Ask an Expert: Should I Consider a Midwife?

Laura Dellos in clinicBy definition, a midwife helps deliver babies. However, midwives’ roles, and the services they provide, can vary quite a bit. We asked Laura Dellos, an advanced registered nurse practitioner and one of seven certified nurse midwives at University of Iowa Hospitals and Clinics, to answer some common questions about midwifery.

How would you explain the different types of midwives?

Midwives who are licensed in Iowa are called certified nurse-midwives (CNMs). Most CNMs ‘catch’ babies in hospitals. Some CNMs do provide home-birth services, but most home-birth midwives are called certified professional midwives (CPMs) and direct-entry midwives. CPMs do have a standardized process to certification, but neither group has an academic requirement. They are not legal in every state and have no prescriptive authority.

You may have also heard of a doula. A doula does not replace your care provider, but serves as a childbirth coach who can offer extra support services to women throughout the birth process.

What services do certified nurse midwives provide?

A common misconception is that CNMs only provide prenatal care and deliveries. CNMs also provide gynecological care for annual exams and common gynecological problems, and they provide contraceptive management services.

How would you describe the philosophy behind midwifery care?

Our model is high-touch, low-tech. Our focus is on listening to women so that we best understand their needs. We want to support them so they can have the best possible outcome and achieve a sense of empowerment. I believe this happens when women have self-determination and active participation in their health-care decisions. We value individualized methods of care and healing guided by the best evidence available. Through “watchful waiting” and minimization of interventions, we support the normal physiologic process of birth.Who is a good candidate for midwifery care during pregnancy?

A good candidate would be a woman without significant medical problems who may be interested in getting more time and education from their provider. Since midwives care for a healthy population, we can really focus our time on educating and building trusting relationships with our patients.

Why should a woman consider a midwife for her pregnancy and delivery?

At University of Iowa Hospitals and Clinics, we really have the best of all worlds to offer. We work in collaboration with our physicians, where the responsibilities for care can be shared. If for some reason we need to get a physician involved, we have experts in high-risk pregnancy care right around the corner. This kind of team approach has resulted in successful outcomes and satisfied patients.

What advice would you give somebody who is considering a midwife for her pregnancy care?

My advice is to read, research, talk with friends, and come in to meet us. Before choosing a place to give birth, take a tour and ask questions like, “How is normal birth is supported here?” Any place that has a midwifery service is most likely supporting normal, physiologic birth.

Last Reviewed: 
September, 2016