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 eight certified nurse-midwives (CNMs) at University of Iowa Hospitals & Clinics, to answer some common questions about midwifery.

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. We 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.

Physiologic birth is a philosophy that acknowledges that a woman's body knows what to do without too much medical intervention. It is a philosophy that acknowledges the strength and ability of a woman to give birth. Medical interventions are only used if clearly needed and only through shared decision making with women and their partners.

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.

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 UI Hospitals & Clinics, we really have the best of both worlds. We work in collaboration with obstetrics and gynecology physicians who are available at all times. Additionally, we have the outstanding neonatal and pediatrics staff to help your baby get the best start possible. This team approach results 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: 
July 2020

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