Not All Midwives Are Created Equally

Our midwife weighs the baby a short while after his birth.

When I was pregnant with my first son, I thought that the fact that there was a midwife on staff in my OB’s office meant that I would be receiving some naturally-minded care (not that I cared much about going “all natural” at the time).  I should have known when she suggested I drink sodas to alleviate early pregnancy headaches that she was not of the “natural persuasion.”

Did you know that there are different types of midwives?  My recent midwife experience with my third son proved to be entirely different than that with my first.  She was very diet-focused, and provided me with herbs and whole food vitamin supplements.  She let me choose any and all interventions and tests I wanted to have done.  And she listened.  We talked about my emotional well-being as much as or more than my physical well-being.

Types of Midwives

So, what is it that makes midwives different from one another?

For starters, their title.  A Certified Professional Midwife (CPM), sometimes called or titled in conjunction with Licensed Midwife, is typically much different from a Certified Nurse Midwife (CNM).  Typically, CPMs go through a direct midwifery program to become a midwife.  CNMs become nurses before going into midwifery training.  While it may seem that a midwife with previous medical training would be superior to one that has become a midwife through a direct training program (and don’t get me wrong, I’m sure there are plenty of really good CNMs out there), in my experience, I greatly prefer a Certified Practicing Midwife, which is what my recent midwife is.

There are some easy ways to choose a midwife based on your preferences.  For starters, simply be aware of the letters following a midwife’s name.  Additionally, any midwife that is employed by a hospital is likely to be a CNM.  CPMs often have their own practices and are more likely to perform births at home or in birthing centers.

If you find yourself needing to make a decision, or with limited decision making power due to insurance or proximity limitations, there are other clues to look for when choosing a midwife.  If a midwife does not emphasize a healthy diet, she is probably going to be more focused on medicine and prescriptions than helping you to have a truly healthy pregnancy.  Your midwife should encourage plenty of fat consumption, as well as a well-balanced diet in general, with plenty of fresh produce and grassfed meats.

Diet was never even discussed during my first pregnancy.   The lack of proper dietary advice and guidelines (and my limited knowledge about healthful eating) led to preeclampsia and early induction with my first son.  Additionally, I had kidney stones during that pregnancy as well.  That was not the pregnancy or birth I wanted!  During my most recent pregnancy, my midwife had me keep a food journal for a couple of weeks so she could monitor what I was eating and help me make good nutrition choices. If my blood pressure was a little off, or blood work showed a lacking in any vitamins, she took the time to discuss with me dietary changes I could make to improve those situations.

Differences in Birth Situations

Another important note of difference (and this is also a basic difference between birthing in a hospital and birthing at home or in a birthing center) was how I birthed.  With my first birth, in the hospital and with a CNM, I had all the routine examinations (and should note that during my first pregnancy was subjected to routine cervical examinations, while my CPM did only one when I asked her to, then none again, even while I was in labor), as well as all the routine monitoring, which is quite annoying when you’re in labor.  I was given Pitocin and other drugs, made to lie on my back while I labored, and put my feet up when it was time to push.

With my CPM at home, I birthed however I wanted, with very little intervention.  She simply reminded me to allow birth to progress by “saying yes” to my contractions and keeping my birthing sounds low-pitched.  What a vast difference in birthing experiences!

Women are starting to catch on to the fact that they have other options when it comes to birthing their babies.  Those wanting to go the natural route should do plenty of research, even consulting with multiple midwives before making a decision if possible.  I could not have asked for a better birth experience the third time around, and wish I could go back and have all three of my boys at home with a midwife!  Home birth may not be for everyone, but the choice of a care provider during your pregnancy is one that should not be taken lightly and should be carefully considered.

For more suggestions on how to choose a midwife, the book Ina May’s Guide to Childbirthis a great resource.

Have you experienced different types of midwives?  Did you have a preference?  Why?

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