Using a Midwife

A midwife is a healthcare professional who has been trained and has expertise in managing low-risk pregnancies and deliveries. A midwife’s philosophy about childbirth is that it can occur naturally until proven otherwise.

A midwife may carry one of several subtitles:

• Certified nurse-midwives (CNMs) have at least a bachelor’s degree, have completed both nursing and midwifery training, and have taken licensing exams to become certified.
• Certified midwives (CMs) have the same qualifications as CNMs, but are not registered nurses.
• Direct-entry midwives may or may not have college degrees or certifications. They are trained through apprenticeship, workshops, and/or formal instruction.
• Certified professional midwives (CPMs) are certified by the North American Registry of Midwives after passing written examinations and skill evaluations. CPMs are required to have out-of-hospital experience.

While midwives are trained to recognize the signs of trouble in pregnancy and labor, they cannot perform surgical interventions in case of emergency. Therefore, midwives are not advised for higher-risk pregnancies, including multiple births, pregnancy-related complications, diabetes, high blood pressure, or pre-existing health problems. Even if you have a low-risk pregnancy, talk to your midwife to find out what would be done in case of a complication.

Water Birth

In a water birth, the woman will go through labor and/or delivery in a warm tub of water. Since the baby lives in the fluid-filled amniotic sac for 9 months, some people believe that being delivered into a similar environment is less stressful for the baby. There are also other potential benefits to a water birth:

• A soothing, relaxing environment for the mother
• Buoyancy, which lessens body weight and increases comfort
• A sense of privacy, which can be calming
• Less pain and use of pain medication during the first stage of labor

A water birth is not appropriate if you:

• Have herpes, since it can be transmitted through the water
• Have physical limitations
• Have a baby in the breech position
• Have excessive bleeding, an infection, or high blood pressure
• Are having more than one child (multiples)
• Are in preterm labor

Your doctor can help you determine whether water birth is a safe option for you. Many hospitals and birthing centers are equipped for water births, or you can rent a birthing tub.

Home Births and Birthing Centers

Your Birthing Plan

If you are considering an alternative birthing method, it is especially important that you and your partner create a birthing plan. Discuss it with your doctor or midwife a few months before you expect to deliver. This plan is a list of preferences that to help minimize the number of decisions that you need to make while you are in labor.

In this plan, you can specify your preferences for options such as pain control and timing of umbilical cord clamping. You also can discuss your preferences in the case of a complication or abnormal situation during childbirth. For instance, if you are giving birth at home, you may plan to transfer to a hospital after being in labor for a specified amount of time. Your doctor or midwife can help you determine the situations that may arise and how you can safely handle them.