By Missy Moore, APRN-CNM, APRN-CNP
Midwifery, Blanchard Valley Obstetrics & Gynecology

Although midwives have been around for hundreds of years, the term midwife is one that not many are able to clearly define. There is often confusion surrounding the many types of midwives and the span of roles a midwife might play. 

Certified Nurse-Midwives (CNM) are highly trained providers who first are educated and trained as registered nurses, then choose to attend accredited universities, followed by passing a midwifery board-certified examination. CNMs also must maintain their licensures every five years by completing a number of continuing education requirements. In Ohio, CNMs work in collaboration with physicians and deliver babies in hospitals and birth centers. In contrast, lay midwives learn their skills through apprenticeship and are not legally recognized by the state they practice in and deliver babies in homes.

Certified Nurse-Midwife is the profession to which the term “midwife” in this article is referring. Midwifery is a profession of individuals who provide healthcare for women across their lifespan, specializing in obstetric and gynecologic care, including pubertal and menopausal concerns, annual preventative appointments, contraception or sexual health concerns, and reproductive concerns. However, midwives are most widely known for their role in delivering babies.

Regarding labor and delivery, midwives are trained in non-intervention and watchful waiting and also specialize in nonpharmacological methods of pain relief like hydrotherapy, massage, and movement and repositioning. They also promote maternal-fetal bonding in all safe circumstances and often are competent in providing some lactation aid as well. 

Mostly, midwives attend normal or low-risk deliveries but are capable of anticipating problems when possible, treating certain complications, and deferring to a physician when necessary. Midwives do not perform cesarean deliveries or assistive deliveries with the use of vacuum or forceps. They do, however, share a collaborative relationship with their physician colleagues who are readily available to them when situations arise that are beyond the scope of a midwife.

What is unique about midwives is their philosophy of care. Midwives believe that women are powerful and strong, and their health is important not only to the individual but also to the well-being of their families and communities. They also support basic human rights for everyone and feel that the normalcy of lifecycle events, like pregnancy, should be honored. Compassionate health care, which is a partnership between midwife and patient, is a gold standard of midwifery care. 

Midwives also acknowledge that working with other healthcare professionals helps promote optimal care and that lifelong learning and development as providers are critical to competent and ethical practice. 

Midwifery care has also been associated with decreased cesarean section rates and increased breastfeeding rates.