Mainstream midwives
Practice no longer only in home
By JAN JARVIS
Associated Press
Article Last Updated: 04/23/2008 01:39:29 AM PDT


FORT WORTH, Texas — Some women want a Jacuzzi. Others prefer having a birth ball handy. And many simply want all of their relatives by their bedside.
More and more mothers-to-be are having babies their way, with the help of a midwife who is there to do as much or as little as the woman wants.

Although midwives have been delivering babies throughout history, their role has evolved over the years. Gone are the days when midwives worked only in homes, helping women have babies the natural way. Today the practice has expanded to include birthing centers and hospitals.


Certification needed|


In Texas, only certified nurse-midwives — who represent the majority of practitioners — are allowed to deliver babies in a hospital. Certified nurse-midwives must have a bachelor's degree and complete an accredited nurse-midwifery program. In 2006, there were 15,679 births attended by certified nurse-midwives in Texas.

In Tarrant County, Texas, for example, midwifery has been growing steadily for more than a decade with the biggest growth over the last six to eight years, said Sharon Lloyd, a certified nurse-midwife with the Midwife Center, which opened in January at Baylor All Saints Medical Center's Andrews Women's Hospital.


Growing profession|

The profession has seen a lot of growth, as the public has learned more about the role of midwives and as women seek out a more holistic, family-centered approach to health care, said Kathleen Donaldson, a certified nurse-midwife with UNTHealth who works with Harris Methodist Fort Worth Hospital.
"The more women are educated, (the more) they are not just settling for the status quo for their women's wellness examination and childbirth experience," she said.


Vital questions|


Here, we answer 10 vital questions about midwives today:

1. What is a midwife?

Midwives are trained to support a woman during her pregnancy, childbirth and the postpartum period.

They see labor as a natural process for healthy women.

2. How long have midwives practiced in the United States?

Native Americans had midwives in their tribes. Midwives also played an important role in the colonies. But over time the practice faded away. In 1915, 40 percent of all births were attended by midwives. By 1935, the number of had decreased to 10.7 percent. Nurse-midwifery never went away entirely, but it wasn't until the 1970s that the profession experienced a rebirth. Today, midwives serve in cities and rural communities throughout the country.

3. If you choose a midwife for birthing, when do you begin working with her?

A woman should begin seeing a midwife as soon as she knows she is pregnant, or sooner. Nurse-midwives also provide routine gynecological care.

4. What are the different types of midwives?

· Certified nurse-midwifes must have a bachelor's degree and complete an accredited nurse-midwifery program. They can practice in hospitals, are licensed in all states, can prescribe medications and are certified by the American College of Nurse Midwives.

· Certified professional midwives are trained in midwifery and meet practice standards set by the North American Registry of Midwives.

· Direct-entry midwives include those who are licensed and lay midwives. They are trained through self-study, midwifery school or apprenticeship. They often practice in homes or birthing centers.

5. What are the advantages of having a certified nurse-midwife attend a birth in the hospital?

The environment is close to being at home but within the confines and safety of a hospital, said Kathleen Donaldson, a certified nurse-midwife with UNTHealth who works with Harris Methodist Fort Worth Hospital. Women who deliver with a nurse-midwife have more choices, including labor positions and IV use during labor. A midwife typically uses natural methods, such as backrubs, to curb pain.


Stays at her side|


6. What are some of the differences between a midwife-attended birth and a physician-attended birth?

A midwife will stay by the woman's side throughout the delivery. They are generally able to spend more time with their patients and sit by a woman's bedside during labor, Reedy said. Their role is to provide support throughout labor and delivery.

7. Why would a woman chose a midwife to deliver her baby?

When Otishae Womack, 20, was pregnant with her first baby she wanted to follow her sister's lead and have a midwife attend the birth. The Fort Worth woman gave birth in February at Baylor All Saints Medical Center. Having a midwife available to answer questions and offer guidance made a big difference, Womack said. "I feel very comfortable knowing they are caring for me and my baby," she said.

8. What do certified nurse-midwives do besides deliver babies?

Nurse-midwives take care of women throughout their life, Donaldson said. They can do everything from a young woman's first pelvic exam to menopausal counseling. They also spend a lot of time on education and prevention of disease.

9. Do nurse-midwives and licensed midwives take insurance?

Most private insurance groups cover nurse-midwifery care. Nurse-midwives are eligible for Medicare/Medicaid reimbursement. Licensed midwives may be covered. Direct-entry and other types of midwives often work with people who have no health insurance. They charge a flat fee that is typically at least $5,000 less than a hospital birth.

10. How safe is a home birth?

Home births are considered safe for low-risk healthy women, and offer advantages including a lower risk of infection and unnecessary intervention

Sources: American Pregnancy Association, North American Registry of Midwives, American College of Nurse-Midwives, UT Southwestern Medical Center.

Source of article: http://www.montereyherald.com/ci_9023913?source=email