Congratulations, you're Pregnant!.
Let the decision-making begin. Choosing a health care provider to care for you and your baby during your pregnancy is one of the biggest decisions you'll make.
In the United States, women's choices once were limited to an obstetrician or a knowledgeable family doctor. But the word is out! More and more women are realizing that they have a choice about where and with whom they give birth and that doctors are not the only providers for childbirth. Midwives, birth centers, home, waterbirth are all valid choices for women. More and more families are choosing midwives as their maternity care providers. Let the decision-making and choice be yours.
Midwives delivered well under 8% of American babies in 2003, a percentage that has been increasing since the seventies. Generally Americans are not educated on what is midwifery or the role of the midwife, how they're trained, or how to find a qualified midwife. Here are some useful details about the practice of midwifery, midwifery training, regulations within Florida and the general history of midwifery. It is our hope that this guide helps you and your family, determine if working with a midwife is the right path for your labor, birth and postpartum care.
Use the links below to learn more about Midwifery
Congratulations, you're Pregnant!
The History of Midwives
What is a Midwife
Types of Midwives and the Kind of Training a Midwife Completes
What's the Midwife's Philosophy?
What Does a Midwife Do?
Is a Midwife Right for You?
Finding a Midwife
.The History of Midwives
Historically and across cultures midwives have been primary care providers to women during pregnancy and birth and throughout the female life cycle. Throughout most of the world and most of history, women have labored and birthed with midwives. Midwifery is the term traditionally used to describe women attending women in childbirth. The simplest definition of midwifery is "with woman”. A practitioner of midwifery is known as midwife.Go Back
.What is a Midwife
Midwives and Midwifery Care in the State of Florida
In the State of Florida, midwives are qualified health care providers who go through comprehensive training and examinations for certification and licensure. TheNorth American Registry of Midwives (NARM) and the American College of Nurse Midwives (ACNM) offer certification. Florida Statute 467 governs the practice of Midwifery and midwives practicing in the state. Midwives are fully trained in a three-year program, licensed by the state, and carry malpractice insurance as required by the law. These autonomous practitioners are specialized in low-risk pregnancy, labor and childbirth, and postpartum care. The midwife provides prenatal care to expecting mothers, attends the birth, and provides postpartum care to the mother and her child. Midwives, trained to recognize and deal with deviations from the norm, and while Obstetricians, in contrast, are specialists in illness related to childbearing and surgery. The two professions can be complementary, but often are at odds because obstetricians are taught to "actively manage" labor, while midwives are taught not to intervene unless necessary.
- Midwives have been licensed and regulated to practice midwifery in the state of Florida since 1931.
- Midwives must graduate from a fully accredited midwifery program.
- Graduates take a board exam to become nationally certified (CPM) and state licensed (LM).
- Currently (2008) there are 207 Florida Licensed Midwives.
- Licensed Midwives function as part of the health care system.
- As educated, skilled professionals, Midwives believe….
- Pregnancy and birth are normal, natural life processes
- Midwifery care is high touch/low tech, time intensive/cost effective care
- The practice guidelines for Florida LMs are provided in Florida State Law (F.S.S. 467) and Rule (F.A.C. 64B24). LMs are independent practitioners
- Florida law requires that the services provided by both LMs and CNMs be reimbursed by private insurers and Medicaid
- Midwives licensed to practice midwifery in the state of Florida are required to carry professional liability insurance in the minimum of $100,000/$300,000
- Research shows midwifery care has been proven to reduce birth injury, trauma and cesarean section.
- The safety and benefits of midwife care has been proven again and again in countries across the world. World Health Organization statistics show that births attended by midwives have lower infection rates, lower C-section rates, and fewer complications, and healthier outcomes – thus, lower overall medical costs than physician-attended hospital births.
- Countries such as the Netherlands, Sweden, and New Zealand, which have the best birth outcome statistics in the world, use midwives as their main maternity care providers
- Midwives attended 297,902, or 9.5% of all births in the United States in the year 2006
- 40,588 or 1% are births at home
- Landmark study published in the British Medical Journal (2005)
- Planned home births attended by Certified Professional Midwives (CPMs), are safe for low risk women and involves far fewer interventions than similar births in hospitals
- Health promotion & disease prevention
- Preventative healthcare
- Reducing health disparities;
- Reducing maternal and infant mortality;
- Promoting infant well-being
- Cost-effectiveness of care
- Access to quality care.
