Posted on Oct. 10, 2014 (
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:
â€¢ Pre-existing diabetes
â€¢ Poorly controlled high blood pressure
â€¢ Poorly managed chronic conditions
â€¢ 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.
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:
â€¢ They take more time with their patients during office visits
â€¢ They provide more prenatal and women’s health education
â€¢ They connect with the entire family, including the mother’s partner and baby
â€¢ They spend much more time at the bedside of laboring patients
â€¢ 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.
â€¢ Pap smears
â€¢ Breast exams
â€¢ Birth control
â€¢ Perimenopausal care
â€¢ Menopausal care
â€¢ 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.