Quick little story before following the yellow brick road – our social media post was deemed too long, and thus a blog was born. We had discussed creating a blog – whether we should or not, and when – and, well, no time like the present and a post with too many words. (I took the liberty to add more words and create a more well-rounded text).
Once upon a time, a woman giving birth need only call on the local knowledgeable lay woman who had been there to support all the other women during their births. Sometimes other women of the community would come and support the laboring mother – much like the beautiful way the matriarchal elephant herds support and protect the vulnerable laboring female elephant, then literally celebrate with her as soon as the calf is delivered. No, we don’t think of women as elephants, just love their wonderful example of women supporting women.
So what do women do now? Well, you may remember our post about the eradication of midwifery (check it out if you haven’t!) in the United States. When obstetrics started to become a field of interest for male doctors during the early 1900s, doctors began to renounce midwifery practice as barbaric and dangerous, insisting women give birth in the hospitals. Now, for the last 100+ years, doctors or nurses have taken the forefront of care in women – ~99% of all women give birth in the hospital. Because of this shift, it has left a lot of questions on what the options for care providers are and what the best option for you may be.
Care Providers and What They Offer
OB/Gyns
There are two related, but distinct fields that doctors study for supporting women during pregnancy – gynecology (Gyn), which is the study of the functions and diseases of the female reproductive system, and obstetrics (OB), which deals with the study of pregnancy, childbirth, and postpartum.
Doctors who specialize in general obstetrics and gynecology typically see women for pregnancy and women’s reproductive health concerns. They facilitate birth in a hospital and are trained in surgical options, ranging from hysterectomies to Caesarean sections.
Because of their skilled training in high-risk settings, such as women who may already be experiencing a difficult pregnancy or have pre-existing conditions that risk them out of care for an out-of-hospital birth.
A further specialized field of OB/Gyns is a doctor of Maternal Fetal Medicine (MFM) who have even more extensive training in diagnosing and monitoring high-risk situations during pregnancy.
CNM
A Certified Nurse Midwife (CNM) is a Registered Nurse who has completed her Bachelor’s degree in Nursing and continues on to get a Master’s degree in Nurse-Midwifery or even a Doctorate of Nursing.
Typically, CNMs are Advanced Nurse Practitioners (ARNPs) that have a specialized focus on women’s health, the female reproductive system, and the care of women during pregnancy, childbirth and postpartum.
A CNM can practice in various settings: home, birth center, or hospital. If your CNM practices in a hospital, you would still have access to anesthetic pain management, such as IV pain medication and/or epidurals.
CNMs have certain prescriptive authority and can prescribe birth control and various medications as it falls within their scope of practice. A lot of midwives will work with a Doctor to be able to access other prescriptive options not generally available.
CPM
A Certified Professional Midwife (CPM) is a type of Direct Entry Midwife (DEM) who goes through specialized training, including a specific amount of formal, didactic training, whether through a school of midwifery or independently, and includes a required minimum of two years of practical, hands-on clinical practice under a qualified, experienced midwife (or midwives).
After graduating through a MEAC (Midwife Education Accreditation Council) school or completing the process of training and submitting in the required documentation, a student midwife will then sit for an exam on a national level (NARM – North American Registry of Midwives is one of the organizations commonly utilized for this process).
Depending on the state, a CPM can still carry certain medications, but are also trained in natural methods of managing potential complications of childbirth, emphasizing a healthy diet and lifestyle to support a low-risk pregnancy. Some states require CPMs to become licensed in order to practice and legally carry medication (check your state’s laws). CPMs practice in out-of-hospital setting.
In Oklahoma, a CPM must also become licensed through the state, giving them the distinction of being a Licensed Midwife (LM).
Lay Midwife
This is generally also a trained, direct-entry midwife, typically someone who is choosing not to seek certification through an organization like NARM, or whose state does not have laws governing midwifery licensing.
Not legally able to carry medication, these midwives have studied and trained on using herbal and other alternative options for managing potential risks of childbirth. Remember the first women we mentioned? This was what they were – lay midwives. They practice in out-of-hospital settings.
These are the typical types of providers you will find when searching for your prenatal care. If you ever have any questions, don’t hesitate to take the opportunity to interview someone from every field to ensure you find the best provider for your birthing goals.
Leave a Reply