What Can a Midwife Do?

The TV series “Call the Midwife” raised the profile of these crucial clinicians, who number more than 13,500 and attend about 10 percent of all births in the United States every year, according to the American College of Nurse Midwives (ACNM).

“Most people aren’t aware of the broad array of duties a midwife can undertake,” says Carole Shipman, RN, CMN, a certified nurse midwife at Pascack Valley Medical Center. “Midwives view prenatal care, birth and postpartum as a normal, natural process.”

Indeed, midwives do far more than deliver babies.

They also provide comprehensive care that spans a woman’s reproductive health, like:

• Prenatal care like ultrasounds, blood work and routine monitoring
• Post-birth checkups and physical examinations, assisting with emotional and physical recovery:
  • Screening for postpartum depression
  • Caring for vaginal tears or c-section wounds
  • Urination problems
  • Reproductive care like birth control options, pap tests and screenings for sexually transmitted infections
  • Treatment for vaginal and urinary tract infections

Some also offer newborn care in the weeks after an infant is born, including:

• Help finding a pediatrician
• Lactation consulting

Understanding the Role of Midwives

Many women first seek a midwife while pregnant because they desire a more “natural” birth experience that’s free of interventions. But choosing a midwife doesn’t mean you must have a home birth—although that’s an option—or can’t decide to induce labor or manage pain with an epidural or other form of anesthesia.

Many women, in fact, prefer a hospital or health care setting while their midwife monitors them during labor, manages any complications and helps deliver the newborn and placenta. Doctors can be on hand if needed or desired, and Carole’s practice collaborates with obstetricians to see each of her patients at least once during their pregnancies. Not all midwives, however, collaborate with obstetricians. 

“When you work with a midwife in collaboration with an obstetrician, you still have the same options and all the same treatment capabilities available for maternal care,” Carole says.

What are two things midwives can’t do?

1. They can’t perform cesarean section surgery to deliver babies, but they can assist at such births. Carole, however, routinely stitches up any tearing around the vagina or perineum that occurs during a vaginal delivery, or can perform an episiotomy when needed (a small cut to allow the baby’s head to pass through more easily).
2. Midwives can prescribe epidurals, but can’t administer them. Epidurals are performed by an anesthesiologist.

“Midwives can offer custom, personal care for pregnancy and birth. If you have any health conditions like high blood pressure or have had a high-risk pregnancy, we encourage building a team with your midwife and an obstetrician,” she says.

Midwives vs. Doulas

Another misconception Carole often dispels centers around the role of midwives compared to doulas. While the two have some overlapping duties, there’s one key difference:

• Midwives provide medical care, and their chief responsibility is to maintain the physical health of a woman and her baby. Not all midwives are also nurses, as Carole is, but all have medical training.
• Doulas, on the other hand, don’t perform clinical tasks. Doulas mainly offer support during labor and birth, helping women remain calm and comfortable by providing hands-on massage and offering suggestions on optimal positions for labor and pushing.

“Midwives and doulas are both professionals, but a doula doesn’t need to have any medical education,” Carole says. “They are there to offer the woman any emotional and physical support she needs. But midwives take medical responsibility for the mother and baby.”

Tips for Seeking Care From a Midwife

If you’re interested in seeking care from a midwife, Carole offers this guidance:

• Check with your health insurer to determine if midwife services are covered.
• Visit the ACNM website to learn more about midwives and how their care aligns with your needs.
• Interview any midwives you’re considering.
• Prepare a list of questions for midwives to determine if they’re a good fit for your needs. Questions can touch on factors such as the birth experience you’d prefer or a midwife’s schedule and availability.

Next Steps & Resources:

• Learn more about maternity services available at Pascack Valley Medical Center

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.