Certified Nurse-Midwives

Certified Nurse-Midwives?
by Mavis Schorn, CNM

Are you looking for a different experience? Perhaps you have been reading, going to childbirth classes, and listening to friends. You may be learning and wanting something different.

Does the thought of having the ability to have a calm environment for the birth, with low lights and music, appeal to you? Do you want your desires for the labor and birth taken seriously and respected?

Perhaps you’ve had a child before and had some frustration from being relegated to the bed throughout your labor, positioned for better reading of the fetal monitor rather than your comfort, and not allowed anything except ice chips to eat. If you think that this may not be something you want to go through again then you may want to consider care with a Certified Nurse-Midwife (CNM).

A CNM is a registered nurse who has additional education in midwifery – the care of pregnant women & newborns. They are certified by the American College of Nurse-Midwives. Their experience and education also includes providing gynecological and family planning care. The number of women using CNMs is growing rapidly. Most CNMs deliver in hospitals, but some practice in birth centers or in your home.

Hospital-based CNM practices have the ability to practice "low-tech" but have the full services of the hospital should problems or emergencies occur. All CNMs have an arrangement with physicians for consultation and a system for managing complications in labor.

Usually the woman who chooses to go to a hospital-based CNM practice wants individualized care and medical intervention only if necessary. Usually things like providing continuous labor support, encouraging you to drink liquids, not requiring an IV, intermittent fetal monitoring, freedom of movement and positions – (i.e. walking, squatting, using a shower or tub), pushing in different positions, no routine episiotomies, attempting to minimize lacerations, encouraging the mother and/or partner to reach down and help bring the baby up to the mother’s arms, and keeping families together by keeping the baby with the parents, are the usual.

Most women who choose a hospital-based CNM practice would prefer not to use pain medication or anesthesia. However, since no one can foresee the future and know what labor will be like, knowing pain medicine or epidural anesthesia is available (not pushed) is reassuring.

CNMs are sometimes confused with another type of midwife. These midwives are referred to as lay midwives, direct-entry midwives, or community midwives. These midwives sometimes are nurses. Some attend midwife training programs and most serve an apprenticeship with another midwife. Their education and experience is variable. They deliver only in homes or birth centers. Generally, they charge less than CNMs. You can contact the Association of Texas Midwives (ATM) in Austin or the ATM Houston Chapter for more information.

There are also CNMs who deliver in birth centers and at home in the Houston area. For a list of CNM practices in your area, you can call the Automated Practice Locator developed by the American College of Nurse-Midwives with a TOLL-FREE telephone number of 1-888-MIDWIFE (888-643-9433) or E-Mail for information at info@acnm.org.

Unfortunately, no one can guarantee you will deliver without any complications or that you have no chance of having a cesarean section no matter how low risk you may be going into labor. You do not want to look back at your labor and say "if only I could have tried …". You will never forget the birth of your children, so you do not want regrets. There are many choices of where and with whom you deliver. You need to be where you feel the most comfortable and trusting. Do some investigating and listen to your instincts!

Editorial provided by Mavis Schorn, CNM from The Women’s Specialists of Houston, Texas.