By Kelli J. Cook

So, you’re thinking of having a baby. WOW—just acknowledging the idea can be both exhilarating and scary at the same time. There are so many things to consider and think about in order to make this journey a physically and emotionally healthy trip. As you begin exploring maternity care and birthing options, it is certainly worth taking a closer look at what is most likely the "world’s oldest profession"—midwifery.

What is this profession called "midwifery," and exactly what does it mean to be a midwife? According to the American College of Nurse-Midwives (ACNM), "Midwifery is a profession born of a woman’s vision, nurtured in an understanding of women’s developmental phases, and committed to assuring women in all populations that it is their birthright to be part of this unique care." In a nutshell, it is healthy woman care by women, for women.

Midwives are generally classified into two categories, according to the level of formal education and training received. Certified nurse midwives are trained in both nursing and midwifery, while direct entry midwives are trained only in midwifery. While there are many highly trained and competent direct entry midwives, this article focuses solely on certified nurse-midwives (CNMs) since they are licensed health care practitioners and are legally available throughout the United States.

A certified nurse-midwife is a registered nurse (RN) who has graduated from one of the advanced education programs accredited by the American College of Nurse-Midwives (ACNM). In addition, nurse-midwives must pass a national certification examination and meet strict requirements set by state health agencies. To ensure your physical health, CNMs provide prenatal, labor and delivery, postpartum, and normal newborn care, as well as routine gynecological care for women of all ages. Prescriptions for medications and vitamins can be written by CNMs in most states; additionally, such care is often covered be many private insurance carriers, Medicare, Medicaid, and managed care programs. And with regard to your emotional health, her care has even greater benefits.

Having the optimal maternity care and birthing experience involves so much more than just the physical wellbeing of mother and baby. CNMs are there to offer women an understanding of their unique physical, emotional and spiritual needs, which seem to multiply exponentially once pregnant. They also provide preconception counseling and family planning services in addition to prenatal, postpartum, and normal newborn care. And it is one profession that appears to be as equally rewarding for the caregivers themselves. According to Jeri Willeby, RN, CNM, practicing in Warner Robins, "Being a certified nurse-midwife is more than I ever thought it would be." I am able to educate, support, nurture, and care for healthy women for a lifetime."

During pregnancy, you can count on your CNM to take time to listen to you and talk with you. While she regularly monitors the health of you and your baby, her goal is to ensure that your pregnancy is both safe and satisfying. She wants you to take an active role in making decisions that are the right ones for you and your family. She will listen and counsel you as you weigh and make choices regarding questions such as:

• What type of delivery room do you want to use?
• What, if any, anesthetic drugs are you considering?
• What type of labor monitoring would you prefer?
• What delivery positions are you considering?
• Who will be present during the birthing process?
• Do you want to breast feed your baby? If so, do you want to nurse immediately following his birth?
• Do you want your baby to room with you?

• What role would you like your husband to have in this experience?

While the questions seem endless, your CNM will help you seek options and answers that meet your individual physical, emotional, and spiritual needs.

With the onset of labor, your CNM will periodically evaluate your progress and is there to offer emotional support. She is there to nurture, comfort, and emotionally support you as she physically guides you through the birthing process. Although she can work as a primary care provider, she consults with a physician if there are complications or any condition that may put a woman at risk.

The CFM’s importance cannot be underestimated. Jennifer Tade, RN, CNM, practicing in Macon, emphasizes that "the art of labor support is so very important to a woman and her birthing process." And the research firmly confirms this. Studies show that the continuous presence of a support person reduces the length of labor, likelihood of medication for pain relief, need for forceps or vacuum extraction, chances of cesarean delivery and low Apgar scores. Moreover, mothers who receive continuous support during labor make for satisfied moms.

Upon your baby’s birth, follow-up care begins immediately. The CNM examines your newborn, provides advice on breast feeding and infant care and makes sure you don’t forget to look after yourself. Women know what women need!

Are you looking for an educated health professional that focuses entirely on the needs of "healthy woman" care? Or perhaps have an adolescent daughter entering puberty? Throughout a woman’s life, CNMs teach and answer questions about proper diets, personal hygiene, exercise, sleep, and how to maintain a health lifestyle. They also provide gynecological care, annual pelvic and breast examinations, Pap tests and screening, and treatment for infections. Additional areas of care include adolescent gynecology and also care for older women, with the authority to provide hormone replacement therapy.

It is vital for women to become as informed as possible when make decisions about maternity and women’s health care. When consulting with a nurse-midwife, you might find the following questions helpful:

• How long have you been practicing and in what kind of setting?
• What is your philosophy of care?
• What are the eligibility requirements for your services?
• What arrangements do you have if complications occur?
• What are your fees and will my insurance cover them?
• Can my family be present during labor and birth?
• What sort of care can I expect to receive following delivery?
• Do you have any patients who would be willing to share their stories? (The most effective advertising for nurse-midwifery care is women who have used them and want to share their experiences.)

Because most nurse-midwives work in private practice with physicians or in clinics, hospitals, and birthing centers, contact your local hospitals or physicians’ offices for help in locating a certified nurse-midwife. Also refer to Georgia Family Magazine for help in making an informed choice. GFM is proud to provide advertising for several respected CNMs in the Middle Georgia area who will be happy to meet with you to answer any questions you may have. Additionally, The American College of Nurse-Midwives offers an automated toll-free practice locator line, 888/MIDWIFE.

More information can be obtained at www.midwife.org