HealthONE - December 02, 2019

After working in the labor and delivery unit at Swedish Medical Center as a registered nurse, Brittney Caspers knew she wanted a midwife to handle her prenatal care and the birth of her children.

“I really liked the midwives approach to labor,” she said. “They were more holistic, more supportive and physically more present during labor, and I like that they were willing to work with more natural, healing options instead of going straight to medication for things like morning sickness,” she said.

While Caspers felt more than confident using the midwives at Mountain Vista Midwifery, she encountered multiple misperceptions from friends and family members, which she gladly dispelled.

Here, with the help of Shana Martin, a certified nurse midwife for 31 years who practices at Mountain Vista Midwifery, we contrast the most common myths surrounding midwifery with the truth of the matter.

1. MYTH: Midwives deliver at home.

TRUTH: “The majority of American babies are born in hospitals, so the majority of certified nurse midwives (CNM) deliver babies in hospitals,” Martin said.

While midwives do attend home births and births at freestanding birth centers, the CNM’s at Mountain Vista Midwifery deliver babies at Swedish Medical Center, a hospital with a reputation for being extremely supportive of natural birth options. The nurses on the labor and delivery unit excel in supporting women in whatever kind of birth experience they want—one with or without interventions like epidurals, Martin said. They’re trained in natural birthing techniques like massage, positioning, water therapy, breathing techniques and more.

“They’re also great at teaching their support people how to do things like counter pressure and what words to say and what not to say,” Martin said.

2. MYTH: You can’t get an epidural or pain medication if you use a midwife.

TRUTH: “Of course you can have an epidural—you can do anything you want for the pain,” Martin said. When faced with this misperception, she reminds women that it’s their birth, and her job is merely to help them safely achieve what they envision. She’s not “attached” to any one vision of what birth looks like, as it’s different for every person.

Caspers also encountered this misperception from friends. “They just expected a very granola kind of delivery, but from working with the midwives, I knew it was my decision,” she said. “They would give me all of the info and tools if I wanted a natural birth but were supportive when I wanted an epidural. I like the midwives because they very much include you in your birthing plan and labor and are very supportive no matter what you choose—pain management, natural pain management or if you want to labor in the tub. They keep your birthing plan top of mind and help you achieve it, so long as it’s safe for baby and mom.”

3. MYTH: Midwives only do births.

TRUTH: Midwives see women throughout their lives for issues ranging from annual exams and pap smears to contraception or STD screenings.

“As certified nurse midwives, we take care of women throughout their lives, so from helping teenagers who just began menstruating or need contraception to women on the other end of the spectrum who are menopausal or perimenopausal, we are with women through their life span,” Martin said.

Also of note, after you give birth with the midwives, you’ll see them two weeks postpartum and again at six weeks postpartum whereas most doctors only see women at six weeks postpartum.

“We want to keep talking and answering your questions and see how things are going,” Martin said. “There is lots to talk about—people are afraid of their stitches, nervous about breastfeeding and more. Everyone is so focused on the day of birth, which is a big deal, but it’s not nearly as big as of deal as now you have a baby to take care of.”

4. MYTH: Midwives don’t have formal training.

TRUTH: Certified Nurse Midwives are advanced practice nurses who specialize in nurse midwifery. “People are used to family practice nurse practitioners; the only difference between us and a family practice NP, or women’s health nurse practitioner, is they don’t do the labor and delivery piece,” Martin said.

When Casper told her grandmother she was using a midwife instead of an OB-GYN, her grandma was concerned she wasn’t using a “real provider.”

“My grandma was under the assumption that midwives were just someone who had delivered a lot of babies but didn’t have formal training.”

Nothing could be further from the truth, Casper explained, as Certified Nurse Midwives undergo a tremendous amount of training.

TRUTH: Midwives work in conjunction with doctors. Nurse midwives have a support system that includes an OB-GYN who can perform a C-section, use forceps or a vacuum during birth or perform a hysterectomy, if necessary. “We always have relationships with physicians who are there if birth circumstances change and they are needed,” Martin said.

5. MYTH: If you have a midwife, you won’t have access to a doctor.

TRUTH: Midwives work in conjunction with doctors. Nurse midwives have a support system that includes an OB-GYN who can perform a C-section, use forceps or a vacuum during birth or perform a hysterectomy, if necessary. “We always have relationships with physicians who are there if birth circumstances change and they are needed,” Martin said.