Pregnancy - What's a Midwife?

For centuries giving birth was strictly an affair between the pregnant woman and a midwife. Though not always present, a mid-wife would frequently aid in the birthing process. The role was often performed by an older woman who had previously experienced birth herself. She gave comfort, medical knowledge based on real experience and a second pair of hands at a critical time.

With the rise of obstetrics in the 19th century, midwifery became much less common, almost disappearing from birthing practice in the U.S., except in circumstances of deep poverty or geographic isolation. In recent decades, it has risen again in a new form in which midwives are often licensed nurses with considerable traditional medical experience.

Though midwifing was historically carried out in the home, modern practitioners carry out their work in hospitals almost entirely today. Many women want to have the services of a midwife, but still avail themselves of the advantages of modern medicine in a traditional hospital setting.

In the overwhelming majority of births, the midwife has to take little active part in the process. She provides assurance, a hand to hold and 'insurance' in the form of letting the woman know that, should the need arise, an expert is at hand. But their presence and practice goes far beyond or rather before labor.

Midwives are available for pre-natal visits, and they offer one-on-one advice, much as an obstetrician will do - though frequently at lower rates. They are often there for much more of the time during the entire process, too, once labor starts. Many obstetricians have more patients than any single person can care for, even working 14 hour or longer days (as many of them do). A midwife can usually devote exclusive attention to a woman during labor.

They will be there at the beginning of the birthing process, continuously up to and after the completion of birth. Having a trusted and experienced medical expert at the bedside for the entire time is a great comfort to many. That's especially true for first time mothers, for whom the experience can be naturally a bit scary.

Midwives have the medical knowledge and the available technology to handle any situation. Breech births, preclampsia and other potential complications are nothing new to a good midwife. They can carry out needed tests - for iron levels, blood pressure and the like. And they can seek additional help, acting as an expert liaison when a woman may have other things on her mind. All midwives have an active working relationship with an obstetrician.

Midwives can be found through recommendations from friends or you can seek one by contacting the American College of Nurse Midwives in Washington, DC. The ACNM website ( is a good place to start your search.

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