Finding a midwife for your care may be the most important step you take during pregnancy.
Most pregnant women skip this step in their pregnancy care and look for the first obstetrics office that will schedule an appointment after their positive pregnancy test (and it’s not uncommon to go with the office that will schedule you first or the soonest).
That may be a mistake for many women. Instead, taking the time to research if midwifery care is for you and if there is a midwife in your community to care for you and your baby may be the best first step you take!
Let’s run through some common questions.
How do I find a midwife?
The quickest way to find a midwife is to look online. In your preferred search engine, look up “midwives in [your city, state].” This will provide you a list of midwives that have businesses in your community.
Search engines won’t catch all the midwives.
I recommend looking two other places.
- For Certified Midwives/Certified Nurse-Midwives: www.midwife.org/find-a-midwife
- For Licensed Midwives/Certified Professional Midwives: https://mana.org/about-midwives/state-by-state
Lastly, look on the STATE RESOURCES page for other midwives, doulas and birth support in your area and ask other women and families in your community if they know or recommend a midwife. Sometimes midwives have been in your community for decades and sometimes they are just starting a practice and haven’t established a website or presence online.
Are all midwives the same?
There are three different types of midwives: certified professional midwife, certified midwife, and certified nurse-midwife.
Certified professional midwives work primarily in the home or birth centers, while certified midwives and certified nurse-midwives work primarily in the hospital – but can also work in the home or birth center environments.
This chart does a great job of comparing the education and training processes of each midwifery path: Comparison of Certified Nurse Midwives, Certified Midwives, and Certified Professional Midwives: Clarifying the distinctions among professional midwifery credentials in the United States (American College of Nurse-Midwives [ACNM], 2022)
This podcast also explains the differences:
What is a Certified Nurse Midwife? (Journey to Midwifery podcast – October 3, 2019)
Why is midwifery care important?
Midwifery care offers a philosophy that differs from the medical model of care: pregnancy, birth and postpartum are normal phases of a woman’s life. Midwives do not view these physiologic processes as medical problems that need to be solved and treated.
Instead, midwives come alongside women and their families as a guide that offers education, support, and if needed, interventions. The center of the midwifery model is the patient and her family and each decision is made through a process called shared decision-making.
Midwifery care has a long history of benefits for mother and baby. When compared to physician only care, midwifery care is shown to have:
- A lower rate of labor induction
- A higher chance of vaginal birth
- A reduced risk of preterm birth
- A higher chance of a successful start to breastfeeding
- A higher level of satisfaction about care and birth (ACNM, 2012)
(Side note: In my experience, many of my patients go on to become lifelong friends. Now that’s a testament to the model of care!)
Will my insurance cover midwifery care? Can I pay cash if insurance is an issue?
Most likely; Medicaid pays nearly 100% reimbursement for midwifery care by a certified nurse-midwife in all states. The majority of states mandate private insurers reimburse certified nurse-midwives as well.
Insurance coverage for certified professional midwives is a little different and coverage can vary from no coverage to complete coverage depending on your insurance.
Cash pay is almost always an option and preferred by some home birth providers – some midwives even offer discounts for paying in full by certain dates or charge lower fees if you are paying in cash .
Where else can I learn more about midwifery?
I recommend checking out these articles and looking into these websites/organizations.
- American College of Nurse Midwives (ACNM)
- Benefits of Midwifery from a summary of research: Research Showing Significant Midwifery Care Benefits
- Certified Professional Midwives in the United States (2008)
- Comparison of Certified Nurse Midwives, Certified Midwives, and Certified Professional Midwives: Clarifying the distinctions among professional midwifery credentials in the United States (ACNM, 2022)
- Become a Midwife (Midwifery Today)
- Essential Facts about Midwives (ACNM, 2019)
- How Does the Role of Nurse-Midwives Change from State to State? (2019, Georgetown University)
- International Confederation of Midwives: Essential Competencies for Midwifery Practice (2018)
- Midwives and Mothers in Action (MAMA) Campaign
- Midwives Alliance of North America (MANA)
- Midwifery Today
- National Association of Certified Professional Midwives (NACPM)
- North American Registry of Midwives (NARM)
- The North American Registry of Midwives – Candidate Information Booklet
- The History of Midwifery and Childbirth in America: A Time Line (Midwifery Today)
- The U.S. Needs More Midwives for Better Maternity Care (Scientific American, 2019)
- U.S. States With More Support For Midwives Have Better Birth Outcomes (Reuters, 2018)
- What is a Certified Nurse Midwife? (Journey to Midwifery podcast – October 3, 2019)
- What is the rate over time that midwives leave clinical practice? (December 2022)
The BOOKS & MORE page also offers some great reads about midwifery.
Some questions to guide your midwife search…
🌟 What’s your philosophy on supporting women during birth?
🌟 What percent of women have a birth without an epidural in your practice? What percent choose to get an epidural? ( 🤔 This is a sneaky way to see how the practice supports physiologic birth – the higher the rate of non-epidural births, the better the practice and the nurses support physiologic labor and birth!)
🌟 What are the primary C-section, preterm birth and pre-eclampsia rates for your practice?
🌟 Are there midwives on your team and am I able to see them during my clinic visits and have a midwife attend my birth?
🌟 What educational classes do you offer for birth or breastfeeding?
🌟 What mental health resources does your clinic offer?
🌟 How often do I come to the clinic for my visits?
🌟 Is there an option for telehealth?
🌟 Who is on my care team? (Your care team may include physicians, nurse practitioners, midwives, or physician assistants.)
🌟 Which provider will attend the birth?
🌟 Where will I birth the baby?
🌟 Where do I go to complete lab draw or radiology appointments? How do I get my lab results?
🌟 What is the after hours number for my concerns?
🌟 Where do I go for care after hours?
🌟 Is group prenatal care an option? (*Benefits: Reduced rates of preterm birth and depression/anxiety, increased breastfeeding initiation and better preparation for childbirth!*)
🌟 What are the out of pocket costs with the insurance I have?
A few more tips….
- If you have already started your pregnancy care with a provider and you don’t like that provider – go find yourself another provider. There is a provider out there for everyone. Transferring care during pregnancy is very easy to do with these steps:
- Find the provider you would like to transfer care to. Call to ask if they are accepting patients (most providers will accept new and transferring patients but some may have reached their cap and will not accept more patients above certain numbers).
- Request your pregnancy medical records from your current provider (you can either ask for a paper copy of the records or have them faxed to your new provider).
- Schedule a “transfer visit.” This is generally a quick but detailed visit to review your pregnancy care to date, your medical history and to orient you to the new practice.
- Although this seems counterintuitive, you may need to interview a few providers to find one you think fits you best. Trust your gut; if you don’t jive with a certain provider in your clinic visits, you’re probably not going to jive with them during your labor and birth. Chemistry is important!
Good luck on your journey! Finding a midwife for your care may be the best decision you make for you and your baby’s care. If I can help at all, email me at email@example.com!