Midwifery Care in Washington State
What is a midwife anyway?
Midwifery is arguably the oldest profession! It is a marriage between the art and science of maternity care, a recognition of both the physical and spiritual nature of childbirth. At the core of midwifery is the belief in balancing the power dynamic between a midwife and their clients. In the spirit of true shared decision making, they strive to arm their clients with knowledge and support to empower them in feeling confident and capable of making decisions for themselves and their families. Midwives recognize and celebrate that people are made unique by their personal, cultural, and religious beliefs. Something that really sets midwives apart is their commitment to spending time with their clients. That extra time is spent on ongoing education, health promotion, relationship building, and clinical assessment, as well as encouragement of the mind-body connection.
Modern midwives are health care professionals who combine traditional techniques and modern medicine to provide holistic care to childbearing people and their newborns. They are dedicated to the belief that birth is a normal life event and a natural and healthy process that most people are fully capable of doing! Midwives have undergone comprehensive medical training and are autonomous, licensed care providers. This allows them to judiciously access medical technology as needed, while avoiding the over-use of interventions. They combine traditional skills and modern medicine to safeguard physiologic childbirth. Midwives maintain relationships with other medical providers and allied health professionals in the event that their expertise becomes warranted.
There are several types of midwives in Washington and the United States as a whole, which is confusing! All midwives attend to healthy, low-risk people in the childbearing year. A certified nurse midwife, or CNM, is trained as a nurse prior to midwifery school. While they can (and some do!) work in private practice and attend births in the community, the vast majority work in the hospital... it's how they are trained! Certified professional midwives (CPMs) are specifically required to be trained in community-based birth. They are the experts in the nuances of birth at home and home-like birth center settings. While community-based midwifery is not regulated in every State, in WA, CPMs hold not only the national certification, but are also licensed specifically for this state and known as licensed midwives (LMs). Totally confusing! The good news is, by a recent analysis, Washington is ranked number one for midwifery, including birth outcomes, access to care, equity in maternity care, and midwifery integration into the larger medical system! Want to learn more about the types of American midwives and/or the ethnocentric, racist roots that led to our divergent maternity care system? The case for midwives: Washington state leads the nation in midwifery care is a great article. We also recommend the documentary Why Not Home? which does a great job of breaking down the science behind the benefits and risks of birth at home!
Modern midwives are health care professionals who combine traditional techniques and modern medicine to provide holistic care to childbearing people and their newborns. They are dedicated to the belief that birth is a normal life event and a natural and healthy process that most people are fully capable of doing! Midwives have undergone comprehensive medical training and are autonomous, licensed care providers. This allows them to judiciously access medical technology as needed, while avoiding the over-use of interventions. They combine traditional skills and modern medicine to safeguard physiologic childbirth. Midwives maintain relationships with other medical providers and allied health professionals in the event that their expertise becomes warranted.
There are several types of midwives in Washington and the United States as a whole, which is confusing! All midwives attend to healthy, low-risk people in the childbearing year. A certified nurse midwife, or CNM, is trained as a nurse prior to midwifery school. While they can (and some do!) work in private practice and attend births in the community, the vast majority work in the hospital... it's how they are trained! Certified professional midwives (CPMs) are specifically required to be trained in community-based birth. They are the experts in the nuances of birth at home and home-like birth center settings. While community-based midwifery is not regulated in every State, in WA, CPMs hold not only the national certification, but are also licensed specifically for this state and known as licensed midwives (LMs). Totally confusing! The good news is, by a recent analysis, Washington is ranked number one for midwifery, including birth outcomes, access to care, equity in maternity care, and midwifery integration into the larger medical system! Want to learn more about the types of American midwives and/or the ethnocentric, racist roots that led to our divergent maternity care system? The case for midwives: Washington state leads the nation in midwifery care is a great article. We also recommend the documentary Why Not Home? which does a great job of breaking down the science behind the benefits and risks of birth at home!
"I hear a lot of confusing and conflicting information. Is it safe?"
Great question! The research is in, and it supports midwifery care as a safe option for low risk families!
Midwifery is associated with increased rates of spontaneous vaginal birth, improved satisfaction with quality of care, and an increase in positive breastfeeding experiences.
Midwifery care is associated with reduced rates of labor induction and augmentation, as well as lower rates of cesarean section and forceps delivery, reduced use of regional anesthesia, fewer preterm births, decreased perineal tears, decreased infant mortality rates, and lower costs for both clients and insurers. (Source)
Not only is midwifery safe for low risk families, but families are more likely to reflect positively on their pregnancy and birth experience. Midwives believe in a sharing of power and decision making. This leads to increased reports of their clients feeling in control, competent, and empowered.
Midwives are becoming increasingly integrated into the Washington State healthcare system. This is not only crucial to improving outcomes, it also allows us to expand access to care by accepting most major insurances, including medicaid!
In other words... the majority of pregnant people fall in the category of "normal" and "low-risk" pregnancy. And for those people, choosing midwifery care gives them the greatest chance of having a normal, uncomplicated birth and reduces the risk that they will have a cesarean delivery, even if they have to transfer their care to the hospital during labor.
Midwifery care is associated with reduced rates of labor induction and augmentation, as well as lower rates of cesarean section and forceps delivery, reduced use of regional anesthesia, fewer preterm births, decreased perineal tears, decreased infant mortality rates, and lower costs for both clients and insurers. (Source)
Not only is midwifery safe for low risk families, but families are more likely to reflect positively on their pregnancy and birth experience. Midwives believe in a sharing of power and decision making. This leads to increased reports of their clients feeling in control, competent, and empowered.
Midwives are becoming increasingly integrated into the Washington State healthcare system. This is not only crucial to improving outcomes, it also allows us to expand access to care by accepting most major insurances, including medicaid!
In other words... the majority of pregnant people fall in the category of "normal" and "low-risk" pregnancy. And for those people, choosing midwifery care gives them the greatest chance of having a normal, uncomplicated birth and reduces the risk that they will have a cesarean delivery, even if they have to transfer their care to the hospital during labor.