WE ARE NATIONALLY CERTIFIED, STATE LICENSED, SAFE, EDUCATED, EQUIPPED and WOMAN-CENTERED
Being a midwife today requires not only good clinical skills but also a broad understanding of the social and emotional adaptation to birth, which a woman must go through. A midwife must be clinically skilled and able to bring "woman-centered" practice to life.
Building on changes which have occurred in midwifery in the past decade, "the new midwife" is a trained professional who specializes in normal childbirth. She offers expert care, education, counseling and support to a woman and her newborn during the childbearing cycle.
NATIONALLY CERTIFIED and STATE LICENSED
Certified Professional Midwives (CPMs) are midwives with specialized training who have met a specific standard for education and who have documented a minimum number of experiential hours in prenatal, birth and postpartum care. They have attained competency in various areas considered "core competencies" for midwifery practice and have passed a standardized examination on these topics. National Certification takes, on average, about three years to complete. CPMs qualify for licensing in states that offer licensing options. Tennessee, along with about 22 other states, offers Licensure to practice midwifery. Georgia and Alabama do not offer Licensure at this time. Continuing education is required to maintain certification.
Certified Professional Midwives (CPMs) are midwives with specialized training who have met a specific standard for education and who have documented a minimum number of experiential hours in prenatal, birth and postpartum care. They have attained competency in various areas considered "core competencies" for midwifery practice and have passed a standardized examination on these topics. National Certification takes, on average, about three years to complete. CPMs qualify for licensing in states that offer licensing options. Tennessee, along with about 22 other states, offers Licensure to practice midwifery. Georgia and Alabama do not offer Licensure at this time. Continuing education is required to maintain certification.
SAFE
Studies about planned home birth and birth center birth in the medical literature uniformly report outcomes equivalent or superior to those of comparable women giving birth in the hospital.
In 2005, the British Medical Journal published a study of 5418 planned home births which once again concluded that this is a safe option for low risk (healthy) women. The study confirmed that home birth with midwives was associated with lower rates of medical intervention, while maintaining similar intrapartum and neonatal mortality as that of hospital birth for low-risk women. 1
Fullerton and Severino report in a 1992 study published in the Journal of Nurse Midwifery that: "[Low risk] women in hospital were more likely to receive an interventive style of labor and birth management. Neonatal outcomes were similar, although the incidence of sustained fetal distress, prolapsed cord, and difficulty in establishing respirations were significantly greater in the hospital sample. Hospital care did not offer any advantage for low risk women, and it was associated with increased intervention.” 2
There are many studies exploring this issue of safety and homebirth. One of the largest, involving over 24,000 births, compared the safety of planned homebirth with planned hospital birth for low-risk women. 3 This study compared several outcomes, the main ones being infant and maternal mortality. There was no difference between the two groups in either infant or maternal mortality. However, "Approximately twice as many babies in the hospital group as in the home birth group had low Apgar scores." Apgar scores are a measure of a baby's well being in the first few minutes of life. Episiotomies (an incision done to enlarge the vaginal opening at the time of birth) are an intervention that is often done in hospitals. This is true, despite the fact that they frequently lead to more severe lacerations and that they do not improve outcomes. In Olsen's study, there were 50% more perineal lacerations among the women who delivered in hospitals. One of the main reasons for homebirth's good track record is that midwives have the flexibility to be patient and wait for the woman to give birth at her own pace. Midwives are not held to tight time constraints, and consequently are not tempted to rush the process of birth. This simple act of waiting patiently for the birth to unfold prevents the need for many interventions that can themselves cause the baby or mom to develop "complications." Midwives combine the art of waiting and watching with careful monitoring of the mom and baby to ensure that the birth progresses normally.
1. Johnson, K. and Daviss, B. (2005) Outcomes of Planned Home Births With Certified Professional Midwives: Large Prospective Study in North America. British Medical Journal 2005;330:1416
2. Fullerton, Judith and Richard Severino. "In-Hospital Care for Low-Risk Childbirth: Comparison With Results from the National Birth Center Study." Journal of Nurse Midwifery. 1992. 37(5): 331-340.
3. Olsen, Ole. "Meta-Analysis of the Safety of Homebirth." Birth: Issues in Perinatal Care. 1997. 24(1): 4-13.
Studies about planned home birth and birth center birth in the medical literature uniformly report outcomes equivalent or superior to those of comparable women giving birth in the hospital.
