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Midwives are autonomous practitioners who are specialists in a low-risk pregnancy, childbirth, and the postpartum stage. They generally strive to help women have a healthy pregnancy and natural birth experience, and often serve as a quality economical option through eliminating or minimizing unnecessary interventions. Their philosophy of care is represented by the Midwives Model of Care.

The Midwives Model of Care Includes:

• Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
• Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
• Identifying and referring women who require obstetrical attention
• Minimizing technological interventions

The services of a midwife depend on the certification and licensing credentials obtained and the practice restrictions within each state. These services include: annual gynecological exams, family planning and preconception care, prenatal care, labor and delivery support, newborn care, and menopausal management. Midwives generally provide reproductive education directed at fertility, nutrition and exercise, contraception, pregnancy health, breastfeeding, and quality infant care.

What Are the Different Types of Midwives?

Midwives are qualified health care providers that go through comprehensive training and examinations for certification. Certification is offered by the American College of Nurse Midwives (ACNM) and the North American Registry of Midwives (NARM). Here is a description of the practice and credentials each of the types of midwives in the United States:

• Certified Nurse-Midwife (CNM): An individual trained and licensed in both nursing and midwifery. Nurse-midwives possess at least a bachelor's degree from an accredited institution of higher education and are certified by the American College of Nurse-Midwives. Because of the additional licensure in nursing, a nurse-midwife provides the most comprehensive array of health care services to women.
• Certified Professional Midwife (CPM): An individual trained in midwifery that meets practice standards of the North American Registry of Midwives.
• Direct-Entry Midwife (DEM): An independent individual trained in midwifery through a variety of possibilities that include: self-study, apprenticeship, a midwifery school, or a college/university program.
• Certified Midwife (CM): An individual trained and certified in midwifery. Certified midwives possess at least a bachelor's degree from an accredited institution of higher education and are certified by the American College of Nurse Midwives.
• Lay Midwife: An individual who is not certified or licensed as a midwife, but they are trained informally through self-study or apprenticeship.

Where do Midwives Practice?

Midwives believe in facilitating a natural childbirth as much as possible. Accordingly, it is common to receive care from a midwife in a private and comfortable birthing center or in the comforts of your own home. Because of their professionalism and expertise, midwives are often part of a labor and delivery team associated with the local hospital. You may choose to use the services of a midwife whether you elect to give birth at home, a birthing center, or in a hospital.

The Benefits of Using a Midwife:

Whether in their homes, at birthing centers or in hospitals, the main reason that women elect to use a midwife is usually to experience the childbirth process as naturally as possible. A focus on options is another benefit associated with electing midwifery care. The decision to use a nurse-midwife and natural delivery may result in the following benefits:

• Lower maternity care costs
• Reduced mortality and morbidity related to cesarean and other interventions
• Lower intervention rates
• Fewer recovery complications

Health Concerns Related to Using a Midwife

Since low risk pregnancies make up 60 to 80% of all pregnancies, this means that 20 to 40% of all other pregnancies could have potential complications. There are times when either the mother or the baby will require medical interventions that are outside the scope of services offered by a midwife. For this reason midwives routinely consult with obstetricians, perinatologists, and other healthcare professionals and will refer women to the necessary medical professionals if complications arise.

It is recommended that women elect a hospital setting where complications are anticipated. A hospital generally provides easier access to obstetricians, perinatologists, and other experts.