Midwives provide obstetrical and gynecological care as well as primary care. We care for women throughout the lifespan, from adolescence to menopause.

Certified Nurse-Midwives (CNM) have a bachelor's degree in nursing and a certificate in midwifery, and most have a master's degree in a health specialty such as nursing, midwifery, or public health. Certified Midwives (CM) have a bachelor’s degree in a health specialty, a certificate in midwifery, and a master’s degree in nursing, midwifery, or public health. Most midwifery programs follow other models of health care training where, in addition to college based theoretical learning, we have hands-on clinical experience in midwifery care settings. While CNMs and CMs provide care in hospital, birth center, and home settings, other types of midwives provide care only outside of the hospital setting.

After college I worked in a family planning clinic as a bilingual health educator and was lucky enough to work with midwives. I was impressed with how midwives provide women with patient education and empowerment regarding their reproductive health. I liked the midwifery philosophy of focusing on normalcy even when complications arise and need to be managed. I wanted to be in a profession where I could interact with all types of people and families; midwifery has been the perfect match for me.

Currently, I work at a hospital in downtown Boston, Massachusetts. I am working in a community-based health center where we care for women from all over the world, including many recent immigrants and refugee women. My practice is mostly devoted to pregnancy and delivery, but we also meet the family planning needs of the women we serve.

People perceive midwives as people who give good and kind care to women during pregnancy. Most people view midwives positively and consider their work to be noble as well as joyful.

Often people think midwives only attend to women during natural childbirth (birth without pain medicine) in the home or at a birth center. The reality is that 95 percent of midwives care for women in hospital settings where they have access to pain medicine. Sometimes people do not understand that midwives care for women during all of pregnancy — from prenatal care, through labor, to the postpartum phase. People also may not realize that midwives care for women throughout the lifespan, providing routine gynecological and primary care.

A midwife’s primary role during pregnancy and delivery is to:

• Provide prenatal care to a woman and her family according to accepted standards for obstetrical care in the United States.
• Attend to a woman during her labor and provide not only emotional and physical support, but also an ongoing assessment of her health and the health of the baby.

Midwives consider it to be their role to encourage women to trust in themselves and their bodies. The hope is for a positive pregnancy and birth experience as they journey into motherhood.

Midwives may deliver babies in homes, in a birth center, or in hospital. 95 percent of midwives attend to deliveries in the hospital setting. There, midwives’ clients have access to pain medicine. Midwives who attend to deliveries at birth centers provide care according to the same standards for safety at hospitals, but with the intention of providing the most individualized care with the least intervention possible in the birth process. Midwives who attend to deliveries in the home are caring for low-risk women who have good support at home. In each type of setting, systems exist to provide safe and efficient care in the case of an emergency. When you are considering where to birth, interview the provider and discuss how they deliver care and what plans are in place in case of an emergency.

The philosophy of midwifery care is that pregnancy and birth is a natural life process. Midwives offer all the same testing and provide care according to the standards of obstetrical care, but they also focus on helping women prepare for labor and birth as well as the postpartum stage.

Some women have medical conditions that require care by a physician during their pregnancies. Yet many women with health problems can be cared for by a midwife. The midwife might discuss the patient’s care with a physician or share care of the patient with a physician. Hospital-based midwives, especially, are often capable of caring for women with risks or conditions which might otherwise remove midwife care as an option. Do not assume that your condition makes you ineligible for midwifery care — ask!

A woman may want to consider using a midwife during pregnancy and delivery if she is looking for an individualized and positive experience. She may want to consider midwifery care if she is looking to include her entire family in her experience. Also, she will want to consider midwifery if she is seeking to use natural methods of pain management and is hoping to avoid extra interventions such as routine episiotomies. Please see the Philosophy of the American College of Nurse-Midwives (PDF, 20 KB).

You should look for a midwife who practices in the setting in which you are interested in giving birth. Then you should look to see if the midwife has the credentials to assure you are getting professional care. Please see the Web site http://www.myMidwife.org for more information about providers, credentials, and licensing.

Certified Nurse-Midwives and Certified Midwives are federally recognized providers of gynecological, obstetrical, and primary care and are licensed in all states. Therefore, in most cases, insurance will reimburse for the care provided by midwives. Of course, each insurance company dictates whom and how they will reimburse (for example, in network and out-of-network services), so check with your insurance company to find out which midwives are covered by your plan. Also, make sure that the site that you have chosen to birth in is covered by your insurance plan.

Everyone should know that midwives offer the best of obstetrical and gynecological care. Our commitment is to the women and their families who seek to make the healthiest possible choices in the most supportive environment. Midwives have all of the tools available to provide the most up-to-date, safe, and effective care. At the same time, midwives work to ensure the most rewarding and positive health care experiences.