Questions to Consider when Using a Midwife

Pregnancy is an exciting experience for couples. With the anticipated birth, many preparations are made in both prenatal care and also postnatal care. For some women, the decision to use a nurse midwife, rather than an obstetrician, is becoming increasingly more common in recent years. Before choosing a midwife, there are considerations and issues of concern that should be addressed early in pregnancy.

Traditionally, a nurse-midwife is a certified nurse who has pursued an education, and certification, in midwifery. With the certification of midwifery, the certified midwife is, essentially, authorized to provide prenatal care, care during labor and deliver and postpartum care immediately after birth. Additionally, with education and certification, the nurse-midwife is also permitted to provide family planing care and gynecological care to women of child bearing age. When considering the use of a nurse-midwife, women should understand the approach to prenatal care, labor and delivery, are considered very low tech with very little intervention in terms of ultrasounds and other various testing provided in the traditional obstetrician's office. This is not to say, however, that these services are not available; they are simply not common practice.

When considering the use of a nurse mid-wife, special consideration should be made in the aspects of prenatal care including the dynamics of the individuals you will see especially in larger clinical practices where multiple nurse-midwives may be present. Also, when interviewing a nurse-midwife, find out how accessible she will be during after hours and hours she is not normally scheduled to work. Is she available for phone consultations?

Of even greater concern is the nurse-midwife's relationship and agreement with an obstetrician. For many nurse-midwives, there is an agreement with a supervising obstetrician who will not only supervise the health services of the midwife but also agree to accept you as a patient when, and if, complications arise. When this relationship exists, interviewing and meeting with this obstetrician is also important. When no such relationship or agreement is available, discuss options with the nurse-midwife as you want to be sure there is an obstetrician who is willing to accept your pregnancy when, and if, a complication arises, even if this is late in the pregnancy.

Another issue of concern, and very similar to the complications associated with the obstetrician relationship, involves the connection of the nurse-midwife to a hospital setting. While birthing at home or in a birthing center is common with a nurse-midwife, when a complication arises, care is often required in a hospital setting. So, for this reason, inquiring of the hospital privileges of a nurse-midwife is crucial to ensuring she is able to remain with you in the event you require hospital services before and during your labor and delivery.

And, finally, check out the certification and credentials of your nurse-midwife. Through local certification programs, you can obtain information regarding the nurse-midwives considered the best in their field. Checking the professional background of the nurse-midwife will provide one additional measure in which to ensure you are receiving the best possible prenatal care for both you and your baby.