The PBS show “Call the Midwife” has been airing for a few seasons now, and we midwives at Avera have been asked many times whether our lives resemble the program. For those of you who haven’t seen it, the show — based in 1950s London — follows a group of midwives who ride their bikes to patients’ homes and help them labor and birth. I *confess* I have watched a few episodes and enjoy seeing the ups and downs of practicing midwifery in an entirely different time and place.
While there are stark contrasts from practicing midwifery today vs. in the 1950s, some things really don’t change about labor and delivery. Babies still arrive at all hours of day and night, we midwives are tired (and tireless!), and we can’t always predict how long the labor and delivery will be. We’re still helping laboring mommas through the process of birth; sometimes with joy but occasionally heart-wrenching sadness. We consider it a privilege to play a role in such a major, life-altering event for so many women and families.
One thing I think has changed in the practice of midwifery since the 1950s is an understanding of the positive role we can play in the delivery room. Back then, the “norm” was for midwives to attend a birth, not physicians. When labor and delivery began happening regularly in the hospital setting, people stopped using midwives and some of the wonderful things of what midwives can bring to a birth were forgotten or set aside for the benefits of what modern medicine and a hospital setting could provide. Because midwifery isn’t as well-known as it once was, when I tell people I’m a midwife by profession, I am often asked questions that I don’t imagine the characters of the show would have ever encountered. Some of the most common questions are:
“What!? A midwife? Isn’t that illegal!?” Thank goodness no, because my partners and I would be in trouble and unemployed! Certified nurse midwives (CNMs) are classified as primary care providers by federal law, and nurse-midwifery is legal in all 50 states and U.S. territories.
“So, you deliver babies at home?” Some midwives do, but we’re happy to help our patients at Avera McKennan Hospital & University Health Center. Many are surprised to learn that midwives who offer home-birth assistance are in the minority; 95 percent of CNM-assisted births take place in a hospital setting. By providing a safe birth environment at Avera, we work closely with physicians if patients develop complications.
“But I don’t want ‘natural’ childbirth!” Many women prefer access to pain relief measures during labor and delivery. Some do not. The midwifery team at Avera supports a woman’s right to make her own decisions when it comes to birth and pain management. We respect a woman’s right to choose this and can provide pain medicine or an epidural if desired. But we also can help facilitate a “natural,” medication-free childbirth if that’s what the mother wants. We do what we can to get our patients the birth experience they desire.
“Is it safe? You aren’t a doctor!” Consider a midwife to be a birth specialist. A review of 21 studies comparing births attended by CNM or physicians found no difference in infant outcomes between the two groups. In fact, there were fewer interventions such as labor inductions, episiotomy and epidurals in births attended by a nurse midwife. When a midwife is the provider, births end less often in cesareans, decreasing the additional risks that surgery presents to the mother and baby.
If a woman chooses to work with a nurse-midwife, she can expect specialized care. We strive to be your partner — not just a “provider” — and walk alongside you during your pregnancy, labor, delivery and post-partum care. And, we welcome you to experience the difference for yourself. The midwifery team at Avera offers free consultations for women who would like to know more about having a CNM-assisted birth. In other words, don’t hesitate to “Call the Midwife” at 605-322-8946 to schedule your appointment today.