Frequently Asked Questions About Midwifery
Champlain OB/GYN is excited to add Certified
Nurse Midwifery care to our practice. All changes bring questions, so we’ve
asked the Fletcher Allen midwives to answer a few commonly asked questions.
I’m confused, I thought midwives delivered
babies at home. Do they deliver babies
at Fletcher Allen?
Many people think “home
birth” when they hear the word “midwife,” and are surprised to learn that
midwives deliver babies in the hospital. In fact, Certified Nurse Midwives
(CNMs) have practiced at Fletcher Allen for over forty years, and have
delivered thousands of babies in Fletcher Allen’s Claire
M. Lintilhac Birthing Center! The
Fletcher Allen midwife team is available 24/7 and provides prenatal, postpartum
and well-woman care in the office, and labor, birth and initial postpartum care
in the hospital.
Most midwife-attended births
in the United States take place with Certified Nurse Midwives in hospitals,
just like at Fletcher Allen. CNMs are
healthcare professionals who specialize in assisting normal, uncomplicated
births. They are Advanced Practice Registered Nurses with graduate education in
midwifery. They have graduated from an accredited nurse-midwifery education
program, which includes a university degree as well as hands-on clinical
training by practicing CNMs. They also have passed the national certification
exam of the American Midwifery Certification Board (AMCB). In
Vermont most home birth midwives are either Certified Professional Midwives or
Naturopathic Doctors, who go through different education and certification
processes.
Why would a woman choose a midwife?
Many women choose to give
birth with the help of midwives because of a desire for individualized care and
a unique birthing experience. The word “Midwife” literally means “With Woman.” The midwifery model of care is evidence-based,
promotes listening to women and respecting their desires, and minimizes the use
of medical interventions unless necessary or requested by a woman. Midwives
believe a woman and her family deserve the knowledge they need to make good
health choices for themselves. A midwife does not simply tell a woman what to
do, since what is right for one person may not be right for the next. Instead, a
midwife offers information and helps each woman decide what is best for
her and her baby, building a healthcare relationship grounded in trust and
respect.
Midwifery care also produces improved
health outcomes. National research indicates that women who choose a Certified
Nurse Midwife have lower rates of induction of labor, cesarean birth, and
perineal trauma, and higher rates of breastfeeding. CNMs can prescribe medications and order
diagnostic procedures when appropriate and medically indicated.
Midwives use the same
schedule of prenatal appointments and routine testing in pregnancy, but they tend
to spend more time with women during prenatal visits, and more time by a
woman’s side in labor – supporting her and watching for any health
concerns. They provide exceptional, individualized care to women across
the lifespan, through pregnancy, birth, postpartum and beyond.
What
if I have a complication that requires an obstetrician?
As a practice based in an academic medical
center, the Fletcher Allen Nurse Midwives collaborate seamlessly with Obstetricians,
Maternal Fetal Medicine specialists, and Pediatricians when needed. If a woman
has a complication during pregnancy, the midwives will consult with
collaborative obstetricians at Champlain OB/GYN and Fletcher Allen. During
labor or prenatal assessments in the birthing center, they may consult with Fletcher
Allen Obstetricians, who are available in the hospital 24/7. If need arises for a cesarean, vacuum or
forceps-assisted birth, a midwife stays with the woman and her family in a
supportive role, and a Fletcher Allen Obstetrician delivers the baby.
Do
I have to have an un-medicated birth if I use a midwife? I think I might want
an epidural.
Midwives offer a variety of
pain relief options in labor, including massage, relaxation, use of a tub, and
epidural anesthesia if desired. Using a midwife does not mean a woman must
have un-medicated childbirth. Approximately 45% of Fletcher Allen midwifery
patients desire or need some form of anesthesia during their births, and
epidurals are readily available.
I’m
hoping for a natural childbirth. Will a midwife stay with me in labor to help
me get through it?
One of the hallmarks of midwifery is labor
support. The Fletcher Allen midwives set up their call days in 24-hour shifts
to help provide continuity of care during long labors, and have the next day
off so they are able to stay up to provide support. Midwives are directly
involved providing care during labor, encouraging movement and position changes
to promote labor progress, and using hands-on support, hydrotherapy, and gentle
words to guide pain coping. The Fletcher Allen midwives stay attuned to their
staffing and their total number of patients so they can provide direct support
as much as possible, when desired.
If you have additional concerns please talk with
us at your prenatal visits! The birth of
your baby is also the birth of you as parents and the growth of your
family. Sometimes navigating this transition
can feel overwhelming. The Doctors and Midwives want you to feel safe,
supported and informed about your care.
