Midwives as Prenatal Care Providers

I am 19 weeks pregnant, and I am considering switching from my obstetrician to a midwife. Where can I get information on using a certified nurse midwife as a care provider?

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ABOUT THE EXPERT

Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

I may be prejudiced, but the care of a nurse midwife is the best of both worlds. She is prepared in both the disciplines of midwifery and nursing, and consequently brings a unique perspective of normalcy, combined with careful observation, to the birthing experience. She is an advocate for women in all phases of the reproductive health life cycle.

There are over 5,000 certified nurse midwives (CNMs) practicing in the U.S. in a variety of settings. Most practice in clinics and hospitals, but many work in birthing centers and some attend home births. The Directory of Nurse-Midwifery Practices is an easy reference for locating CNMs. To order one or learn more about nurse-midwifery, you should contact:

American College of Nurse Midwives
818 Connecticut Ave. NW Suite 900
Washington, DC 20006
(202) 728-9860
(202) 728-9897 FAX
info@acnm.org

The U.S. Department of Health and Human Services conducted a study of CNMs in 1992 and found that "quality of CNM care is equivalent to physicians' care within their area of competence. Further, they are better than physicians at providing services which depend on communications with patients and preventative action. Judged by the only two measures of outcome available on birth certificates, birth weight and Apgar score, mothers and babies have distinctly better than average outcomes when births are attended by midwives, either in or out of hospitals."

Because CNMs work closely with obstetrician consultants and are highly skilled at identifying deviations from normal, they do not practice beyond the scope of their expertise, which is the normal birthing process. They attempt to keep their clients within the bounds of "normal" by relying on the couples internal strengths and instincts. CNMs do intervene when necessary. They administer pain medication, place and interpret fetal monitors, cut and repair episiotomies if indicated. You can be certain that an intervention was required and alternatives have been considered. When nurse midwives are allowed to care for the majority of women who are experiencing normal pregnancies, obstetricians may focus their energies on what they're best trained to do -- handle problematic pregnancies and births.

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