What is a midwife?

Plus, what’s the difference between a midwife, a doula and an OB-GYN?

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Edited by: Justin Martino
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Midwives have been around for centuries and are becoming increasingly common as an alternative to a traditional obstetrician. As the practice of midwifery sees a resurgence and grows in popularity, you may be wondering: What is a midwife? And is a midwife right for you? Read on to learn more about midwives, what they do, how they’re trained and how much they cost.

Key insights

Midwives provide personalized care throughout pregnancy, labor and postpartum, offering emotional support, monitoring vital signs and assisting with newborn care. Their level of involvement depends on the birth setting and the type of midwife chosen.

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There are four main types of midwives, ranging from highly trained certified nurse midwives (CNMs) who can prescribe medication to traditional midwives who operate without formal licensure, often serving specific cultural or religious communities.

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OB-GYNs are medical doctors trained to manage high-risk pregnancies and perform surgeries like cesarean sections, whereas midwives typically focus on low-risk pregnancies and provide a more holistic, non-interventionist approach.

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What does a midwife do?

When working with a midwife, the services provided will vary based on the type of midwife you hire and where you choose to deliver your child. During your pregnancy, a midwife may handle your prenatal appointments. Some obstetricians may have a midwife in their office, and, if you are doing a home birth, you will see the same midwife throughout your pregnancy.

If you choose a home birth, your midwife will typically bring medical supplies, monitor your baby’s heart rate, and be prepared to transfer you to a hospital if complications arise.

During labor, a midwife helps guide you through the birthing process. A midwife monitors your progress and keeps an eye on your baby’s heartbeat and other vital signs. They are also there to provide information, encouragement and emotional support.

Immediately after birth, a midwife cares for the mother and baby. Midwives offer postnatal care in hospitals and at home. They offer breastfeeding advice and support and help with learning how to bathe or change a baby, and midwives can conduct some newborn screening tests. When you go home from the hospital, a midwife will visit you there.

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What are the different types of midwives?

Traditionally, a midwife is a nurse who has received a master’s degree in midwifery and has been trained in the aspects of women’s health care. Currently, there are four types of midwives.

  • Certified nurse midwife (CNM): A certified nurse midwife is the traditional formally trained nurse with a master’s degree in midwifery. A certified nurse midwife is qualified to work in all birth settings. CNMs can also write prescriptions and provide other reproductive healthcare services.
  • Certified midwife (CM): Certified midwives are individuals who have a background in a health-related field other than nursing and have a master’s level midwifery education program. Their training is similar to a CNM.
  • Certified professional midwife (CPM): Certified professional midwives work exclusively in settings outside of hospitals, such as homes and birth centers. A CPM has completed coursework, an apprenticeship and a national certifying exam. CPMs are licensed to practice in 37 states. In some states, CPMs may also practice in clinics and doctors’ offices.
  • Traditional midwife (unlicensed): There are also midwives who have chosen not to pursue licensure to become a midwife in the United States but still serve birthing families in home settings. Their training and background vary. Often, traditional or unlicensed midwives serve specific communities, such as indigenous communities or religious populations.

OB-GYNs vs. midwives

While OB-GYNs are the most common professionals who deliver babies in the U.S., midwives are increasing in popularity. An OB-GYN or a midwife can deliver your baby, but they have different skill sets.

An OB-GYN is a doctor who has completed 12 years of education. They are qualified to manage high-risk pregnancies and any complications that may arise during labor and delivery. An OB-GYN delivers in a hospital and is qualified to perform cesarean sections if needed.

A midwife, while trained in labor and delivery, cannot perform all of the tasks that a doctor can, such as surgery if a cesarean section is needed. Most midwives deliver babies in hospitals, birthing centers or at the mother’s home. Some also facilitate alternative birthing preferences, including water births. Midwives can provide additional services, including postnatal care for mothers and babies and emotional support during labor and delivery.

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Doulas vs. midwives

A doula is a trained professional who has experience in labor and delivery and is traditionally hired to provide emotional, physical and informational support to a laboring mother and partner. A doula is often hired to work in tandem with an OB-GYN to ensure a mother’s birth plan is executed per her wishes. A doula can be hired to assist a midwife. In either case, a doula should be accompanied by a medical professional in case any complications arise.

How much does a midwife cost?

The average range of midwife costs in the US is $2,000 to $9,000, but the cost of a midwife varies based on the area in which you hire one and their level of experience and certification. This price can include prenatal care and home visits postpartum. Depending on the type of insurance plan you have, a portion of your midwifery costs may be covered by your health plan.

FAQ

Are midwives doctors?

No, midwives are not medical doctors although some do earn doctorates in nursing practice. They are trained healthcare professionals specializing in pregnancy, childbirth, and postpartum care, but they do not attend medical school like OB-GYNs.

Can midwives give epidurals?

No, midwives cannot administer epidurals, they can only prescribe them. If you want an epidural, an anesthesiologist or other medical professional in a hospital setting must provide it.

Can midwives perform C-sections?

No, midwives cannot perform cesarean sections. If a C-section is necessary, an OB-GYN or surgeon will conduct the procedure in a hospital setting.

How do midwives get paid?

Midwives can be paid through private payments, insurance reimbursement or Medicaid in some states. Midwives can also get paid as salaried employees through hospitals or birthing centers. Costs and coverage vary depending on the midwife’s certification, location and insurance provider.

Bottom line: Should I get a midwife?

A study published in “Obstetrics & Gynecology” shows that moms who use midwives have increased access to prenatal care, lower rates of cesarean births and obstetric interventions and babies with higher birth weights. Midwives are an excellent option for mothers who are interested in home births, nonmedical intervention labor and delivery and are generally considered a healthy or low-risk pregnancy.

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