CHOOSING A MIDWIFE
"In every country where I have seen real progress in maternity care, it was women's groups working together with midwives that made the difference." -Marsden Wagner, MD, MSPH
TYPES OF MIDWIVES
A Certified Nurse Midwife (CNM) is a University education at a Master’s level for the Advanced Practice Nurse/CNM. A Certified Professional Midwife (CPM) has received less formal training through sources such as apprenticeship, workshops, correspondence courses, reading, self-training and experience, then successfully passes the North American Registry of Midwives exam. While the State of Oklahoma does not provide licensing or certification or even acknowledges CPMs, many other states are acknowledging CPMs as a viable option as qualified providers.
THE FACTS ABOUT CHILDBIRTH IN THE UNITED STATES
Resource: Citizens for Midwifery Fact Sheet “Midwives” – www.cfmidwifery.org
• Standard U.S. maternity care is big business, with many unnecessary interventions:
About 4 million births per year.
About 6 million obstetrical procedures, primarily on healthy women in normal labor.
Includes 4 of the 8 most common surgical procedures in the U.S.
• Midwives are key to affordable and effective maternity care in universal health care
systems, as many countries have discovered including: England, France, Germany,
Netherlands, Denmark, Sweden, Norway, Finland, Spain, New Zealand, Australia, Japan,
• Every country in the world with maternal and infant mortality rates lower than the U.S. has
universal health care AND midwives attending the majority of births.
• Midwifery care is cost effective compared to physician care:
Midwifery training costs less.
More full term, full weight, and healthy babies not needing special care.
Fewer costly and risky interventions.
• Pregnancy and childbirth are normal processes, not diseases. Contrary to widespread
beliefs, expensive and interventive doctor care and hospitalization are rarely needed.
• The Midwives Model of Care is health-promoting – an evidence-based wellness model
that improves birth outcomes and is mother-friendly and baby-friendly.
• The American Public Health Association supports “increased access to midwifery
services,” and “efforts to increase access to out-of-hospital maternity services … through recognition that legally-regulated and nationally certified direct-entry midwives can serve clients desiring safe, planned, out-of-hospital maternity care services.” (APHA
Resolution Increasing Access To Out-Of-Hospital Maternity Care Services Through State-Regulated and Nationally-Certified Direct-EntryMidwife,” October 24, 2001)
Consumers are directly affected by all health care policies!!!
CONSUMERS must be included at every level of health care policy development!
WHO IS QUALIFIED FOR A HOME BIRTH / BIRTH CENTER BIRTH WITH US?
We want you to make the decision to have a homebirth an educated decision and
take the responsibility involved. Homebirth has proven to be a safe alternative for low risk
birthing women. Women have given birth in their homes for centuries; however, as with life in general, there is always the chance of the unexpected. If at any time you feel you need to be in the hospital, please let us know. We would never encourage any woman to deliver in an environment that makes her feel unsafe or uncomfortable. Homebirth is a safe alternative for the vast majority of women, but it is not for everybody. You have to decide what is best for you.
We also believe both parents should be in agreement with the decision to give birth at home. You will be expected to transfer to the hospital should circumstances come up that make you high risk or that the midwives feel are outside of their ability to take care of. You will be expected to follow a healthy diet, prenatal vitamins, appropriate exercise, and frequent prenatal care.
AN INFORMED CHOICE
An informed choice agreement is so that you, the client, can make an informed and educated decision as to who will be your birth attendant. This agreement gives you the information you need concerning my background, experience, training, etc.
PRENATAL CARE WITH OUR MIDWIVES
You are expected to receive regular prenatal care. This is extremely important to the outcome of your birth. There are many situations that potential problems, if dealt with in a timely fashion, never become true complications. At this time there are very few doctors in the Tulsa area (that we are aware of) offering prenatal care and emergency back up to homebirth parents (primarily due to liability issues and disapproval of homebirth). If we have to transport to the hospital, we will go to the nearest emergency room and take the doctor on call. A midwife will stay with you through that process as well. Our midwives provide prenatal care. We will see you monthly until your eighth month of pregnancy, after that time a midwife will see you more often. If you are having problems, we will see you more frequently. If you go past your due date, a midwife will see you weekly to keep a closer watch on you and your baby.
Each prenatal visit will include: checking your urine for glucose and protein if you are having problems, taking your blood pressure/pulse, weight gain, listening to the baby’s heartbeat, and feeling the baby’s size and position. We will discuss your diet, vitamins, problems, questions, birth preparation, tests, etc. We will discuss with you at the appropriate time in your pregnancy, tests and procedures routinely done with pregnancy. Such as, at 15-19 weeks you would be offered testing for the AFP test (a blood test for birth defects) and at 18-24 weeks you would be given the option for an ultrasound, Glucose Tolerance test, etc. A midwife will give you the information on what the test is, what it checks for, if you have indications for it, etc.
You will be required to have regular prenatal blood work, which may include a complete blood count, antibody screen, blood typing, Rh factor, syphilis and hepatitis. At 28 weeks testing for gestation diabetes and anemia screening is routinely done. Last, but not least would be a culture for Group B strep (GBS), routinely done at 35-38 weeks. Approximately 2 to 3 weeks before your due date, the midwife may offer an internal exam to determine dilation, effacement, position, and station of the baby’s head. If you go past your due date by 1-2 weeks, you will be asked to have a Non-Stress Test and/or ultrasound to evaluate the health of the baby, and status of the placenta, amniotic fluid, etc.