Frequently Asked Questions About Midwifery

The definition of midwife literally means "with women." A midwife provides compassionate, holistic, woman-centered care for feminine health. The practice of midwifery is commonly considered a blend of emotional care and clinical care that focuses on supporting women physically and emotionally.

Midwives are trained in all aspects of pregnancy and childbirth, but unlike doctors, they do not go to medical school. However, different types of midwives have different levels of training and education and some can provide many of the same services a doctor can. Midwives focus on minimizing technological interventions, especially during birth.

Midwives are also known for providing personalized care. For example, during the birth process, a midwife will often stay by your side throughout labor and help you with positional changes, rub your back, provide positive encouragement and offer other types of personalized support that a doctor may not be available for.

Just like any health care provider, midwives can have different levels of education and training. Generally, the types of midwives can be broken down into 5 categories.

• Certified nurse midwife (CNM): A certified nurse midwife has the highest level of education and training among the different types of midwives. Certified nurse midwives have completed nursing school and are registered nurses. They also complete a master or doctorate degree in nurse midwifery and receive additional training in pregnancy and childbirth. CNMs are certified by the American Midwifery Certification Board and are recognized as part of the medical community. Most work in hospitals or birth centers and some have hospital privileges. All health system CNMs have earned this level of achievement.
• Certified midwives (CM): A certified nurse midwife has the same education and training as a certified midwife, but does not hold a degree in nursing. Like CNMs, certified midwives often work with doctors and may work in hospitals or birth centers. They are certified by the American College of Nurse Midwives.
• Certified professional midwife (CPM): Individuals with various educational backgrounds can be become a CPM. CPMs are trained in midwifery programs accredited by the Midwifery Education Accreditation Council and must meet standards of the North American Registry of Midwives. CPMs most often practice in homes or birth centers.
• Direct-entry midwives (DEMs): A direct-entry midwife refers to an individual who has independently pursued midwifery training through various avenues. This many include an apprenticeship, college/university program, self-study, midwifery school or some other path. Direct-entry midwives do not work in hospitals or with doctors and most often attend home births.
• Lay midwives: A lay midwife is someone who has received informal midwifery training but is not certified or licensed as a midwife. Lay midwives are not recognized as medical professionals and are not typically allowed to work in hospitals or clinical settings. Most attend home births and some may work in birth centers.

A midwife’s role will depend on the level of education they have received, their licensure, state designations and medical practice or health system supporting their care. All midwives care for women before, during and after birth by providing physical, psychological, and social support. Midwives offer counseling, education and other resources to support women in their health care needs.

The University of Kansas Health System offers comprehensive midwifery care that includes:

• Prenatal care/labor and delivery
• Pelvic exams
• Sonograms
• Pregnancy counseling and education
• Routine checkups
• Prenatal testing
• Assistance during labor and delivery
• Intermittent monitoring
• Postpartum care
• Breastfeeding guidance and support
• Physical assessment of healing after birth
• Screening for postpartum mood disorders
• Emotional support through your transition to parenting
• Referrals for additional community resources as needed
• Women’s health
• Well-woman exams
• Contraception management
• STD testing
• Breast exams
• Family planning
• Fertility counseling
• Counseling for abnormal pap smears
• Primary care
• Physicals
• Immunizations
• Prescriptions
• Asthma management
• Testing and treatment for minor illnesses
• Upper respiratory infections
• Strep throat
• Influenza
• Earaches
• Urinary tract infection testing and treatment

A doula is often thought of as a "birth coach" who provides support and guidance during birth and the postpartum period. But, unlike midwives, doulas do not provide medical care. Doulas are often present during birth as a guest or support person and act as an advocate for the mother – ensuring her birth plan is followed and that medical interventions are minimized when possible. Many women have a doula and a midwife present, as well as extended family member participation, during their birth. Our physicians (MDs/DOs) welcome doulas and additional support persons. Our certified nurse midwife and other care providers offer doula referrals for women seeking a natural birth in Kansas City.

Many women feel that they receive more attentive and personalized care when working with a midwife. They benefit from a strong bond and trusting relationship that helps them feel more confident, safe, and empowered during birth. Additionally, research from the American College of Nurse Midwives shows that midwifery care offers many other benefits.

While midwives most often see pregnant women, some midwives provide an array of health care services, such as physicals, immunizations, gynecological exams, contraceptive counseling, prescriptions and more. Our practice often provides primary care to patients we have seen through pregnancy, labor and delivery.

Many women in Kansas City want a natural birth, and a midwife can help make this possible. Midwives are experts in birth – including natural, vaginal birth – and can identify the difference between normal labor and when a woman needs a higher level of medical care. This expertise reduces the number of interventions given and gets the right women the help they need, while also reducing unnecessary treatments.

The Women's Health Specialty Clinic at The University of Kansas Health System gives women the option of having a birth their way by offering both midwifery and obstetric care. We often see women who request the following as part of their birth plan:

• Unmedicated
• Intermittent monitoring
• Positional changes
• Minimal or no interventions
• Breastfeeding support

Because we are an academic medical center, we are also uniquely equipped to handle complicated pregnancies and births. Learn more about our advanced fetal care for complex pregnancies.

Insurance coverage for midwifery care will depend on the type of care you receive, where you receive care, your insurance provider and the state you live in. Many plans cover midwifery services at hospitals and freestanding birth centers. Check with your insurance provider about your options.