Some people might think that midwives are just for pregnant people, but that is not true. Midwives provide specialized care throughout the reproductive journey, from adolescence, through pregnancy, birth, postpartum, and menopause.
“We care for people across all stages of life, from adolescence through menopause. A big part of what we do is take time to talk, educate, and support our patients so they feel confident in their care,” said Grace Ferguson-Pell, CNM, WHNP, RN, a certified nurse-midwife at the Midwife Practice at Mount Sinai Doctors at Delancey Street, in Manhattan’s Lower East Side.
“Midwifery model care, typically, we really like to focus on education. We always say, most of our visits are talking, and I think it’s a way for people to feel more prepared and ready for birth,” said Johanna ”JJ” Monro, DNP, CNM, RN, also a certified nurse-midwife at the Delancey Street practice, which is part of the Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science at Mount Sinai.
In this Q&A, Grace and JJ explain the role of midwives, how their care differs from other providers, and what patients can expect when working with them.
Johanna “JJ” Monro, DNP, CNM, RN (left) and Grace Ferguson-Pell, CNM, WHNP, RN (right) are certified nurse-midwives at the Midwife Practice at Mount Sinai Doctors at Delancey Street.
What is a midwife and how is it different from an OB-GYN and a doula?
Grace: A midwife is an independent practitioner who focuses on reproductive health. This includes a wide range of care such as contraceptive counseling, menstrual cycle issues, prenatal care, helping with births, postpartum visits, and annual reproductive health exams like cervical cancer screening and STD testing. In addition to pregnancy care, midwives support patients through menopause and perimenopause, providing ongoing reproductive health services such as screenings, symptom management, and education.
The main difference between a midwife and an OB-GYN is that midwives do not perform surgery and focus more on pregnancies that are low-risk or generally uncomplicated. People with certain conditions like diabetes or high blood pressure might need to see an OB-GYN instead.
JJ: A midwife is a licensed professional in New York State. We are Certified Nurse Midwives (CNMs), which means we have nursing degrees and additional training in midwifery, with either at the master’s or doctorate level. We currently only attend hospital births at this time.
A doula is different from a midwife because doulas provide emotional and physical support during labor and postpartum, though do not receive medical training and do not provide medical care.
How might having a midwife’s support improve my pregnancy experience?
JJ: Midwives focus a lot on education and communication. Most visits involve talking through what to expect during labor, how to prepare for breastfeeding, and how to manage postpartum care. This approach helps people feel more prepared and confident.
Grace: Midwives provide care that is personal and holistic, focusing not only on the medical aspects of pregnancy but also on emotional, mental, and social well-being. This approach means addressing a patient’s overall health, lifestyle, and support system throughout their reproductive journey. They manage pregnancies that are low-risk or generally uncomplicated and collaborate closely with OB-GYNs if any complications arise. Midwives also provide essential medical services such as ultrasounds and routine testing, blending medical expertise with individualized attention.
Is it hard to access a midwife and integrate it into my care team?
Grace: In New York, midwifery care can be accessed through self-pay, private insurance, or public insurance. Midwives practice in a variety of settings, including hospital systems and private midwifery groups. Some private midwifery groups may not accept insurance or may provide care at out-of-network rates, so it’s important to check coverage details with your provider and insurer.
Mount Sinai’s midwifery groups in New York City is in-network for many private insurances. to make this care more accessible. Mount Sinai Hospital also has a midwifery service uptown that provides care for folks with public insurance. Patients do not need to pay out of pocket for reproductive health care.
How does Mount Sinai approach midwifery care differently?
Grace: Mount Sinai allows midwives to lead how they provide care. As the first private midwifery practice at Mount Sinai, the team has been given a lot of trust and support.
JJ: Being part of a large hospital system also means midwives have easy access to other specialists and services when needed. Mount Sinai’s midwives provide a small practice feel while being backed by the resources of a large health system. Another important difference is that patients are guaranteed to have a midwife present at their birth with 24/7 coverage.
What else should we know about midwifery care?
JJ: Many people think you have to be pregnant to see a midwife, but that is not true. Midwives care for patients at all stages of reproductive life. This includes general reproductive health visits, menstrual concerns, and gynecological care like Pap smears.
Grace: Midwives also provide care for menopause and perimenopause, which can often be confusing topics. The care model is similar to seeing a nurse practitioner, but focused on reproductive health.