Many women know midwives offer support during labor and delivery, but did you know you can see a midwife for Primary Reproductive Care, too? Certified Nurse-Midwives are Registered Nurses with advanced education and training in midwifery and advanced practice nursing. You are able to see a CNM for any routine care in addition to their role in labor and delivery.
Midwives have been an option with SSM St. Mary’s Hospital for almost 3 years, and they are covered by most insurance (including BadgerCare).
We had the chance to chat with one of the Certified Nurse-Midwives (CNMs) from SSM St. Mary’s Hospital and get the scoop on everything you’ve ever wanted to know about working with a Midwife.
Many thanks to CNM, Jessica Vaughan, for her time and effort putting this information together!
What is the role of a midwife during pregnancy, labor or delivery?
The term Midwife means “with woman”, which really describes our partnership with our patients. There are two types of midwives:
Certified Nurse-Midwives (CNMs) have a bachelor’s degree in nursing (therefore a registered nurse- they hold a nursing license)and go on to get an advanced degree- either a master’s or doctorate in nursing practice (DNP) or nursing research (PhD). CNMs practice in clinic, hospital, birth center, and home settings. Licensed Midwives (LMs) do not have a nursing background but have a graduate degree, and they take care of individuals in birth centers and home settings. The clinical skills required are the same for both types, and the certification exam is the same.
Certified Nurse Midwives (CNMs) are women’s health providers with advanced education and training in midwifery and advanced practice nursing. The midwifery model of care is a holistic approach which emphasizes women-centered care. CNMs educate their patients, advocate for each woman’s individual health goals and wishes, and build lasting relationships with their patients. CNMs manage many of the primary care needs of women from the early teen years throughout a woman’s childbearing years and into menopause.
If you choose midwifery care for your pregnancy and delivery, your midwives will provide your prenatal care and attend your birth at the hospital. The majority of women will not need to see a physician during their pregnancy/birth if they are seeing midwives, unless a complication occurs.
Certified Nurse Midwives care for women and their babies during pregnancy, labor, birth and beyond. In addition, CNMs provide routine care for women through all phases of their life.
Our services include:
- Personalized care tailored to a woman’s health goals and needs
- Emotional and physical support during labor and birth
- Individualized guidance and education regarding care of yourself and your baby
- Breastfeeding support and lactation counseling
- Women’s health and gynecological care
- Family planning
Pregnancies with higher risk may benefit from consultation or care from an obstetrician or maternal fetal medicine (high risk pregnancy) specialist. SSM Health midwives do not attend home births or manage pregnancy with multiples (twins, triplets, etc.), and SSM Health St. Mary’s Hospital – Madison does not offer water birth at this time.
What are some things midwives can do/offer that women may not be aware of?
We see women for primary reproductive care. You do NOT have to be pregnant to see a midwife.
Midwives see individuals throughout the reproductive cycle (adolescents all the way to menopause) for routine annual exam, pap, birth control consults, gynecologic concerns, and menopause concerns.
The SSM Health Midwife Practice does not attend home births, but we work closely with home birth midwives in our community in the event that their client needs to be transferred to the hospital setting. That way they can still have a midwife attended birth, even if it is in a hospital setting.
Midwives try to provide constant labor support, which differentiates us from obstetricians. Numbers permitting, we try to be at the bedside for as much or as little as the patient needs and literature shows that continuous labor support – (whether by a midwife, doula, or nurse), reduces the number of medical interventions that occur during labor and birth. It even lowers the number of Cesarean births!
How has Covid changed pregnancy for women and how can midwives help support women during this difficult time?
COVID has really isolated women during their pregnancies and postpartum – many clinics and hospital have put in visitor restrictions for clinic visits and limited a labor support person to one. Postpartum, the recommendations are to limit visitors to ensure the safety of your family, and because the impact of COVID on newborns is relatively unknown. As a result, families are really isolated and it isn’t possible to have the village support that we normally encourage for new parents. Meals being brought to the home, family and friends to hold baby while the mother takes a nap or clean the house for the new family. I personally had my first baby in May and although my husband is wonderful, once he returned to work it was really tough for me to be home alone all day with a new baby- because as a family, we had decided that it would be safest to not have anyone else hold our baby until she was 2 months old. Mothers are unable to get the breaks they need to recharge and catch up on sleep or self care. They are also unable to meet with other new moms at in-person mother’s groups to have a better sense of community.
Postpartum Group for New Moms
Our midwife group has been running a postpartum group (it was a weekly in-person group pre-Covid) virtually through Zoom every Tuesday. It is free to join and is not exclusive to midwife patients- we have plenty of patients who saw obstetricians for their pregnancy and birth. This group has helped support mothers and we have been told that they look forward to the meeting every single week. We have experts present every few weeks- such as psychologists, pelvic floor therapists, babywearing specialists and sex therapists to help mothers navigate the life changes that a new baby brings. The Facebook group is called SSM Health New Beginnings and is open to anyone (not just SSM Health patients), we post the zoom link every week on there.
Can you share a story about your own work as a CNM?
A really meaningful experience for me was to be at the labor and birth of one of our patients who had previously had a pregnancy loss around 20 weeks. A very difficult experience that she went through with our midwife group as her providers. Her due date of subsequent current pregnancy was on the one year anniversary of her loss, and we talked about how serendipitous it would be for this baby to be born on that day. She went into prodromal labor (contractions that don’t build) for a day and a half before the contractions ramped up… on her due date! I was so excited to get her call around 3 in the morning. She labored in the tub, and later before she started pushing, I asked her husband if he would like to assist with catching the baby. He enthusiastically said yes and we caught the baby together. She birthed a beautiful, healthy baby boy. It was such a special birth. (I asked for this patient’s permission to share her story).
Why do you think midwives are a good choice for moms?
Midwives are a great choice for individuals who are seeking more personalized, low-intervention care for their pregnancies/births and postpartum. We are also a great choice for any female seeking primary health care – whether it is an annual exam, birth control, menopause, or gynecologic concerns. Although we are a great choice for healthy, low risk pregnancies, we also consult and work closely with our OB physician colleagues if the pregnancy develops complications. In some high risk cases (preeclampsia, gestational hypertension or diabetes requiring medication) we transfer the care of the woman to the physicians who specialize in high risk pregnancies. This way, the appropriate care is given by the appropriate providers.