When you find out you're pregnant you are faced with many choices. One of those choices is whether to have a physician or midwife care for you during your pregnancy and birth.
Depending on where you live, you might think that only physicians care for women in pregnancy. But, midwives are a safe choice for most women.
In the U.S., certified nurse midwives and certified midwives attend 8 percent of births and the rate is about 12 percent if you look at just vaginal births. In Utah, midwives attend about 10 percent of births.
Celeste Thomas, CNM, with Intermountain Healthcare says typically, midwives allow more time during prenatal visits and can also provide additional support during labor and birth.
Midwives provide the same prenatal screening tests physicians do, including lab tests, ultrasounds, blood pressure checks, and monitoring for complications.
Midwives generally have the philosophy to use interventions judiciously. For example, they may not break your bag of waters to speed up the birth process as long as labor is progressing normally.
Midwives will typically intervene as needed. They can prescribe medications and use medications to induce labor. They care for women who are laboring with or without epidural anesthesia for pain relief, and they may recommend a Caesarean section be performed.
Midwives generally don't do a routine episiotomy or order a routine hydration IV, although an IV may routinely be placed for emergencies. They allow moms to eat and drink during normal labor if they desire.
There are many ways to become a midwife and the laws are different in different states. In Utah, Certified Nurse Midwives (CNMs) earn their bachelor's degree and become registered nurses first, and then go on to receive a Master's or Doctorate degree in nurse midwifery. Nationally, 98 percent of certified nurse midwives deliver in hospitals.
In Utah, only certified nurse midwives have privileges at hospitals.
If you prefer to deliver in a hospital, find out if your midwife is licensed to do so. Ask questions, share your birth goals and health history to find a provider who can attend to your specific needs.
If you are considering a midwife who practices outside of the hospital, learn about their certification and licensure, and find out what the conditions are for transfer to a hospital.
There are many studies that show that midwifery care for healthy pregnant women is as safe or even sometimes safer than physician-led care. Midwifery care is cost-effective, because it results in fewer unnecessary interventions such as Cesarean section. Preterm birth rates are also lower in women who receive their prenatal care from a midwife.
Midwives provide general women's care and can manage some complications during pregnancy
Midwives may care for you if you have a health problem that arises before or during your pregnancy, whether independently or jointly with an OB/Gyn or maternal fetal medicine specialist.
There are midwives who work collaboratively with physicians to jointly care for women with high risk chronic conditions such as Type 1 diabetes, high blood pressure, or autoimmune diseases. Midwives can attend births for women who have had a previous Cesarean birth.
Midwives aren't just for pregnancy and birth. You can also see a midwife for general women's primary care and gynecological issues such as pap smears, annual exams, birth control and family planning, immunizations and breast exams. Midwives care for women throughout the lifespan, from puberty to menopause and beyond.
Intermountain Healthcare is committed to making sure you and your baby have the safest birthing experience possible. They're taking every necessary precaution against exposure to COVID-19 to ensure the risk is extremely low. They've also prepared for any other potential complications of pregnancy. For most healthy women, their delivery experience will be the same as before the pandemic, except caregivers and support people are wearing masks or personal protective equipment.
Currently, all Intermountain hospitals allows moms in labor (who are not COVID-19 positive) to have two designated visitors at the bedside during delivery. Visitors should be prepared to stay in the labor suite until after delivery, and one of the two visitors will need to exit the facility shortly after delivery. A doula is considered one of the two designated visitors.
Moms who are COVID-19 positive may have one visitor during delivery. Their hospital staffs are ready and prepared to care for you and your baby safely if you have COVID-19 symptoms, are COVID-19 positive or are awaiting COVID-19 test results. They have care protocols and personal protective equipment to keep everyone safe and healthy.
Intermountain Healthcare has midwives at locations near Intermountain Medical Center, and Alta View, Riverton, and Layton Hospitals. For more information, visit intermountainhealthcare.org.
You can also learn more about Alta View Women's Specialists here, Intermountain Medical Center Nurse Midwives here, Layton Parkway Nurse-Midwives here, and Midwives at Riverton's Southridge OBGYN here.