Around the world, up to 80 percent of babies are born with the help of midwives. The percentage isn’t quite as high in the U. S., though the numbers are on the rise. While the profession of midwifery has evolved with modern health care, misperceptions persist based on centuries-old images or misunderstandings. UR Medicine certified nurse midwife Michele Burtner sorts out facts from some of the fiction.
MYTH: Midwives only provide care for pregnancy and childbirth.
FACT: Along with care during pregnancy and birth, midwives also provide well-women gynecological care across a woman’s life span, including contraception, preconception planning, annual exams, gynecologic issues, and referrals for laboratory testing and radiology such as mammograms and pelvic ultrasounds.
MYTH: You and your baby won’t be as safe with a midwife as you would be with a doctor.
FACT: Midwives complete extensive training to provide safe care to expectant moms and their babies. It’s important to choose a certified nurse midwife (CNM), which indicates a midwife has specialized training in maternity and routine gynecologic care. CNMs are independent health care providers. They also work with other members of the health care team, such as physicians and nurses, to provide the highest quality care.
MYTH: Midwives won’t allow women in labor to get an epidural or take pain medicines.
FACT: Midwives partner with women to develop a birth plan that fits their personal needs and to explain pain relief options, which include medications. Midwifery patients choose from numerous pain management techniques in labor, some of which are hydrotherapy (using a Jacuzzi tub), movement during labor, relaxation techniques, narcotics, and epidurals. Midwives are leading experts in how to cope with labor pain.
MYTH: If you have a midwife, you have to have a home birth.
FACT: While some midwives attend to women during home births, many work in hospitals that support midwifery care. These hospitals offer choices for women and their families, including natural, low-intervention childbirth or higher-level evaluation and medical monitoring if needed.
MYTH: Midwives are opposed to medical technology and won’t work with doctors.
FACT: Certified nurse midwives work with all members of the health care team, including doctors. Midwifery care fits well with the services provided by obstetrician-gynecologists who are experts in high-risk pregnancy, medical complications and surgery. If a high-risk condition arises, a midwife will consult with a doctor or make a referral. When a woman needs a cesarean birth, the doctor performs the surgery but the midwife remains part of the care team through recovery and post-partum care.
MYTH: Midwives and doulas are the same thing.
FACT: Doulas are trained, non-medical professionals who provide physical and emotional support during labor, delivery and after childbirth. Some women choose to have a doula as part of their care team. Midwives provide support too, but are also responsible for monitoring the health of mother and baby during labor, providing information about progress, giving options or advice related to labor, discussing medical decisions as needed, and delivering the baby.
MYTH: Insurance may not cover a midwife’s services.
FACT: All forms of insurance in New York state cover midwifery care. In some cases, a referral is required. It’s a good idea to contact your insurer’s member services department to confirm your coverage and find out if you need a referral.
Michele Burtner, CNM, MS, IBCLC, is director of the UR Medicine Midwifery Group and has been a midwife for 12 years. Originally from western New York, she trained as a midwife at Oregon Health and Science University. She specializes in normal pregnancy, birth, gynecology care and has a special interest in breastfeeding.