The word midwife literally means ‘with woman’. When we hear the word we immediately think of babies being born. Traditionally, a midwife was someone—almost always a woman—who assisted other women during the labor and delivery process of giving birth. Today there are two types of midwives: A lay midwife and a Certified Nurse Midwife.
Lay midwives may be referred to as traditional or direct-entry midwives. They are usually not nurses. They have had specific training in midwifery through self-study, apprenticeship, or school programs separate from schools of nursing. They are trained to care for healthy women and newborns during pregnancy, through labor, delivery, and shortly after childbirth. Lay midwives often care for women in their homes. They typically do not provide care in a hospital setting. Some lay midwives take an exam to become certified professional midwives. A number of states provide for licensure of lay midwives. Although lay midwives are found in our area caring for women, the state of Ohio does not license them.
A Certified Nurse Midwife, or CNM, is a registered nurse who received advanced training in midwifery. CNMs complete a program accredited by The American College of Nurse Midwives Certification Council and must pass the certification exam. They are licensed by individual states. In Ohio, a CNM must have a “collaborative” relationship with a physician. This means the midwife has a physician who can be consulted if a woman’s condition is not normal. The woman’s care may be transferred to a physician or obstetrician-gynecologist who is able to manage many of the abnormal conditions that would be out of the scope of practice for a CNM. For example, ob-gyns have the ability to perform surgery, if necessary.
CNMs are trained to manage many aspects of women’s health, not just pregnancy, labor & delivery, and postpartum (after delivery). CNMs can manage simple primary care problems; provide gynecologic and family planning services, and preconceptual (before pregnancy) care. To assess, diagnose, and treat many conditions, CNMs may order and interpret lab and diagnostic tests such as blood work, mammograms, ultrasounds, and X-rays. CNMs are trained to prescribe medications and medical devices as necessary. Midwifery care includes health promotion, disease prevention, individual education, and counseling. You can find CNMs in a variety of settings such as clinics, private offices, homes, hospitals, and birth centers.
For additional information about the role of a midwife, please visit www.midwife.org.
Gail Bocian is a Certified Women's Health Nurse Practitioner with Neighborhood Health Association. For more information about the women’s services offered through NHA, please visit http://nhainc.org/womens-health. To make an appointment, please call 419-214-5700, ext. 6228.