Five Things You Might Not Know About Working with A Midwife

Perhaps, you have decided that you would like to see a midwife over the course of your pregnancy journey. Midwives embrace a client-centered model of care that reinforces the normalcy of birth and are sensitive to the unique needs of individuals and their families. But what else will you get when you sign up for midwifery care? Here are five things that you might not know about working with a midwife:

1. Different kinds of midwives provide different options for care.

Midwives, although perhaps trained and created equally, are not all the same. The experience you will have working with one is largely dependent upon the type of midwife or midwifery practice you choose. 

Think about a birth setting that feels best or safest to you, and whether or not you need to account for particular medical or social conditions. Taking in factors like this can help you find the right fit. If your health status or personal preference compels you to give birth in a clinical environment, you will likely work with a Certified Nurse-Midwife (CNM), some of whom provide out-of-hospital options for birth. For those who prefer to stay away from the hospital, working with a Certified Professional Midwife (CPM), who has been trained to manage normal birth in non-clinical settings, might offer the greatest compatibility. For some, having access to time-tested traditions and anecdotes of their foremothers is an important aspect of their birth experience, in which case, a lay midwife may be just right. 

Some states only acknowledge certain types of midwives, which can be a significant factor when finding a practice that is ideally suited for you. Ultimately, don’t be shy about your opinions to whomever you are considering to help guide you to your perfect match.

2. Midwives are open to collaborative care.

Midwives are interested in supporting your optimal health throughout pregnancy and are more amicable than you might think when it comes to integrating alternative modalities that keep you feeling your best.

Open communication is the safest strategy. For example, if there are special considerations to make regarding how your chiropractor or massage therapist should adjust to your pregnancy, then your midwife can discuss that with you. Additionally, there may be circumstances that arise during the course of your care that would benefit from acupuncture, craniosacral therapy, or some other complementary modalities with proven success for treating your specific issue. It can be educational and emotionally nourishing to have a midwife on board to offer alternative perspectives during a very classical course of care.

3. Midwives don't force women to have unmedicated births.

While the profession of midwifery may reach back to antiquity, many of the options available to assist women during their labor and birth are planted in modern medicine. Midwives are skilled care providers and are connected to the ever-changing dynamics in medicine. As methods of pain relief have evolved, midwives stay aware of what is in common use, even when they don’t offer it.  

In an effort to protect your physiological process, your midwife may strongly encourage you to persevere through the discomforts of labor using non-pharmaceutical techniques. However, in the event that you decide ‘enough is enough’ and you require relief, you will be supported in your journey even when it necessitates transport to a different setting and a change in their role.

4. Midwives can follow a healthy baby for at least six weeks.

Are you having trouble finding a pediatric practice that feels like the right fit? Not a problem. Midwives who attend births in out-of-hospital settings are not just experts on normal birth. They are also specialists in care for normal babies. 

Your midwife will do a thorough newborn exam just after the birth of your child and can spot and tell you when things appear out of alignment. Moving forward, the frequency of postpartum visits (a hallmark of homebirth midwifery) is precisely for close observation of you and your baby, to assess smooth transitioning, strong establishment of breastfeeding, and proper adjustment to extrauterine life.

Should there be a concern, a referral for immediate pediatric care, lactation support, or whatever therapy is most appropriate can be activated. The standard weight checks and assessments done in a pediatric office are part of your postpartum visit and can be done in the convenience and safety of your home.

5. Midwives are not doulas.

This may seem obvious, but often the roles are confused, leaving many families wondering if they need to have both a midwife and a doula. Yes, one thousand times yes!

Midwives, in whatever setting they work, are responsible for your clinical well-being. This does not exclude them from educating their clients or providing emotional or social support. Nor does it mean that they (depending on the setting) will not sit with you in labor and help you to cope with what you are experiencing. What it does mean is that they will need to stay on top of the medical aspects of your pregnancy, which includes monitoring your vital signs, the progression of your labor, and the health and safety of the baby until you both are stable in the postpartum.

Doulas are valuable team members who aid both families and midwives by providing educational resources during pregnancy, and offering continuous and informed presence throughout labor and birth. While the roles in many ways overlap, they are not the same. Including both midwives and doulas on your dream team is likely to result in the support you need to experience the birth you desire.

Pregnancy is a dynamic time that certainly becomes a bit easier to navigate when you have a reliable partner in care helping you along. The more clarity you have about what you would like to experience, the easier it becomes to create. Ask questions, and don’t be afraid to communicate your feelings. Remember, midwives are here to help people out.