In 2005, the British Medical Journal published a study of 5418 planned home births which once again concluded that this is a safe option for low risk (healthy) women. The study confirmed that home birth with midwives was associated with lower rates of medical intervention, while maintaining similar intrapartum and neonatal mortality as that of hospital birth for low-risk women. 1
Fullerton and Severino report in a 1992 study published in the Journal of Nurse Midwifery that: "[Low risk] women in hospital were more likely to receive an interventive style of labor and birth management. Neonatal outcomes were similar, although the incidence of sustained fetal distress, prolapsed cord, and difficulty in establishing respirations were significantly greater in the hospital sample. Hospital care did not offer any advantage for low risk women, and it was associated with increased intervention.” 2
There are many studies exploring this issue of safety and homebirth. One of the largest, involving over 24,000 births, compared the safety of planned homebirth with planned hospital birth for low-risk women. 3 This study compared several outcomes, the main ones being infant and maternal mortality. There was no difference between the two groups in either infant or maternal mortality. However, "Approximately twice as many babies in the hospital group as in the home birth group had low Apgar scores." Apgar scores are a measure of a baby's well being in the first few minutes of life. Episiotomies (an incision done to enlarge the vaginal opening at the time of birth) are an intervention that is often done in hospitals. This is true, despite the fact that they frequently lead to more severe lacerations and that they do not improve outcomes. In Olsen's study, there were 50% more perineal lacerations among the women who delivered in hospitals. One of the main reasons for homebirth's good track record is that midwives have the flexibility to be patient and wait for the woman to give birth at her own pace. Midwives are not held to tight time constraints, and consequently are not tempted to rush the process of birth. This simple act of waiting patiently for the birth to unfold prevents the need for many interventions that can themselves cause the baby or mom to develop "complications." Midwives combine the art of waiting and watching with careful monitoring of the mom and baby to ensure that the birth progresses normally.
1. Johnson, K. and Daviss, B. (2005) Outcomes of Planned Home Births With Certified Professional Midwives: Large Prospective Study in North America. British Medical Journal 2005;330:1416
2. Fullerton, Judith and Richard Severino. "In-Hospital Care for Low-Risk Childbirth: Comparison With Results from the National Birth Center Study." Journal of Nurse Midwifery. 1992. 37(5): 331-340.
3. Olsen, Ole. "Meta-Analysis of the Safety of Homebirth." Birth: Issues in Perinatal Care. 1997. 24(1): 4-13.
EQUIPPED
Midwives working in a home setting are well outfitted with essential material and equipment. Instruments, thermometer, blood pressure cuff, a stethescope, newborn resuscitation bag and mask, baby scale and sterile supplies are among some of the items you will find in a midwife’s bag. Midwives also carry and adminIster medications such as Oxytocic drugs for hemorrhage, local anesthesia for suturing, oxygen, eye prophylaxis and Vitamin K for the baby.
Midwives working in a home setting are well outfitted with essential material and equipment. Instruments, thermometer, blood pressure cuff, a stethescope, newborn resuscitation bag and mask, baby scale and sterile supplies are among some of the items you will find in a midwife’s bag. Midwives also carry and adminIster medications such as Oxytocic drugs for hemorrhage, local anesthesia for suturing, oxygen, eye prophylaxis and Vitamin K for the baby.
WOMAN CENTERED
The hallmark of midwifery is the time they spend with a woman.
The national average time that a woman spends with her obstetrician in a prenatal visit is 10 minutes.
The average prenatal visit with a midwife is one hour.
The value of spending time with a woman during a prenatal visit cannot be overemphasized. It lays the foundation for providing support, education and information. The concept of education and providing complete information is based on the principle that parents are qualified to make decisions concerning their pregnancy and birth. Midwives encourage women to be involved in active, ongoing participation and decision making in all aspects of their pregnancy and birth. They are committed to helping women identify areas where they can help themselves to have the healthiest possible pregnancy and birth experience. Concurrently, the time that a midwife spends with a woman plays a vital role in building trust and mutual respect. This important part of the relationship contributes to an atmosphere of comfort during the birth process and diminishes unwarranted anxiety of both parents-to-be.
The hallmark of midwifery is the time they spend with a woman.
The national average time that a woman spends with her obstetrician in a prenatal visit is 10 minutes.
The average prenatal visit with a midwife is one hour.
The value of spending time with a woman during a prenatal visit cannot be overemphasized. It lays the foundation for providing support, education and information. The concept of education and providing complete information is based on the principle that parents are qualified to make decisions concerning their pregnancy and birth. Midwives encourage women to be involved in active, ongoing participation and decision making in all aspects of their pregnancy and birth. They are committed to helping women identify areas where they can help themselves to have the healthiest possible pregnancy and birth experience. Concurrently, the time that a midwife spends with a woman plays a vital role in building trust and mutual respect. This important part of the relationship contributes to an atmosphere of comfort during the birth process and diminishes unwarranted anxiety of both parents-to-be.