Florida Licensed Midwives: “experts” in healthy, natural pregnancy and childbirth
Florida Licensed Midwives: “experts” in healthy, natural pregnancy and childbirth
Florida Licensed Midwives: “experts” in healthy, natural pregnancy and childbirth
The Importance of Midwifery (what other professional organizations say)
"The curricula for the education of all health professionals should reflect the role of the midwife as the primary care giver in maternity care.” ~ World Health Organization
"The midwifery model of care is an essential element of comprehensive health care for women and their families that should be embraced by, and incorporated into, the health care system and made available to all women.” ~ PEW Commission
“ We support efforts to increase access to out-of-hospital maternity care services and increase the range of quality maternity care choices available to consumers, through recognition that legally-regulated and nationally certified direct-entry midwives who can serve clients desiring safe, planned, out-of-hospital maternity care services.” ~ The American Public Health Association
“The midwifery model of care is an essential element of comprehensive health care for women and their families that should be embraced by, and incorporated into the health care system, and made available to all women” ~ PEW Commission
Research & Statistics
Outcomes of Planned Home Births with a Certified Professional Midwife
Study showed:Safe & Healthy Outcomes
Low Rates of Medical Intervention
Few Transfers to Hospital
The Safety of Planned Home Births -
98.4 % of all the mothers were in good health after birth
98.3% of all the babies were in good health after birth
99% initiated breastfeeding and 95.8% were still breastfeeding at 6 weeks!
Episiotomy rate = 2.1% (compared to 33.0%)
Cesarean Section rate = 3.7% (compared to 19% nationally) It is now up to 30 % nationally
Infant mortality rate = 1.7 in 1000 live births (similar to hospital outcomes for low risk)
No maternal deaths
Midwives and Midwifery care support and promote the many Public Health initiatives:
Types of Midwives and their training
Midwives today come from a variety of backgrounds.Licensed Midwife (LM) Autonomous maternity care providers providing primary health care to woman of childbearing age. Licensed Midwives are direct-entry midwives. A direct-entry midwife receives specialized training and education in the academics and skills specific to midwifery practice. A License Midwife is licensed to practice in their particular state. (currently 24 states have LMs)
Certified Professional Midwife (CPM) A skilled and professional independent midwifery practitioner Has met the standards for national certification set by the North American Registry of Midwives (NARM) The CPM is the only US credential that requires knowledge about and experience in out-of-hospital settings. Certified Professional Midwives are direct-entry midwives. At present approximately 1,215 CPMs practicing in the US.
Certified Nurse-Midwife (CNM) Licensed healthcare practitioners educated in the two disciplines of nursing and midwifery. Provide primary healthcare to women of childbearing age CNMs attend over 10 percent of the births in the United States. 96 % of these births are in hospitals. At present there are approximately 5,700 CNMs practicing in US.
.What's the Midwife's Philosophy?
A midwife stresses that pregnancy and birth are normal, natural, healthy events in a woman’s life…a time of tremendous growth and discovery. Midwives share with women the knowledge, wisdom and understanding of birth…identifying interferences and variances to this process. Midwives also focus on the psychological aspects of how the mother-to-be feels about her pregnancy and the actual birth experience. They encourage women to trust their own instincts and seek the information they need to make their own valuable decisions about pregnancy, birth, and parenthood.
Midwives support the wisdom that women intuitively know how to give birth and babies know how to be born. Women need to be supported and reassured of their knowing. Midwives TRUST birth…Midwives believe in BIRTH and in BIRTHING WOMEN!"At Spirit of Life Traditional Midwifery, Sheila's birth Philosophy is one that strives to help women have a healthy pregnancy and natural birth experience." Learn More»
.What Does a Midwife Do?Midwives have been attending women during pregnancy and birth since the beginning of time.
Midwives are specialists in normal reproductive care. During their education and training, midwives become experts in normal pregnancy, birth and newborn care, and recognize that pregnancy and birth are normal functions, not illnesses. Midwives spend considerable time educating and counseling mothers and families during pregnancy and preparing them for birth, breastfeeding and caring for the newborn. Midwives monitor the physical, psychological, and social well-being of the mother throughout the childbearing year; provide continuous assessment and support while minimizing technological interventions during labor and birth; identify and refer women who require obstetrical attention; provide outstanding and personalized postpartum care for women and their newborns. Midwifery care is individualized to address each woman and each family’s physical, emotional and spiritual needs. Midwives are able to help most women avoid the use of routine obstetric interventions such as labor induction, IVs, anesthetics, and episiotomies.
One of the most significant aspects of midwifery care is the relationship that forms between the mother and midwife. All visits are at least a 45 minutes to one hour long providing the mother with time to discuss questions, concerns and desires. Most Midwives understand that your partner, children and family are an integral part of your life and they are encouraged and welcome to be at your visits to ask their own questions and to witness the miracle of your baby's growth.Go Back
.Is a Midwife Right for You?
