A midwife is a professional trained in the care of a mother and baby during pregnancy, delivery, and the immediate postpartum period (the first 6 weeks following the delivery). A midwife is generally trained through an apprenticeship program under an experienced midwife, and may have no formal medical training. A person with this training is also known as a lay-midwife. There are also more formal training programs which vary in length from 1 to 3 years and award a technical certificate. State regulations of midwives vary. The practice of midwifery is illegal in some states and highly regulated in others. Some states require that midwives become licensed (LM) before practicing. Lay-midwives and LMs are very different from certified nurse midwifes (CNMs), which are advanced registered nurse practitioners who specialize in midwifery. Lay-midwives and licensed midwives generally provide care and attend deliveries in a patient’s home or in a free-standing birth center. Most hospitals and physician offices ban these categories of midwives from practicing within their facilities. A midwife may not carry the same malpractice insurance as a physician. Medical insurance does not generally cover the services of a lay or licensed midwife, but they typically provide services at a deep discount compared to a hospital. The salary of the midwife varies according to the number of patients. A midwife must assess the patient and her pregnancy to determine if a home or birth center birth is safe. If a patient is deemed “high-risk,” she must be transferred to a physician for care. The midwife follows the woman throughout her pregnancy, assessing for any abnormalities. The midwife attends to the woman during her labor and delivery, and ensures safe delivery of the newborn. The patient assesses the mother post-delivery, repairs any lacerations, examines the newborn, and assists with breastfeeding. The midwife generally visits the pair the day after delivery to assess condition, and at 6 weeks postpartum. A midwife must be dedicated to the care of women, and able to understand and practice within the legal restrictions imposed.
Provide direct care before, during, and after pregnancy.
Manage and coordinate care during labor and delivery with the physician.
Provide gynecological and reproductive planning services.