Childbirth Choices :: Choosing a Care Provider
OB/GYNs | Family Practitioners | CNMs | CPMs | CenteringPregnancy
Certified Nurse Midwives, or CNMs, are registered nurses who have completed an additional graduate course of study in the care of healthy mothers and babies during the perinatal period.
According to the UNC Midwifery Practice website, “The safety and benefits of care given by CNMs has been well documented in the research literature. Nurse-midwives have a strong record of reducing rates of low-birth weight, prematurity, and neonatal death (Journal of Epidemiology and Community Health, 1998) as well as preventing complications. According to the American Journal of Obstetrics and Gynecology, ‘Mothers and babies have distinctly better than average outcomes when births are attended by midwives.’ (1993). Nurse-midwifery care and services are covered by most major insurances including HMOs, indemnity plans, and Medicaid.”
Many people have misconceptions about midwives—like “you can’t get an epidural if you have a midwife”. This is simply not true. Certified nurse midwives are very capable and competent care providers who work independently to manage the care of healthy women. If complications arise that require a cesarean, CNMs work collaboratively with obstetricians to ensure that mothers get the care they need. The benefit of having a midwife, even if you need a cesarean, is that you get “two-for-one”—your midwife will stay with you and coordinate your care, while you have an obstetrician present to handle any surgical needs.
In our area, there are several different types of CNM practices:
- hospital-based groups with 24-hour “on-call” services,
- hospital-based groups of CNMs who work alongside physicians (without a midwife available 24/7),
- birth center-based groups with 24/7 midwifery care, and
- single midwife home birth service.
When you choose a group midwifery practice, you will see all of the midwives during your prenatal care, and whichever midwife is “on-call” during your labor will attend your birth, whether in the hospital or birth center. If the group does not have “24/7” coverage, then a physician who is affiliated with the group (and who therefore supports midwifery care) will attend your birth instead.
An individual midwife service, on the other hand, is just one midwife, who will provide all of your prenatal care and be on-call for your birth. This type of practice is much less common—since it’s hard for the midwife to be in practice alone—but many women prefer to have this one-on-one relationship with their midwife and know that she will be there for their birth.
For more on certified nurse midwives, visit myMidwife.org.
Group midwifery practices in our area with 24/7 services include:
Group midwifery practices who work with physicians (not 24/7 midwifery coverage) include:
- Duke Nurse Midwifery Service, 919-681-1598
Individual homebirth CNM practices include:
- Nancy
Harman, CNM
www.midwifewisdom.com
nwharman@gmail.com