Midwives have an excellent record of safety with numerous studies have showing that midwife-supervised births produce excellent outcomes with fewer medical interventions. The countries with the world’s lowest infant mortality and lowest rates of technological intervention have midwives attending 70 percent of all births without a physician in the birth room. The results of midwifery care show that the level of prenatal care, education, birth and postpartum care midwives provide results in a low rate of technological intervention, low c-section rates, and healthy babies. Midwives offer a preventive, holistic model of care, a more personal relationship with their clientele, and a philosophy of care that recognizes the importance of parental responsibility and choice within the birth process
Complications and Emergency Plan
Midwives are trained to watch for and identify potential or actual complications, to recognize abnormal conditions and to provide stabilizing care and emergency treatment until additional assistance or help is available. Because midwives are experts in normal pregnancy and birth, midwives are experienced in the variations of normal birth and recognize the early signs or conditions that are not “normal” including medical conditions or complications that may occasionally arise during pregnancy or the birth process.
An Emergency Care Plan (ECP) is a plan that is utilized to outline care to be provided in the event of an emergency or non-emergency abnormal condition. The plan outlines which doctors and hospitals will be used if necessary. In the state of Florida, the ECP will be completed by 28 weeks of pregnancy. It will include the names, addresses and phone numbers for all facilities and doctors to be used as needed. The completed form will be clearly posted in the client’s home and one copy placed in client’s file.
- What training or equipment does your midwife have to handle emergencies?
- How far will you be from the nearest hospital?
- Do they have fail-safe transportation?
But it's a good idea to get answers to these questions:
.Finding a Midwife
You can decide to use a midwife at any time during your pregnancy. Women often turn to midwifery care when they begin to seriously consider their birth plans. Midwives provide a full range of services including prenatal care. They follow guidelines in providing this care and to evaluate your medical needs, and keep detailed prenatal care records for each of your appointments. A midwife can accept a woman well along in pregnancy as long as she has had adequate prenatal care.
Interview a prospective midwife carefully. Investigate the midwife's background, certifications, experience, and emergency procedures. Because you'll be closely involved, make sure your personalities mesh. Do you feel comfortable with the midwife? Can you talk easily?
At Spirit of Life our Midwifery care includes…..
Monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle Providing the mother with individualized education, counseling and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support Prenatal care that promotes informed decision-making (spending time with pregnant woman – 45 minutes to hour visits)Go Back
Providing A Choice….Providing choice for place of birth – attendance at home or birth center Breastfeeding support Examination and evaluation of the newborn/early parenting support Well woman/GYN care Minimizing technological interventions Identifying and referring women who require obstetrical attention
Respectful TreatmentGentle, nurturing care that respects you, your family and your beliefs. Respect for your informed decisions, about medical tests, recommendations and interventions Respect for the birth process as it unfolds uniquely each time. Each woman’s experience is unique
Personal AttentionPrenatal visits that allow plenty of time for questions and answers 45 to 60 minutes for each prenatal appointment is common Meaningful discussions to explore and help resolve fears and concerns you or your family may have Caring attention to develop a trusting and nurturing relationship with you and your family that can help you to labor and birth naturally and safely
Plenty of InformationInformation about pregnancy, birth and the newborn, breastfeeding and newborn care Suggestions on ways you can take good care of yourself and your baby Encouragement and practical suggestions for good nutrition and for making healthy lifestyle choices. Information on testing, procedures or treatments so you can make informed choices about your care
Pregnancy and Childbirth is a Normal Healthy Process
Women in Florida are learning that pregnancy and childbirth is a normal, healthy process, not a disease. They are discovering that they and their families can benefit from the care of a Florida Licensed Midwife. Women are discovering that the hospital is not the only option for a safe birth. Many women find that they feel most comfortable at home or in a birth center, attended by a midwife trained in gentle, natural, safe childbirth - someone who is trained in normal birth and provides the Midwives Model of Care.
Pregnancy and childbirth involve every part of you. Feelings, hopes, fears, physical and practical needs, and spiritual or religious beliefs can all affect your pregnancy and birth. A midwife addresses all of these aspects to help you give birth naturally, safely and confidently. Women who experience this type of care report feelings of great satisfaction and empowerment.
Just as each woman's dream childbirth is different, each natural home childbirth story is different. It is the role of a midwife to help each dream come true, within the parameters set by the baby's unique journey into the world. The midwife is a guide, mentor, educator, and professional dedicated to the most modern techniques to guard the safety of mother and baby.
For women with low-risk pregnancies, natural homebirth with a qualified midwife is as safe as hospital births. In fact, reducing stress and elevating comfort and joy has been shown to reduce pain and the need for unnecessary procedures, which can lead to other complications.
The Midwives Model of Care
At the core of the Midwives Model of Care is deep respect for the normalcy of birth and for the uniqueness of each childbearing woman and her family. This approach to maternity care promotes health and helps prevent complications. Care providers who practice this model of care have excellent outcomes while providing safe individualized care. The midwives model of care includes:
• monitoring the physical, psychological and social well being of the mother throughout the childbearing cycle
• providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum
• minimizing technological interventions; and identifying and referring women who require obstetrical attention
The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.