What do I think of midwives practicing without a Certified Nurse Midwifery license?
Again, I surprised the heck out of my young friend. Several avenues of education and training produce top-notch midwives. Certified Practical Midwives become experts in out-of-hospital births like at home or in birth centers. Certified Nurse Midwives have RN licenses as well as midwifery training, which helps them become experts in hospital births (though many practice at home or in birth centers). Many practical midwives (AKA lay midwives) who receive their training through apprenticeships are great too. The problem with lay midwifery though is that there’s no specific educational pathway, curriculum or licensing process that determines they know what they’re doing. Many are great. Some aren’t, but the same can be said for all types of health providers.
See more: How to choose a midwife >>
Am I pro-home birth?
I think for some healthy mothers who have great, well-trained and careful midwives who know when and how to get patients to the hospital if complications arise, home birth can be a safe option and the data supports me on this one.
Do I think most women should use midwives?
Yeah, I kind of do, but not necessarily at home. Midwives are the experts at normal physiologic birth, whereas obstetricians are the experts for medically complicated ones. Most women don’t have significant medical problems and are fully capable of having normal labors and births. The problem we’re seeing in the US is too many normal mothers are being treated as if they have medical complications. Ironically, it’s that over-medicalization of normal pregnancy and labor that’s leading to increased complications.
At the end of our conversation I recommended this young student educate herself in all the options available to mothers, not just the ones presented by the hospital. I also hoped that as a brand new nurse, she’ll be part of the revolution that makes hospital birth less intervention-oriented and more welcoming and respectful to all mothers.
Jeanne Faulkner, R.N., lives in Portland, Ore., with her husband and children. And co-author of, The Complete Illustrated Birthing Companion: A Step-by-Step Guide to Creating the Best Birthing Plan for a Safe, Less Painful, and Successful Delivery for You and Your Baby. Got a question for Jeanne? Email it to email@example.com and it may be answered in a future blog post.
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