Midwives Blend the Personal and Professional in Obstetrics

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pregnant woman talking to a doctor

For some people, the term “midwife” still conjures up an image of a helpful local woman who guides expectant moms through medication-free childbirth at home. The reality is often far different, however.

“In Pennsylvania, a Certified Nurse Midwife (CNM) is a nurse who receives additional education in a two year graduate program and is licensed to practice in the state,” says Victoria Ferguson, CNM, MSN, a nurse midwife at Pennsylvania Hospital.

Penn Medicine Midwives

“Our midwives see patients in the office and help deliver babies in the hospital,” she continues. “Midwives typically care for healthy pregnant women that are considered “low risk.” In many cases, it’s common for ob/gyns and midwives to work collaboratively with patients. The decision on whether to receive most of their care from a midwife or an ob/gyn comes down to a woman’s preference. Those who choose a midwife may benefit from the extra time they can spend with a CNM during and after pregnancy.

Though Penn Medicine’s midwifery practice has been in place since the 1970s, such programs have become more common in recent years thanks to the growing popularity of natural births and the fact that midwifery services are commonly covered by insurance.

“Penn offers the oldest midwifery practice in Philadelphia, and we’re involved in over 5,000 births a year at Pennsylvania Hospital and 40000 at the Hospital of the University of Pennsylvania,” Ferguson says. “People come here because they know we offer a culture of supporting women’s choices and birth plans."

Midwives are licensed to prescribe a range of medications and treatments, including birth control and pain medication during labor. They can also conduct prenatal exams, order tests, offer advice for a healthy pregnancy, deliver babies, and employ techniques for managing labor pain.

“Patients who want to have a natural childbirth experience may turn to a midwife, as they are skilled in non-medicinal options for pain management, such as aromatherapy, guided imagery and positioning,” explains Jessica Lazzeri, MSN, RN, NEA-BC, Clinical Director of Women’s Health at the Hospital of the University of Pennsylvania. “However, at many hospitals, if a patient chooses to have an epidural to manage their pain, they can still be cared for by a midwife.”

Lazzeri recommends choosing a midwife who takes into account the delivery experience that a woman and family desires and is willing to do things differently to achieve that plan.

“Our midwives are incredibly passionate about childbirth,” she says. “Nurse midwives do a great job of listening to patients and families and collaborating with the rest of our staff to make sure patients have the best childbirth experience we can offer.”

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