your optimal birth experience includes using an epidural, many CNMs are onboard. What you can expect from a midwife is a highly educated and passionate care provider with a nursing background and in-depth knowledge of “normalcy”. Unlike an OB (who has an education also completely focused on pathology and not normal health pregnancy and birth), a CNM will come to support you through most of your labor, not just walk in to catch your baby after all the work of labor is already complete.
Now, on the subject of home birth… I do not consider myself a champion of home birth, but I am also not opposed. I think that for some mothers, this is a valid and positive choice, but I also do not think it’s for everyone. In fact, it’s not for me. I do think that anyone who is in the market for a home birth should be supported by a competent and capable care provider. There are states where Midwives are not legally permitted to attend home births which results in mothers who want this to deliver unsupported on their own against medical advise at home. Why can’t we just let them be, and be safe? I do not wish to be a home delivery mother or midwife, but I do think that it should be an option on the table.
So, remember, CNMs are out there. There are more of them every year. There is a true renaissance going on that all women should be excited about. Go out there and research it for yourself; don’t rely on me to tell you about it. If you want to know where to start, you can click on the “Midwife info” tap above.