Ask the Expert: Midwives and Their Role in Women's Health

Midwives are medical care providers with special training in obstetrics and gynecology. Many midwives primarily provide prenatal care and deliver babies, but most midwives do more, including offering women care throughout life. Some midwives work independently, others work as part of a team. In the United States, all midwives fall into one of three categories: Certified Nurse Midwives (CNM), Certified Midwives (CM) or Certified Professional Midwives (CPM).

What is the difference between each type of midwife?

Certified Nurse Midwives (CNM) have a Master's or Doctorate degree in Nursing and have completed an accredited program of midwifery education. They must pass a national certification board examination and maintain a nursing and midwifery license in the state where they practice and generally provide care in hospitals, offices, birth centers and clinics. CNM's can also prescribe medications. The majority of midwives in the United States are Certified Nurse Midwives.

Certified Midwives (CM) usually have a college degree in something other than nursing but complete an accredited program of midwifery education. They too must pass a national certification exam and have a state midwifery license. They work in many of the same areas as CNM's but do not have a nursing background.

Certified Professional Midwives (CPM) are apprentice trained or have completed an accredited midwifery education program. They typically work in birth centers and homes. They do not take the same national certification exam as CNM's and CM's. They do not prescribe medications and do not work in hospitals.

What do Midwives do?

Most people think of delivery when they think of typical midwife duties. Midwives certainly deliver babies, but we also do much more. The term “midwife” means “with woman” which we are throughout their life span. Meaning, we provide care during pregnancy, assist with both vaginal and cesarean deliveries and provide any postpartum care a new mother may require.

What most people do not know is that a midwife can help women with a variety of non-pregnancy related care. Midwives can assist in choosing and initiating a birth control method that may be best for a patient. We perform well-woman gynecological exams. We can manage and assist with solutions that affect women who experience heavy and/or painful periods. Midwives often assist in easing a woman’s transition through menopause and beyond. CNM’s and CM’s can prescribe medications, order tests and perform procedures.

Why should I choose a Midwife?

Midwives can provide care for you beginning in adolescence and continue throughout your life. We understand normal processes and can recognize problems that may develop. In addition to the specialized care previously discussed, we promote healthy lifestyles and provide education and support. We focus on best practices and evidence-based care. Our approach is centered on individual needs that allow a patient to make informed choices.

If I have a Midwife while I am in labor, can I get pain medication?

Of course! Our goal is to ensure that you have a smooth labor and delivery, and that you and your baby are healthy. Many women need medication and/or an epidural and that is okay. Others prefer to try alternative comfort measures such as use of labor balls and water therapy in a jacuzzi tub. Some will do both. Either way, midwives are trained to assist any patient with personalized choices and help support you through the entire pregnancy process.

What if I have a complication during labor or delivery?

Although CNM's are trained to handle normal processes and perform vaginal deliveries, we are also able to recognize problems. We work closely with OB/Gyn physicians who are always available for consultation and referral when needed. CNM's and OB/Gyn physicians are all part of the same team. And as your women's healthcare team, our goal is to make sure you have the best healthcare services available to you, whether your needs are basic and uncomplicated or high risk and complex.

What if I have a gynecological complication or need surgery?

If a gynecological complication arises that requires special procedures or surgical intervention, there are physicians readily available for consultation and referral. The physician will perform the procedure and keep the midwife informed of results so that care can be continued with minimal interruption.

CaroMont is proud to employ several midwives who offer their services through multiple practice locations.

Stephanie Gilliam, CNM at Ashley Women’s Center

Nancy Kuney, CNM at Ashley Women’s Center

Sarah Schubert, CNM at Ashley Women’s Center

Deborah Grigg, CNM at Gaston Women’s Healthcare

To learn more about Women’s Services at CaroMont Health, visit our website.