Midwives are health professionals who are best known for providing critical support and care for many expectant mothers, but their role is often little-known or understood. Patients may wonder if you can have a midwife and an OB/GYN, how their roles differs from a doula, and how to locate a reputable midwife.
In this Q&A, Rochelle Lipshutz, CNM, Clinical Director of Midwifery at The Mount Sinai Hospital, explains how midwives support patients before, during, and after childbirth and discusses how midwives work with consulting physicians at Mount Sinai to offer integrated care.
What is a midwife?
Midwives are licensed independent health care providers, meaning they provide care without the supervision of a physician. Certified nurse midwives are trained in both nursing and midwifery while certified midwives have graduated with a master’s-level degree in midwifery but do not have nursing training.
They offer a full range of reproductive and primary health care services for patients from adolescence through menopause. These services include independent provision of primary care, gynecological care, and family planning services; preconception, pregnancy, and postpartum care; and care of healthy, full-term infant for the first 28 days of life.
What is the difference between a midwife and a doula?
Both midwives and doulas are trained professionals. Midwives care for clients throughout the life cycle, especially during prenatal care, delivery, postpartum care, and gynecological care as well as primary care. Doulas provide non-medical physical, emotional, and informational support to a woman before, during, and shortly after the process of childbirth. A doula is an additional support during the birth process who—like a midwife—helps a woman achieve the healthiest, most satisfying experience possible.
If you are interested in working with a doula, Mount Sinai has partnered with Oula, a modern maternity care center that provides similar care.
Do midwives only provide services for child birthing?
Midwives are best known for attending childbirth. But that is not all they do. About 76 percent of midwives provide reproductive care and about 46 percent offer primary care. Reproductive care can include annual gynecological exams, Pap smears, and prescriptions including contraceptive methods, patient education, and reproductive health visits.
Midwives also treat the partners of patients in cases of sexually transmitted infections. They can also diagnose and offer initial and ongoing comprehensive care for many common health care problems as well as admit, manage, and discharge patients from hospitals. When appropriate, midwives prescribe use of medical devices, such as breast pumps. Midwives also promote health education, disease prevention, and personal wellness programs to patients and their families. They work in a variety of settings, including ambulatory care centers, hospitals, community and public health care arenas, and homes and birth centers.
What benefits do midwives offer?
Midwives are experts in ‘normal.’ For the most part, they respect and enjoy observing the natural birth process. Midwives encourage women to use their inner strength to cooperate with this process. If a woman in labor requests pain relief, midwives support her decision-making skills. In fact, the relationship between the midwife and patient focuses on shared decision making. If medical intervention is necessary, midwives will discuss the risks, benefits, and any alternatives. Together, midwives and patients reach a decision that will guide the care in a safe and comfortable manner. And, if necessary, the midwife will work closely with doctors and nurses to ensure safety throughout the birthing experience.
How do doctors and midwives work together?
Midwives participate in hospital births as well as home births and those at birth centers. In general, the midwife will focus on basic care, however, if complications develop, the midwife will work with the physician to ensure a comfortable, rewarding, and safe experience.
How do I find a midwife?
Midwifery services are available at The Mount Sinai Hospital and Mount Sinai West. Additionally, the Mount Sinai Health System partners with several well-established local midwifery groups including Central Park Midwifery, Community Midwifery Care, and Nettle Wellness.
You can also check with the American College of Nurse-Midwives to find a local midwife. This national organization lists midwifery practices and private groups in most communities. Many patients go by word of mouth. In addition, many websites that focus on local reproductive care provide information about midwives.