If
you are considering having a midwife attend the
birth of your child, then its likely that you are a person who trusts
the natural ability of a woman's body to give birth successfully. You
desire someone who also trusts in that ability; who will be present for
the entire course of labor, no matter its length; someone who will listen
and follow you from the first prenatal visit through the important post-partum
period. You are someone who wants pregnancy and birth care different from
standard medical care.
What is a midwife? "Midwife" simply means "with woman." Midwifery is a tradition that predates modern medicine and obstetrics. Women have always looked to other women to help them through labor. It is only in the last 100 years in the United States that attendance at births has been primarily in the hands of physicians. In the mid-twentieth century, midwives and homebirth had all but disappeared in the United States. Only a few midwives continued to attend births for low-income and minority families. Thankfully, midwives and homebirth made a resurgence in the 1960s and 1970s and its popularity continues to grow.
Types of Midwives
The legal status of the practice of midwives varies greatly from state to state. There are also several types of midwives practicing in the United States, some legally and some illegally, and it can be hard to sort them out. Midwives are often classified as being certified nurse-midwives or lay midwives. Even this basic distinction doesn't fully explain the differences in training or legal status. (Click here for information on midwifery education and certification in the United States)
In Indiana and Michigan, certified nurse-midwives (CNMs) are able to practice legally. Most CNMs deliver babies in hospitals but some work in birth centers and a few, like myself, attend homebirths. There are many other homebirth midwives who are lay or direct-entry midwives, some are Certified Professional Midwives (CPMs), and some are not. Their practice is illegal in Indiana and legal in Michigan.
A midwife's legal status does not represent their ability nor their experience as a midwife. My daughter's homebirth in Indiana was attended by a good friend who is a direct-entry midwife. While I decided to become a certified nurse-midwife, I support the legalization of direct-entry midwifery in Indiana. The issue is complex however, because, if their practice were legal, direct-entry midwives would lose some of the benefits of their current status. As it stands now, a direct-entry midwife is not accountable for her practice to anybody but her clients. This allows a skilled and conscientious midwife to give safe, individualized care without much regard to fear-based medical attitudes. Direct-entry midwives practicing in Michigan have a nice situation where they do not need to fear prosecution, but are not regulated by a state agency.
I believe that it is important for all types of midwives to be attending births because many families will have a preference of one type of midwife over another. In choosing a home birth attendant, some people feel comfortable with a certified nurse-midwife who works legally, has a relationship with a physician in case of transfer to the hospital, can write prescriptions and whose services may be reimbursed by their health insurance. Transferring a client to the hospital may be easier for a certified nurse-midwife because she does not face being identified as practicing midwifery or medicine without a license. For other people, the non-medical training and manner of a lay midwife may be more appealing. In all cases, the midwife you choose should be someone who you trust and feel comfortable with and who best fits your needs and desires.
Choosing a Homebirth with Laura
My training has been excellent preparation for attending homebirths. My roots in lay midwifery mean that, unlike most CNMs, I first attended births in a birth center and in homes where I saw many natural births without medical interference. I then completed the extensive nursing and nurse-midwifery training. Most recently I worked in a practice where I attended hospital births. So I have most expertise with natural homebirth, but familiarity with hospitals and birth technology.
Other Area Midwives
While I hope it will work out to for me to be your midwife, I am also very willing to give you contact information for my sister midwives in the area. Each of us has a unique practice style and personality which allows clients to choose the midwife with whom they are the most comfortable.