Choosing the best care for your prenatal, delivery and postpartum needs can be daunting, especially with your first pregnancy. Luckily there are a growing number of alternative birth options to consider, especially if you want a personalized approach with minimal intervention. I met up with two Pittsburgh midwives with over 30 years of combined experience that gave me the lowdown on midwifery practice. We discuss everything from what a midwife is, how they differ from physicians, and why they are becoming mainstream for a very personalized experience.
What is a Midwife?
Midwives have many different roles in a women’s health from prenatal care and birth plans through delivery. But did you also know that midwives help with postpartum recovery and women’s health well beyond having kids? They support women much like OBGYNs when it comes to annual care visits, birth control consultations, menopause, post-menopausal care, and more throughout the health of a women’s life.
Midwifery practice dates back from the times of ancient Egypt and Greece. It’s been practiced by colonists in the US for hundreds of years and has come in many forms of women’s care. Today, midwives (or birth attendants) focus on education, prevention and support in their practices for the entire family. They provide a very personalized care, which is different in many ways from your typical physician.
Midwives have a different philosophy on birthing than physicians. They feel birthing is a normal and natural event that can be optimized. With a premeditated birthing plan, midwives talk with their patients about pain management and discover what options are best for them. Water births, use of oils, massage and epidurals are all options. By creating a plan, it helps to use as little intervention as necessary and avoid unnecessary procedures when they can.
What Certifications Does a Midwife Have?
A Certified Nurse Midwife is the most common LEGAL form of midwife in the US. This requires an undergraduate degree in nursing, a master’s degree in midwifery and passing the American Certified Midwifery Board exams. In all states (except PA), midwives are allowed to support home births. In Pennsylvania, Certified Nurse Midwives work in hospitals, birth centers and special practices.
One of the most positive experiences women like when working with a midwife is the personal relationship that is formed. These relationships are often founded during the pregnancy journey, but continued for years after having children.
Choosing Between a Midwife and a Physician
The biggest difference between midwives and physicians are that midwives approach each pregnancy individually, giving the mother the ultimate choice for her birth plan. In addition, midwives add education prevention and support to every visit.
Midwives are with mom through every step of the planning and delivery. They also support the new mom post delivery with breast-feeding and making sure mom and baby are happy and healthy.
Midwives DO seek the advice of a physician when something out of the ordinary happens. High-risk pregnancies and women carrying multiples can still choose to use a midwife, however these births will take place in the hospital and may be switched over to a physician’s care if complications arise. The midwives approach high-risk and multiple births as a team effort between the physicians and themselves.
For a quick reference, below is an outline of the major differences between midwives and physicians:
| Midwife | OBGYN / Physician | |
| Philosophy: | Pregnancy is a normal event. Focus on education, prevention and support. | Pregnancy can be complicated and women need to be monitored. |
| Delivery Location: | Home births (Except in PA), birthing centers, special practices and in hospitals. | Hospitals |
| Birth plan: | Personalized, the mother chooses birth plan ahead of time | Mother goes to hospital to deliver baby |
| Pain Management Techniques: | Mother chooses | Determined by Doctor |
| Labor: | Spends up to 80% of time with mom during labor | Nurse attends to mom during labor
Physician on call delivers baby |
| Perform: | Delivery
Some can perform vacuum assisted deliveries or assist with C-Section deliveries.
|
Delivery, c section, vacuum assisted delivery, forceps, GYN surgery.
|
| High-risk Deliveries: | Work with doctors for high-risk & multiple baby births
Occurs at hospital |
Occurs at hospital |
| Postpartum Care: | Attends to mom post-delivery, for breastfeeding, and recovery
|
Nurses monitor recovery, lactation consultants visit, Doctor checks on daily |
| Insurance: | Insurance covered | Insurance covered |
If you think a midwife or birth attendant is right for you, check into these resources from our Pittsburgh midwifes:
Helen Behn is the creator and founder of Spand-Ice: wearable, flexible, gear made for women to get pain relief while staying mobile throughout their entire motherhood journey. Helen started Spand-Ice because of her own personal struggle to relieve chronic back pain without taking time out of her life.