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Midwife or OB? How to decide which is right for you

Posted on Oct. 10, 2014 ( comments)
A growing number of women are turning to certified midwives (CMs) or certified nurse midwives (CNMs) for personalized prenatal, labor, delivery and gynecological services. 
Is a midwife the right option for you? Here are a few things to consider.

Midwife vs. OB/GYN: What’s the difference?

Midwives are trained experts in closely monitoring normal pregnancies, including labor and delivery. CNMs may also prescribe medications, including epidurals. 
Unlike obstetrician/gynecologists (OB/GYNs), midwives are excluded from treating pregnant women with:
• Pre-existing diabetes
• Poorly controlled high blood pressure
• Poorly managed chronic conditions
• Any other condition that puts the pregnant woman at high risk.
Some CNMs manage vaginal births after cesarean (VBAC). They may also perform limited, in-office ultrasound exams. (At MultiCare, only OB/GYNs can provide VBAC care.)
Caesarean sections and forceps deliveries are only performed by OB/GYNs, often with assistance from CNMs. Typically, only OB/GYNs perform suction-assisted deliveries, but some CNMs also perform them.

Midwife certifications 

Certified nurse midwives are registered nurses who have graduated from a nurse-midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME) and have passed a national certification examination. 
Certified midwives are individuals who have a background in a health-related field other than nursing and have graduated from a midwifery education program accredited by ACME. Graduates of an ACME-accredited midwifery education program take the same national certification examination as CNMs.

Why choose a nurse midwife?

Women turn to midwives for multiple reasons. 
“My patients tell me they feel that I’m more of a partner in their care,” said Advanced Registered Nurse Practitioner Jodee Gutierrez, a certified nurse midwife at MultiCare Women’s Center in Gig Harbor. 
Other commonly cited reasons for choosing nurse midwives:
• They take more time with their patients during office visits
• They provide more prenatal and women’s health education
• They connect with the entire family, including the mother’s partner and baby
• They spend much more time at the bedside of laboring patients
• They offer coaching and support during labor.

Working together for healthy women and newborns

Although MultiCare CNMs have their own independent medical practices, they share offices with OB/GYNs and are required to have a back-up OB/GYN on-call whenever they deliver a baby. 
Conversely, if a woman goes into labor and her OB/GYN is unavailable, a CNM is called in first, as long as the woman is beyond her 34th week of pregnancy, is free of complications and hasn’t asked to be attended by a doctor. 
"Sometimes, for whatever reasons, a normal labor gets more complicated. “When that happens and a C-section becomes necessary, my back-up OB is just a phone call away,” said Gutierrez.

Beyond birthing babies

In addition to OB care, CNMs provide a full complement of gynecological care for patients ranging from pre-adolescent girls to post-menopausal women. 
Services include:
• Pap smears
• Breast exams
• Birth control
• Perimenopausal care
• Menopausal care
• Colposcopy (a cervical biopsy performed as a follow-up to an abnormal pap smear).
Caring for women before, during and after their childbearing years is a labor of love for Gutierrez. 
“Every woman’s experience is different and I get to share in that — and in the joy of a good outcome,” she said.
More information
Currently, our nurse-midwifery services are offered at MultiCare Women's Health & Wellness Center at Gig HarborMultiCare Women's Center - Bonney LakeMultiCare Women's Center - Northshore Clinic MultiCare Women's Center - PuyallupMultiCare Women's Center - Tacoma and MultiCare Women's Center - Auburn. Today you can choose to be seen by an OB/GYN or a Certified Nurse-Midwife who collaborate and see patients within the same practice.
All MultiCare midwives deliver babies at Tacoma General Hospital’s Family Birth Center, with the region’s only Level IV Neonatal Intensive Care Unit.
Posted in: Tacoma | Women's Health
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