Myths and misunderstandings about nurse-midwives
The term "midwife" has been used for centuries. Literally meaning "with woman," the word has historically been used to describe someone, usually a family or community elder, who assists women during childbirth. Consequently, this past often creates misconceptions about today's Certified Nurse-midwives.
You may have heard that nurse-midwives do not prescribe medication or offer epidurals, only deliver babies at home and learn through apprenticeship. Also, many people think that nurse-midwives only provide care to pregnant women. However, all of these assumptions are false.
Here are the facts:
- Truth: CNMs have the authority to write prescriptions, and they can order pain medications and epidurals if you need them.
- Truth: 96% of CNM-attended births occur in hospitals.
- Truth: They can care for you throughout your entire life and offer a variety of services.
- Truth: They are licensed after graduating from an accredited nurse-midwifery education program and must pass a rigorous certification exam.
- Total # births 518
- Vaginal rate 84%
- Cesarean section rate 14%
- Assisted delivery rate 2%
- Episiotomy rate <1%
- Epidural rate 32%
Learn more about nurse-midwives and what they do by reading about their childbirth and well-woman care expert services.
To learn more about Swedish Covenant Hospital's Midwifery Services, email midwives@schosp.org or call (773) 989-6200.
Nurse-midwifery history & statistics
Throughout American history, nurse-midwives have been attending births and acting as caregivers. However, in the early 1920s, nurse-midwifery began to gain status as an established profession in response to a high rate of infant and maternal mortality. By the 1950s, there were several options for nurse-midwifery education programs, and the profession's popularity continued to grow and prosper over the years. Today, there are more than 7,000 CNMs, practicing in all 50 states.
Nurse-midwives have been practicing at Swedish Covenant Hospital for 10 years. The practice has flourished since it began; it has grown from having 2 members to 7. Originally, they performed about 5 births per month, but they now average about 30-35 per month. Each of the nurse-midwives on staff at Swedish Covenant Hospital has the medical knowledge and experience to guide you through a safe childbirth.
HISTORY AND STATISTICS
Swedish Covenant Hospital Nurse-Midwifery Group
| |
2006 |
2007 |
2008 |
| Number of births attended |
487 |
467 |
379 |
| Vaginal birth rate |
86% |
84% |
85% |
| Total cesarian section rate |
14% |
16% |
14.5% |
| Primary cesarian section rate |
10% |
10% |
10% |
| Vaginal birth after cesarian (VBAC) success rate |
92% |
68% |
62% |
| Assisted vaginal rate |
2% |
2% |
0.5% |
| Epidural rate |
31% |
32% |
32% |
| Episiotomy rate |
5% |
2% |
1% |
Number of births attended:
Number of births during which the nurse-midwives are present for the labor and birth but are not always performing the delivery because some of those births end in cesarean section or assisted births.
Vaginal birth rate:
Percentage of births delivered vaginally.
Total cesarian section rate:
Percentage of births delivered by caesarian section.
Primary cesarian section rate:
Percentage of all births delivered requiring a caesarian sectionsection for the first time. Total cesarean section rate is the percentage of all patients requiring cesarean sections (primary or repeat).
Vaginal birth after cesarian (VBAC):
If you have had a cesarian delivery (also called a C-section) before, you may be able to deliver your next baby vaginally. This is called vaginal birth after cesarean, or VBAC.
Learn more about VBAC >
Assisted vaginal rate:
Percentage of vaginal births performed with the assistance of a vacuum or forceps.
Epidural rate:
Percentage of births using epidural anesthesia, which is considered the most effective and easily adjustable pain medication for childbirth. It can be used to partially or fully numb the lower body, either allowing you enough feeling to push with your contractions or blocking all feeling for a cesarean delivery if that becomes necessary.
Learn more about epidural anesthesia >
Episiotomy rate:
Percentage of births using an episiotomy, which is a cut that the doctor or nurse-midwife makes in the perineum-the skin and muscle between the vagina and anus. This cut is made just before the baby's head is delivered. It makes the opening of the vagina larger. It may be done to help deliver the baby or to prevent deep tears around the vagina. After delivery, the doctor sews the cut closed.
Learn more about episiotomy >
To learn more about Swedish Covenant Hospital's Midwifery Services, email midwives@schosp.org or call (773) 989-6200.
Questions to ask your nurse-midwife
When choosing a nurse-midwife, it is important to ask her questions and make sure that the group is right for you. Some good questions to start with are:
- How frequently do you use interventive methods, such as cesarean section, episiotomy and anesthesia?
- Do you require or recommend prenatal testing and sonograms?
- What role will my support person play during delivery?
- What kind of childbirth preparation do you recommend?
There are many decisions to make about your labor and delivery. Before your last weeks of pregnancy, be sure to talk to your nurse-midwife about your birthing options and what you prefer, such as:
- Who you want to be with you: You may want to have family and friends around you or only your significant other or another support person.
- What comfort measures you want to try: Breathing techniques, hypnobirthing, laboring in water, trying different positions and having one-on-one support may help you best manage labor pain.
- Your preferences for pain medication: If pain medication during labor is a consideration for you, it is important to learn what type of medications are available and discuss the risks and benefits with your provider.
- How your baby will be cared for after delivery: This might include delaying some tests and procedures and initiating breastfeeding with your newborn.
- All of your preferences as a birth plan: This gives you a chance to think through your preferences for an ideal birthing experience. Just keep in mind that it is not possible to predict exactly what will happen during labor and delivery. Sometimes there are quick decisions that only your nurse-midwife can make, which is why it is important to build a trusting relationship with your caregiver ahead of time. Any interventions deemed necessary for the health of you or your baby will be discussed with you.
To learn more about Swedish Covenant Hospital's Midwifery Services, email midwives@schosp.org or call (773) 989-6200.
