At home births with the assistance of a midwife are increasing in popularity throughout the United States. This method is popular world wide, but in the United States traditional hospital births are more common. In the past couple of decades, this has changed. Many women are tired of crippling hospital fees and are turning to midwifery as an alternative.
Giving birth is an extremely personal task. Every woman is different, and her ideas of giving birth are also different. For one woman, a hospital setting may be preferred, however some hospitals limit who can be in a birthing room. Siblings, grandparents, aunts, and uncles are often told to wait for long hours in the waiting room. With a home birth, everybody is more than welcome if the mother-to-be wants him or her there.
Midwives are also available for traditional hospital births as well. There are four levels of midwives: Certified Nurse-Midwives (CNM's), Certified Midwives (CM's), Direct-Entry Midwives, and Certified Professional Midwives (CPM's.) Each level requires a certain level of training and education. Some states do not recognize all three levels.
CNM's are the highest level. A Certified Nurse Midwife must have a Master's or Doctoral degree in health sciences. The CNM must also have passed national and state licensing tests, and completed both midwifery and RN training. CNM's often work alongside a doctor in a hospital setting.
CM'S are only recognized by the state of New York. These midwives do not have training as a registered nurse, but they do meet all the other requirements to become a CNM. CM's have only been recognized since the late 1990's, so more states may allow them soon.
Direct Entry Midwives are professionals who work as apprentices to a CM or CNM. Direct Entry Midwives work most commonly in home settings. Their only education comes from time spent apprenticing, attending lectures, or workshops. Many states do not require or permit Direct Entry Midwives to be licensed.
Finally, CPM's have passed a written and hands-on exam given by the North American Registry of Midwives. CPM's must have had practice helping deliver an infant and can work in both home and hospital settings.
If you choose to give birth within your home, it is critical that any midwife makes home visits before agreeing to attend a couple's home birth. A midwife is responsible for not only assisting at the birth, but for also ensuring there is reasonable emergency care in case of an emergency. Though rare, some deliveries do require immediate hospitalization, and ambulance and other emergency services must be available if maternal or fetal distress occurs.
Midwives work closely with a mother to provide her with her ideal birthing situation. A midwife will spend a good deal of appointment time asking about the birthmother's goals, wishes, and concerns.
Discussions into birthing positions and more natural pain-relieving methods (breathing, walking, rocking, showering, Jacuzzi use) are all commonplace during these appointments. Midwives often can alternate between a birth on a bed, birthing chair, and even birthing pools.
During active labor, midwives tend to be more lenient than an OB/GYN. Hospital personnel often restrict food and liquids to a woman in labor. Midwives do not do this. However, midwives rarely are able or willing to use equipment such as ultrasounds and fetal monitors. Additionally, midwives are never authorized to perform a C-section.
After birth, a midwife is trained to handle basic care for a newborn, but if the situation is life or death, she will need to call in paramedics. This can be a concern to parents.
It is ultimately a birth mother's choice on who she wishes to deliver her child. Weigh all options carefully and then make the choice that fits your needs.