By Ursula Miguel, Princeton HealthCare System
For most healthy women, having a baby can be a natural, safe and empowering process.
Recognizing this, more and more women are choosing midwives to provide healthcare services during childbirth and throughout their lives.
Midwifery care encompasses a full range of primary healthcare services for women from adolescence to beyond menopause. These services include primary care, gynecologic and family planning services, preconception care, and care during pregnancy and childbirth.
In fact, while midwives are well known for attending births, more than 50 percent identify reproductive care and over 30 percent identify primary care as their main responsibilities, according to the American College of Nurse Midwives.
Partners in care
The vast majority of midwives in the United States are certified nurse-midwives. There are a smaller percentage of certified midwives, who do not have a nursing background.
Both midwives go through a rigorous graduate level of education accredited by the Accreditation Commission for Midwifery Education, which ends with the passing of a national certifying exam.
Certified nurse-midwives in New Jersey are licensed by the Board of Medical Examiners and have prescriptive privileges.
Both certified nurse-midwives and certified midwives must be recertified every five years to maintain their certification.
In general, midwives strive to be partners in care, providing a personal approach that often involves spending extra time listening to your concerns, addressing and treating health issues, and providing education. They are experts in normal labor and birth and offer hands-on support to women and their partners through the natural process of labor.
Supporting healthy births
Midwives attended nearly 314,000 births in 2012, according to the American College of Nurse Midwives. This represents 11.8 percent of all vaginal births and 7.9 percent of total U.S. births. Moreover, the proportion of births attended by midwives has risen nearly every year since 1989, the first year statistics were available.
According to the American College of Nurse-Midwives, research shows that women cared for by certified nurse-midwives have a significantly higher chance of giving birth vaginally. Women cared for by midwives also have fewer episiotomies, less perineal trauma, increased breastfeeding right after birth and lower rates of labor induction.
Vaginal births often mean shorter hospital stays, lower infection rates and quicker recovery periods. Babies born vaginally have a lower risk of respiratory problems.
Cesareans involve risks, such as bladder and bowel injuries, as well as serious complications for future pregnancies. Placental problems, uterine rupture, and emergency hysterectomy are all risks that increase with each subsequent cesarean.
The American College of Obstetricians and Gynecologists recommends that pregnant women plan for a vaginal birth unless there is a medical reason for a cesarean. Midwives do not perform cesarean sections.
What about pain relief?
During normal, healthy birth your body releases hormones that help you labor effectively, cope with pain and bond with your baby. However, certified nurse-midwives are able to prescribe pain-relieving medication and an epidural is an option if giving birth in a hospital. Other techniques to manage pain may include Jacuzzi baths, breathing exercises, birthing balls and massage.
Midwives attend births in many settings. In 2012 nearly 95 percent of all births attended by midwives occurred in hospitals, according the American College of Nurse Midwives. Other low risk women choose to give birth in a freestanding birth center or at home.
Complications?
At times, birth can become complicated and needs medical intervention. Midwives work collaboratively with medical doctors and can consult with them or refer to them as needed. This collaborative model of care has been shown to have positive outcomes for mothers and babies.
Learn more
To learn more about midwifery care join me for a live Web-chat hosted by Princeton HealthCare System from 7 p.m. to 7:30 p.m. on Thursday, Dec. 18. I will take your questions about how midwives fit into the childbirth experience and what midwives can do for mothers and babies.
To participate, simply go to the USTREAM Channel at www.ustream.tv/channel/princetonhealth <<a href="http://www.ustream.tv/channel/princetonhealth>on">http://www.ustream.tv/channel/princetonhealth>on your computer, tablet or smartphone on the day of the seminar.
If you’d like to ask a question during the web-chat you can log in using your Facebook or USTREAM account or you can create a new account. Alternatively, you can also submit questions in advance by sending them to [email protected].
To pre-register visit www.princetonhcs.org. All those who pre-register will be entered to win one of several gift cards that will be awarded immediately following the web-chat. Must be present to win.
To find a nurse-midwife with Princeton HealthCare System call (888) 742-7496 or visit www.princetonhcs.org/physiciandirectory and search by the term midwife.
Ursula Miquel, M.S., C.N.M. is a certified nurse-midwife and a member of the medical staff at University Medical Center of Princeton.
