What is a midwife?

Since the beginning of human history, women have helped other women in the transition to motherhood. Midwives are the primary health care providers in most countries where birth is an integral part of family life. Countries with the highest rate of midwifery care today – emphasizing competent prenatal care, education, and empowerment for the woman giving birth – also have the best outcomes for mothers and babies. The World Health Organization (WHO) declared in 1990 that birth was actually safer for mothers and babies when utilizing midwifery for pregnancy and childbirth.

The modern midwife is a health professional who provides holistic heath care to the childbearing woman and newborn. She respects a wide range of women’s needs including personal and cultural values. Focusing on the natural processes of pregnancy, labor, and birth, she combines traditional skills and modern medical techiques to safeguard normal childbirth. The midwife maintains associations with physicians and other health care providers to ensure that mother and child have the best knowledge and technology available.

Midwifery is based on a strong belief in partnership with childbearing women and respect for birth as a normal life event. Midwives strive to empower parents with knowledge and support their right to create the birth experience which is best for them. Midwives respect intimacy, privacy, and family integrity, and draw on their own patience and understanding to provide care during pregnancy and birth.

The midwife sees pregnancy and childbirth as normal states for the healthy mother. Out of respect for the birth process and a woman’s innate ability to bear a child, the midwife believes unnecessary interference is an unwise interruption of the body’s functions. She carefully watches and guides, assisting the woman to give birth, respecting the choices and values of the family. She is a skilled practitioner, giving care and advice to the mother during normal pregnancy, labor and birth, and caring for the mother and newborn following delivery. A midwife is trained to detect any abnormality in mother or child and refers to medical aid if necessary. In the absence of medical aid, a midwife is ready and willing to use emergency measures to the limit of her education and experience.

Types of Midwives

There are essentially three types of midwives: Certified Professional Midwives, Certified Nurse Midwives and direct-entry midwives.

Certified Professional Midwives (CPMs) may gain their midwifery education through a variety of routes. They must have their midwifery skills and experience evaluated through the North American Registry of Midwives (NARM) certification process and pass the NARM Written Examination and Skills Assessment. Legal status varies from state to state, and many states use the CPM credentialing process in granting licenses to non-nurse midwives.

Certified Nurse-Midwives (CNMs) are educated in both nursing and midwifery. After attending an educational program accredited by the American College of Nurse-Midwives Certification Council (ACC), they must pass the ACC examination and can be licensed in the individual states in which they practice. CNMs practice most often in hospitals and birth centers. CNMs can prescribe medication, attain hospital privileges, file for insurance reimbursement, and are legally recognized by every state. For low-risk women desiring hospital birth, they are an excellent choice.

“Direct-entry” midwives, who are licensed in some states, are not required to become nurses before training to be midwives. The Midwifery Education and Accreditation Council (MEAC) is currently accrediting direct-entry midwifery educational programs and apprenticeships in the U.S. Direct-entry midwives’ legal status varies according to state and they practice most often in birth centers and in homes.

In Wisconsin, a law to license Certified Professional Midwives passed the state legislature in April of 2006 and was enacted in May of 2007. Wisconsin grants a midwifery license to women who pass the NARM requirements and become a CPM. However, since this law is quite new, formal schools to train midwives are just emerging. At present, most CPMs in Wisconsin have been trained via the apprenticeship method.

For more information on Nurse Midwives, visit the website of the American College of Nurse Midwives at http://www.midwife.org/

For more information on the CPM credential, visit the website of the North American Registry of Midwives at http://www.narm.org/