Midwives Becoming More Popular Than Ever

By Emory Johns Creek Hospital

Most people have heard of midwives. Established in America in the 1920s, nurse-midwives have provided women with both routine gynecological and child-birth related care for years. And although 10 years ago, only three percent of births were attended by a nurse-midwife, the American College of Nurse-Midwives (ACNM) estimates that soon, one in 10 babies in the United States will be delivered by a certified nurse-midwife. Worldwide, statistics show between 60 and 80 percent of babies are delivered by midwives.

A certified nurse-midwife in America is a registered nurse with a master’s degree in midwifery. They are licensed healthcare practitioners certified by the American Midwifery Board and work in hospitals and birthing centers. They view life stages such as birth, puberty and menopause as normal life events. Certified nurse-midwives are required to have established relationships with physicians for collaboration, consultation and referral purposes.
 
“We are currently experiencing a move toward less intervention when it comes to childbirth,” said Robert Modugno, MD, obstetrician and gynecologist at Emory Johns Creek Hospital. “These days and particularly in this area of Atlanta, moms-to-be are highly educated. They’ve done their homework when it comes to pregnancy and childbirth, and are increasingly focused on a more natural birthing experience,” he said.

That’s where the doctor and nurse-midwife team approach comes in. Modugno said doctors are trained to focus on what might go wrong during delivery. Midwives, however, are trained to look at childbirth as a natural physiological event. While they are trained to recognize when problems exist and know when a doctor’s intervention is necessary, they pay particular attention to the patient and provide personalized care whenever possible.

And that type of philosophy could pay off. According to Childbirth Connection, a national not-for-profit organization founded in 1918 as Maternity Center Association, 32 percent of deliveries in the United States in 2007 were by cesarean section—a record for America. In addition, the organization states that rate could be significantly lowered through care that supports physiological labor, such as offering continuous emotional support or by using hand-to-belly-movements to turn a breech baby into the head-first position.

“One of the great things about the doctor-midwife team approach to delivery is that often, it’s the midwife that has the most amount of time to devote to how the patient feels—to provide a nurturing type of care,” said Diane Tandy, certified nurse-midwife at Emory Johns Creek Hospital. “We earn the mother’s complete trust and give her the respect to hear what she wants, as long as it’s safe.”

Tandy also said that because doctors and certified nurse-wives have somewhat different types of training, they complement each other well. She said patients have not only a wide variety of opinions on what’s best for them, but different personalities as well. One patient’s personality may work well with the doctor, while another’s works well with the certified nurse-midwife. It’s having both types of medical professionals available, according to Tandy, that is important.

So what should women look for when choosing a medical provider? First and foremost, experts say a caregiver’s practices should be consistent with the best research available regarding safe and effective care. The doctor or midwife’s personal style should be compatible with the patient’s needs preferences and values, and the relationship should provide for good communication between patient and caregiver.

“Just like it takes a whole village to raise a child, it takes a whole practice to ensure a safe delivery that caters to the mother’s preferences,” said Tandy. “Certified nurse-midwives simply let nature take its course.”