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Once you have learned you’re pregnant, the first step on your journey toward giving birth is finding the right healthcare professional. In today’s healthcare space, you have many options. A nurse midwife might be your ideal choice.

From the first plus sign on a pregnancy test to your newborn’s well-child checks, nurse midwives offer a unique, holistic approach many parents find reassuring and enjoyable.

These professionals also have an impressive track record of reduced cesarean deliveries and high patient satisfaction. In fact, one 2018 study found that women who chose midwives were three times more likely to be satisfied with their care than those who saw obstetricians.

Here’s a look at what nurse midwives do, how they differ from other healthcare professionals, and the benefits you can expect from their care.

According to the American College of Nurse-Midwives (ACNM), both certified nurse midwives (CNMs) and certified midwives (CMs) provide medical care during pregnancy, childbirth, and the postpartum period.

They can also serve as healthcare professionals for gynecological health, sexual and reproductive health, family planning, and even primary care.

Nurse midwives have some key distinctions in education and philosophy that differentiate them from other healthcare professionals like OB-GYNs.

Whereas OB-GYNs are trained as surgeons, nurse midwives are trained in the physiology of birth, says Karen Jefferson, DM, CM, FACNM, director of midwifery practice for the ACNM. And never fear: Nurse midwives go through plenty of education.

“In this country, CNMs and CMs are educated at the graduate level in credited education programs,” Jefferson says. “We sit for a national certifying exam, and we have to do continuing education in order to maintain that. We work where we can be licensed, and we are really integrated into the healthcare system.”

In terms of philosophy, nurse midwives seek to offer a more whole-person form of care than a traditional clinical approach. This might look like educating about how to integrate nutritious eating and exercise into your pregnancy, discussing stress management, or checking in on your mental wellness.

And while you may associate the word “midwife” exclusively with home births, today’s nurse midwives can deliver babies not only in homes but also at birthing centers and often hospitals. The vast majority of nurse midwives in the United States attend births in hospitals.

There are several excellent reasons you might select a nurse midwife for your pregnancy or any other female health need. As you weigh the decision, consider these benefits.

Holistic approach

Among the ACNM’s core values is person-centered care.

“We focus on the whole person: their nutrition, their home life, their mental health or illness, all of the social determinants of health,” Jefferson says.

In a healthcare system that can feel fragmented and impersonal, this cohesive strategy may be a welcome change.

Reduced risk of cesarean delivery

You’ve got enough things to deal with after giving birth. Recovering from major surgery doesn’t need to be one of them. Choosing a nurse midwife could significantly reduce your risk of a cesarean delivery, also called a C-section.

According to 2020 research, women with low risk pregnancies giving birth to their first child had just a 6% rate of cesarean delivery when under the care of a midwife. (Compare this to the national average of 31.8% for all births.)

A study from 2021 found that cesarean deliveries have decreased in the United States as a result of more midwife-attended births.

Fewer interventions

Letting Mother Nature take her course is a hallmark of the nurse midwifery approach. Midwife-attended births have lower rates of interventions, like induction, and higher rates of vaginal delivery versus cesarean delivery.

Of course, this doesn’t mean nurse midwives won’t implement interventions when necessary.

“We expect [a pregnancy] to be healthy and good, but we are very close monitors of every activity for prenatal care to the baby,” Jefferson says. “When things don’t go according to plan, we’ll do what’s necessary and collaborate with all kinds of other professionals as needed.”

Options for birthing location

Want some flexibility on where your baby enters the world? Unlike OB-GYNs, who largely deliver only at hospitals, you can likely find a nurse midwife to accompany you at the birthing location of your choice.

While most nurse midwives attend births in hospitals, many work in freestanding birth centers, and some provide home birth care.

Many nurse midwives have hospital privileges — or they can guide you through delivery elsewhere.

“If [a mother’s] community has a freestanding birth center, that’s an option. They could also have a home birth if they were essentially healthy with only one baby at term,” says Jefferson.

Relationship-based care

If you’ve ever had a doctor breeze through your appointment in a 3-minute whirlwind, you know: Sometimes the healthcare experience can feel rather impersonal. Nurse midwives seek to connect with their patients through relationship-based care.

You may find a nurse midwife takes more time to get to know you personally, thoroughly answering your questions and inquiring about your emotional health.

“We have a lot of respect for women, a lot of respect for newborns, a lot of respect for how the newborn enters the world,” Jefferson explains.

To obtain a certified nurse midwife credential, people must be educated in graduate-level midwifery programs accredited by the Accreditation Commission for Midwifery Education. They must then pass the American Midwifery Certification Board’s national certification exam.

Certified nurse midwives have an active registered nurse (RN) credential at the time of their certification exam. Certified midwives, on the other hand, do not have nursing credentials.

There are times or circumstances when you may want or need an OB-GYN and other healthcare professionals to be involved in your pregnancy and delivery care, such as if:

  • your insurance company does not cover nurse midwives (this is not common)
  • your pregnancy is high risk due to other medical conditions, like high blood pressure or diabetes
  • you are pregnant with multiples (twins, triplets, etc.)
  • your baby is in a breech position
  • you have considerations from previous pregnancies and births, such as past cesarean deliveries or stillbirths

Many OB-GYN practices include nurse midwives, so even if you need a doctor during your pregnancy and delivery, you may still be able to see a nurse midwife for some of your prenatal care and delivery planning.

In highly populated areas, you may find entire practices of nurse midwives in close to your home. Most CNMs are employed in larger urban areas.

But since these prenatal professionals aren’t as numerous as OB-GYNs, you may have to do a little digging.

The ACNM offers a searchable database for locating nurse midwives by geographical region. Your insurance company or state health services department may also be helpful resources.

Questions for your doctor, midwife, or other healthcare professional

As you navigate the options for prenatal through postnatal care, consider asking potential healthcare professionals these questions:

  • Do you offer all types of reproductive healthcare, or just prenatal care?
  • Where can I give birth if I choose your practice?
  • What can you tell me about your philosophy and approach to prenatal care, birth, and postpartum follow-up?
  • What will happen if I have an emergency during a home birth or delivery at a birthing center?
  • What pain management options do you offer during labor?
  • What are your rates of cesarean delivery and induction?
  • Are you in network for my insurance?
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Every pregnancy and birth experience is unique, and only you can decide what type of healthcare professional you’d like to accompany you on your journey.

If you’re looking for a whole-person, relationship-based experience in prenatal or other women’s healthcare, a nurse midwife might be a good option for you.