Debunking Six Myths of Midwifery

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Myths of Midwives“So, are you having your baby in a barn?” Unfortunately that is a question some people ask when they hear a woman has chosen to use a midwife to deliver her baby. While the use of midwives in the United States has climbed over the last few years, they still only assist 10 percent of births, as opposed to over 90 percent in some other developed nations. Perhaps part of the low numbers in the U.S. is due to the myths surrounding who midwives are and what exactly they do.

Kristin Vincent, certified-nurse midwife who practices as part of Saint Joseph OB-GYN Specialists and Midwifery, has faced many of those myths during her 12 years as a midwife. Kristin currently practices at both Memorial Hospital and Saint Joseph Regional Medical Center, and has caught over 1500 babies throughout her career. And, no, none of them were born in a barn.

Here are the six most common myths of midwifery and the facts that debunk them.

Midwives are only for home births.

“That’s a very common one. When people hear that someone is using a midwife, the first thing they think and assume is that they will have the baby at home. The truth is that more midwives are delivering in the hospital than out of the hospital,” Kristin said. She went on to explain that in the state of Indiana, certified-nurse midwives (CNMs) can legally deliver at home, or in the hospital or birth center.

Midwives don’t allow pain medicine and epidurals in birth.

“That’s another one people worry about. I always tell people, ‘You’re having the baby; not me. This is about how you want to have the baby.’ People who choose midwives often have an opinion about having a baby and that’s what matters. Currently, 47 percent of women in our practice have epidurals.” Kristin said the hospital average is around 80 percent. She has no objection to women choosing to receive pain medicine if they need it. “Everybody’s level of pain is different.

If the patient so chooses, the midwives do offer alternatives, including laboring in the water. “We like people to get in the tub. I think the water works better than IV medications and reducing pain. I always say that if you get in the water and it doesn’t work, you need an epidural.”

Midwives aren’t formally educated.

“A CNM is somebody who has a degree in nursing and then goes on to midwifery school where they receive a master’s degree and OB-GYN training. Their training involves obstetrics and gynecology, well-woman primary care, and newborn care.” Kristin went on to say that the difference between an OB-GYN’s education and a CNM’s is that an OB-GYN receives surgical and high-risk care, but a midwife doesn’t. But, the OB-GYN does not receive the well-woman primary care training that midwives do. As Kristin said, “Midwives are considered low-risk pregnancy specialists.”

Midwives aren’t covered by insurance.

“Actually, we are covered by more insurance companies than most offices because we practice at both hospitals. Insurance companies require us to have a preexisting collaborative agreement with a physician,” Kristin said. “Insurance likes that because the research says that’s the safest thing to do. If a patient needs a C-section, I know who to call because I am already working in collaboration with that doctor in my practice. I don’t have to find someone else who I don’t have a relationship with.”

Midwives only handle pregnancy and birth.

Kristin pointed out that midwives can also act as primary care physicians for women and do gynecological visits as well. “We do a ton of gynecological care. I like to be able to care for people even after they have their baby. When you get to know someone and like them, it’s hard to find someone you trust and who has your same philosophy. You don’t have to do that with us. It’s a continued relationship.”

Midwives don’t handle chronic health conditions or high-risk pregnancies.

“If you develop a high-risk condition or have a chronic underlying condition, we can co-manage with an OB-GYN. Some practices may turn you over to a different doctor, but I don’t find that’s beneficial to the patient. Most patients chose a midwife for a reason and they still want to see that midwife.” Kristin said she has co-managed high-risk pregnancies that have included twins, repeat C-sections, vaginal delivery after a C-section (VBAC), bleeding disorders, clotting disorders and even a patient who had a pacemaker. “If you think about it, 30 percent of my patients are high-risk. If I couldn’t co-manage them, that would be 30 percent of my patients who I couldn’t see. Even with 30 percent of high-risk patients, we still only have a 7 percent C-section rate overall. It’s because we follow the research and practice accordingly.”

In the end, Kristin pointed out that oftentimes the midwifery difference is that it’s about the patient and what she wants. And, in her typical, honest way, she said, “You’re having the baby; not us. Everyone has a different idea of what they want their birth to be. Some want an epidural when they walk in the door and some want to be buck-naked in the corner. I don’t care. It’s whatever you want.”

{This article first appeared in The Family Magazine of Michiana. Photo credit @iStock.com/Pliene.}

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