What is a Midwife? The Truth About 5 Common Midwifery Myths.

If mention of a midwife brings to mind imagery of a 19th century homebirth, you’re not alone. Many people don’t know the truth about who a midwife is and what a midwife does in today’s modern world. In fact, misconceptions about midwives lead to many pregnant people thinking they aren’t eligible for midwifery care. 

Midwives provide holistic maternity care centered on the mother’s desires and preferences for birth.

So, what is a midwife? Midwives are trained healthcare providers who care for pregnant people before, during, and after a vaginal delivery, with an emphasis on minimizing medical intervention whenever possible. Like an obstetrician, midwives offer thorough maternity care, including performing standard labs and ultrasounds during pregnancy. You may be surprised to learn that midwives also provide routine gynecologic care, from routine pap smears to addressing concerns like heavy bleeding or vaginal pain.

Midwives value and support an individual’s physiological capability in childbirth. They use their professional medical expertise in combination with a personable approach to empower and educate patients to make informed decisions about their body and their baby when it comes to pregnancy, labor, delivery, and the postpartum period. As a result, families working with a midwife often experience less medical intervention, with lower rates of needing a labor induction, episiotomy, or cesarean section. Read on to learn the facts as we debunk common myths about midwives.

5 Common midwife myths and the truth.

1. MYTH: Midwives and doulas are the same.

TRUTH: Midwives are medical professionals with advanced training and education, while doulas offer nonmedical support.

Midwives are not the same thing as doulas, which is a common misconception. A doula is an individual who has undergone a certification course to become a birthing coach. They can offer helpful physical, emotional, and practical support for families during birth, but they cannot provide any medical care nor can they deliver babies. 

In contrast, a midwife is an advanced practice healthcare professional with formal medical education and training in obstetrics and gynecology, as well newborn care. While there are different types of midwives with different scopes, many are certified nurse midwives (CNM) who began their careers as nurses before advancing to a graduate degree in midwifery. There are benefits to having both CNMs and doulas with you during labor and delivery. 

2. MYTH: Midwives only deliver babies at home.

TRUTH: Midwives care for patients in a variety of settings, including hospitals.

Contrary to popular belief, midwives do not just attend home births. Certified nurse midwives can also deliver babies in the hospital setting, as well as freestanding birthing centers. This allows families who still want access to the full range of medical services to receive individualized care from an experienced midwife in the hospital. Under the care of a midwife, you can also expect more individualized labor options than a traditional hospital birth, such as wireless monitoring that allows you to walk around freely, labor in the shower, and deliver in different positions.

Patients choosing midwifery care in the hospital setting also have access to neonatologists, anesthesiologists, and maternal fetal medicine specialists, should anything unexpected arise. In addition, midwifery care in the hospital is covered by most major health insurance plans.

3. MYTH: Patients who have had a c-section can’t work with midwives.

TRUTH: Midwives can care for most pregnant people desiring a vaginal birth.

Most individuals with no other medical conditions are considered to have a low or moderate risk of complications during pregnancy and are therefore eligible to work with a midwife. This includes people who have had a cesarean section (c-section) in the past but desire a vaginal birth in a subsequent pregnancy (VBAC delivery). A thorough health history is taken during the first visit with a midwife to make sure one is an appropriate candidate for midwifery care. Factors such as number of previous c-sections or incision location can impact your eligibility.

Even patients who have some risk factors during pregnancy, such as being of advanced maternal age or having gestational diabetes, may still be able to see a midwife throughout pregnancy and delivery. There is no one-size-fits-all approach to your pregnancy, and midwives will cater their care based on your risk factors and preferences. If something more complicated arises, certified nurse midwives work closely with obstetric physicians to plan for any additional monitoring and appointments to help keep you and your baby safe and healthy. 

4. MYTH: Midwives don’t offer pain relief during labor.

TRUTH: You can still choose to have an epidural during birth under the care of a midwife.

Many pregnant people choose to work with a midwife because they desire an unmedicated birth in a hospital setting. And it’s true that midwives are experts in supporting families through a natural, unrushed labor experience. But they also know that every person’s perception of pain is unique. Therefore, their approach to pain management is centered on what you need and want, helping you to understand the pros and cons of all of your pain relief options. Throughout the course of your pregnancy, your midwife will get to know you personally and understand your preferences so that when the baby is ready to come, you can be as relaxed as possible knowing you have a birth plan that equips you to cope with pain. Whether that plan involves having a natural birth or using an epidural or nitrous oxide for pain management, your midwife will support you.

5. MYTH: Midwives only deliver babies.

TRUTH: Midwifery services expand beyond pregnancy and delivery.

Midwives are trained to care for people in all stages of life. Most commonly, individuals seek midwifery care for the entire span of pregnancy, from prenatal care to delivery and the postpartum period. However, the scope of a midwife spans beyond that into gynecologic services. Midwives can also provide preconception counseling, conduct routine gynecologic exams and pap smears, prescribe birth control, and evaluate patients for other gynecologic concerns.

Midwives care for patients 24/7 at MedStar Washington Hospital Center.

The Midwives of MedStar Washington Hospital Center includes fourteen certified nurse midwives who care for families in Washington, D.C. With longer-than-average appointments, you can expect our midwives to take the time to get to know you and your preferences for birth at each visit. We also take the time to share evidence-based information, encourage and empower you to make your own decisions when it comes to your birth experience, and help you understand the benefits and drawbacks of all of your options. There is always a midwife on staff, so whenever you go into labor, we’ll be there for you.

To schedule an appointment for your pregnancy or gynecologic needs with the midwives at MedStar Washington Hospital Center, please email us at whcmidwives@medstar.net.