While physician-attended childbirth may be the most common way to deliver a baby, midwives have attended at least 10 percent of all vaginal births in the United States since 2005, according to the American College of Nurse-Midwives.
In Kentucky, Frontier University in Hyden offers a graduate program for registered nurses to become midwives. “I think there are a lot of misconceptions about what midwifery actually is, here in the United States,” said Dr. Susan Stone, president of the university. “And there are many different types of midwives. I happen to be a certified nurse midwife.”
A nurse midwife is trained as both a nurse and a midwife, Stone said. There are over 11,000 certified nurse-midwives in the United States.
Melinda Courtney, a certified nurse midwife, said they offer the same care as an obstetrician/gynecologist, as far as lab work and ultrasounds. “But we just spend a lot more time with women in the process and helping walk them through, so that they’re more prepared for the birth. We also stay longer with them in the labor process. And then in postpartum, we do a lot more time with them, making sure that they’re doing well with that transition.”
Where did the term “midwife” come from? Kendra Adkisson, certified nurse midwife, said the term means “with woman.”
“A lot of what I spend my time doing is listening,” she said. “Because when you listen to women, you figure out the layers of what’s really going on, what’s behind her stress levels. It’s not just the thyroid check —- it’s something else. And so it really is a different profession.”
Adkisson sees herself as a health-care educator. “I see myself as someone who empowers women to take charge of their health and to set them on the right footing for a healthy lifestyle, not just through the course of this pregnancy.”
Certified nurse midwife JoAnne Burris said it’s important for women to know they don’t have to have a completely natural, un-medicated birth in order to see a midwife. “If you want an epidural, you may have an epidural, and see a nurse midwife,” she said. “What a midwife wants and is focused on is supporting a woman as she births in the way that she want to birth.”
The majority of births attended by a nurse midwife in Kentucky take place at a hospital, Courtney said. “We do not have birth centers as of yet in Kentucky,” she said.
Stone said physicians are needed to provide high-level health care when things go wrong. “And I believe that physicians need us to provide that high-level education and support for the woman when things are all going right,” Stone said.
Many studies have shown a lower rate of Caesarean sections when nurse midwives are involved in pregnancy and birth care, Stone said. “Staying with her during the labor, having that kind of labor support, and different strategies to just kind of relax into the labor and let the natural process happen, can be really effective in reducing the Caesarean section rate.”
Midwives pride themselves on establishing good relationships with the mother. “Just having someone to call when you have the smallest question or the biggest question can be really helpful. And this relationship goes on…even after the birth,” Stone said.
Nurse midwives want women to be partners in their health care. “We don’t approach pregnancy as let’s see what is going to go wrong,” Stone said. “It’s more about what is going to right, and what a joyful experience this is, and what a really wonderful time in your life, and being able to enjoy that to the fullest extent possible.”