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Midwifery Career Guide
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Midwives support women throughout pregnancy and supervise during the birthing process. Some people confuse midwives with birth doulas since both practitioners perform similar roles. However, midwives hold a more medically involved position and are qualified to participate fully in the birthing process while birth doulas can only observe and advise women as they're giving birth. Midwives can also advise, and in addition, they serve in a gynecological capacity to women who are not pregnant, performing pap smears and cervical exams.
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Midwives have been a part of the birthing process for thousands of years. Greek and Roman writings mentioned midwives, as did ancient Hindu records. Before the term "midwife" was invented, civilizations had termed women who supported other women during pregnancy as wise women. As time went on, the field of midwifery became increasingly formalized. Training requirements varied greatly in different areas of the world. In the mid-1500's, French midwives had to pass an exam to receive a license, and then followed certain regulations to practice. In colonial America, midwifery education wasn't formal. Women learned the trade through apprenticing and often used tinctures and herbs to ensure a safe delivery. English midwives didn't receive licensing capabilities until 1902.
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Since people normally visit a midwife during pregnancy, the first visit usually starts with a discussion of how the pregnancy is going, and whether the patient has any concerns. The midwife will ask the patient to fill out a medical intake form to take a record of family history and past pregnancies. This will give her an idea of the issues she may have to deal with before the pregnancy is over. She will also check the patient's weight and blood pressure. If the patient is past the first trimester of pregnancy, the midwife will listen to the baby's heartbeat, feel for the size of the womb and make sure that the appropriate lab appointments are made and kept.
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- Ante partum hemorrhage
- Breech presentation
- Dystocia
- Fetal distress
- Labor
- Meconium aspiration
- Multiple pregnancies
- Placenta
- Postpartum hemorrhage
- Pregnancy
- Prematurity
- Routine gynecological procedures
- Stillbirth
- Tearing
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- Better communication between doctor and patient
- Fewer required medical interventions
- Less likelihood that women will need pain medication
- Less time in active labor
- Lower C-section rate
- Lower infant mortality rate
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Side-Effects/Contra-Indications:
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- Before allowing a midwife to conduct medical tests or other nurse-related procedures, double-check her credentials as programs allow midwives to receive certification without medical training.
- There are no known contra-indications or side-effects to midwifery.
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Education and Schools:
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There are many paths to becoming a midwife, and each has its own requirements. The basic prerequisites to entering midwifery school include a high school diploma, at least 45-quarter hours of college, high school/college level biology, anatomy, and physiology. Those who want to take the nurse-midwifery path have to complete a Bachelor's or Associate's degree in nursing. Because regulations and paths to licensing vary by state, students should investigate whether their state provides licenses for midwives or only provides certification. Certified nurse-midwives can usually practice across the country, while licensed midwives are limited to the state they are licensed in. All midwife programs require that students complete classes in Integrated Medical Sciences, pharmacology, neonatology, postpartum care, antepartum care, clinical practicum, gynecology, and intrapartum care.
Degree/License offered: Master of Science in Midwifery, Advanced Certificate in Midwifery, Certified Professional Midwife (CPM), Certified Midwife, Certified Nurse Midwife, Licensed Midwife (LM).
Length of study: 7 months-4 years
Cost/Financial Aid: Full time: $335 to $5,000 per year. Costs vary widely because there are many paths to take in midwifery, each qualifying midwives for certain duties.
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Research:
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- Researchers compared the care provided by midwives to that by obstetricians in women who were in a low-risk pregnancy. The study involved more than 400 women attended by midwives and more than 600 who were attended by obstetricians. The study was held in Hong Kong. The results showed that women who were attended by midwives needed less labor help from oxytocin and less I.V. medication.
- Researchers compared how safe home births were in comparison to hospital births. Over the course of six studies, which included more than 24,000 subjects, scientists determined that women who gave birth at home with the help of a midwife had a lower occurrence of low Apgar scores and fewer medical interventions.
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Practitioner Training & Licensure:
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Most midwives will complete a bachelor's degree in nursing and complete midwifery training with a Master's Degree and subsequent certification through the American College of Nurse-Midwifery. But eleven states currently license midwives after they have completed an independent midwifery school and taken a qualifying exam. Other states don't require midwives to have a degree or licensure at all, as long as they have been designated as a Certified Professional Midwife by the NARM, which may be accomplished through attending workshops and apprenticing under a licensed/certified midwife.
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Average Salary/ Hourly Rate:
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A midwife's salary varies depending on whether she chooses to open her own practice or work for someone else. Most privately employed midwives get paid per pregnancy, averaging 2-4 births per month for $2,000-$4,000 each. Many CNM's are employed by hospitals or group practices, and in this case, they make approximately the same as a nurse practitioner.
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