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Ask a Doc Midwives Their Role in Todays OBGYN Practice

May 25, 2015

Dear Doc,
My OB/GYN office scheduled my next appointment with a midwife. I didn’t realize that midwives worked in an office. Can you tell me more about midwives and what they do?

Dear Uncertain,
This is an excellent question. To help sort out the differences between the types of midwives, I have asked Kay Hausman for her expert advice. Kay is a Certified Nurse Midwife who sees patients at The Women’s Center in Newark.

There have been midwives caring for women as long as babies have been born. We often think of a midwife as a person who goes to someone’s home to deliver their baby. Today’s midwife is so much more than that!

Certified Nurse Midwives (CNM’s) and Certified Midwives (CM’s) are independent health care providers. They work with the healthcare team; physicians, physician assistants, nurse practitioners, nurses, medical assistants and specialists, to provide women the highest quality healthcare. Midwives can work in a variety of women’s healthcare settings: hospitals, medical offices, clinics, birth centers and at home. Midwives provide gynecology services and maternity services. This means that midwives can provide you OB and GYN healthcare from your teen years to beyond menopause. Almost all insurances cover midwives.

There are different types of midwives and if you are thinking of having a midwife as your health care provider, it is important for you to understand the different options available to you.

A Certified Nurse Midwife is a registered nurse with a graduate degree in midwifery and has passed a national certification exam of the American Midwifery Certification Board. They provide women’s health check up’s, gynecology physical exams, prenatal care and education, perform vaginal deliveries and repair episiotomies or lacerations as well as assist at cesarean sections, provide postpartum care, family planning and treatment of sexually transmitted diseases. CNM’s can prescribe medications and treatments including pain management therapies. However, midwives specialize in helping women avoid medications during birth as well.

A Certified Midwife is a midwife who has a bachelor’s degree in a field other than nursing and a graduate degree from a graduate level midwifery program that has been accredited. They also pass a national certification exam. CM’s provide the same services and work in the same health care settings as CNM’s. CM’s can also prescribe medications and therapies.
Certified Professional Midwives (CPM’s) are certified by North American Registry of Midwifes (NARM). CPM’s can obtain their education through accredited programs of education or through direct entry as an apprentice. They only provide care in relation to pregnancy, birth and postpartum. They work out of hospital as in birth centers or home, and are usually unable to prescribe medications.

Other midwives who are not certified by AMCB or NARM may be practicing in the United States. They may or may not be licensed. Typically these midwives focus on pregnancy, birth and postpartum care only. They are usually not able to prescribe medications.
Midwives approach pregnancy, birth and women’s health as normal life events. Midwives pride themselves on providing patient-centered health care, and making your health care tailored to your specific needs or desires. Midwives provide education to women and their families that is research and evidence-based.

You may also wonder if you have a chronic health condition or have a high risk pregnancy if you can still see a midwife. The answer is yes you can, as your midwife will help you access specialists such as Obstetrician/Gynecologists, Primatologists, Geneticists, Endocrinologists and Oncologists who would be experts in your particular high-risk condition to be certain that you have a safe and healthy outcome.

So to determine if a provider of women’s health is right for you, ask yourself these questions:

  • Did they graduate from an accredited school?

  • Are they licensed to practice?

  • Do you feel comfortable talking and spending time with them?

  • Will they listen to you and work with you to plan your care?

  • Can they support your individual birth or healthcare choices?

  • Do they provide you with research and evidence-based education?

  • Do they accept your insurance?

I hope this helps you to feel confident and excited about seeing a midwife in your OB/GYN office. If you would like more information on midwifery care, or would like to find a midwife in your area, you can go to as a resource.

Tara Gellasch, MD, is the Associate Chief of Obstetrics and Gynecology at Newark-Wayne Community Hospital (NWCH) and sees patients at The Women’s Center at NWCH, a Rochester General Medical Group practice. Dr. Gellasch earned her Medical Doctorate from McGill University in Montreal, Quebec and completed her residency in Obstetrics and Gynecology at Emory University. This column is meant to be educational and not intended to be used to make individual treatment decisions. Prior to starting or stopping any treatment, please confer with your own health care provider. To send questions on women’s health, please email Dr. Tara Gellasch’ s assistant, Monica Decory with questions for Dr. Gellasch at [email protected] and write “Ask a Doc” in the subject line. The Women’s Center at NWCH is located at 1250 Driving Park Avenue, Newark. Call (315) 332-2427 to schedule an appointment.

About Rochester Regional Health
Serving the greater Rochester and Finger Lakes region and beyond, Rochester Regional Health System combines the resources, skills and accomplishments of Rochester General Health System and Unity Health System in an integrated network of nationally recognized, community-focused services. The full care continuum now includes four full service acute-care hospitals (Rochester General, Unity, Newark-Wayne Community Hospital, and United Memorial Medical Center); comprehensive ambulatory services; leading cardiac, orthopedic, neuroscience, oncology, surgery, women’s health and medicine programs; more than 80 primary and specialty medical practices; innovative senior care programs, facilities and independent housing; a wide range of chemical dependency and behavioral health services; and ACM Medical Laboratory, a global leader in patient and clinical trials testing, with worldwide locations and lab partnerships.

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