The early weeks of pregnancy are fragile—and confusing. Here, the answers to your questions.
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When I found out I was pregnant, I chose my OB-GYN for two reasons: She came highly recommended and I had heard through other moms that she was supportive of natural childbirth.
The fact that she also shared her practice with a midwife didn’t play a part in my decision. At the time, I thought you only needed a midwife if you were having a home birth. I knew I was having my baby in a hospital, so what did I need a midwife for?
As it turns out, the midwife in the practice became an integral part of my pregnancy experience. I alternated between my OB-GYN and midwife for each of my prenatal appointments and, by the time I had packed my bag and mapped my route to the hospital, I no longer differentiated between them: I viewed their individual skill sets as both complementary and totally necessary.
What I’d stumbled upon was a collaborative practice between an OB-GYN and a certified nurse midwife (C.N.M.) or certified midwife (C.M.). Setups like it are becoming increasingly popular throughout the United States as obstetricians and midwives hit what some experts are referring to as the sweet spot in obstetrical care.
“Midwives are educated to ensure that women own their bodies and make good decisions about their health and to provide primary care to women across their lifespans,” says Elaine Germano, Dr.P.H., C.N.M., a Glenford, N.Y.-based midwife and senior education policy adviser for the American College of Nurse Midwives in Silver Spring, Md. “OB-GYNs are educated differently. They are surgeons and trained to heal the sick.” The idea is that with both forms of expertise on your side, you’re covered, from natural childbirth to emergency surgery and everything in between.
Recent research backs this up. A 2011 study published in the journal Nursing Economic$ found fewer Cesarean sections, lower rates of episiotomies and higher breastfeeding rates in practices that include both midwives and OB-GYNs. The American College of Obstetricians and Gynecologists and the American College of Nurse-Midwives issued a joint statement of practice in 2011, suggesting that care is most effective when practitioners work together.
In addition, leading experts in obstetrics and midwifery are collaborating on a series of papers supporting joint practice scheduled for publication this fall in Obstetrics and Gynecology Clinics of North America. According to Melissa Avery, a co-author of one of the papers and chairwoman of the Child and Family Health Co-operative at the University of Minnesota School of Nursing in Minneapolis, a joint practice allows you to maximize your care with the support of two pregnancy and childbirth experts who can provide the best care based on your individual needs. Some practices include both midwives and OB-GYNs in the same office. In others, patients primarily see a midwife and will see an OB-GYN if a complication arises.