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FAQ: Understanding
Women’s Health Care Choices

Only you can decide which health care provider is best for you. Our Moment of Truth encourages you to learn more about your options and use your new knowledge to make educated, informed decisions to meet your personal needs and goals. Our Moment of Truth regularly surveys women ages 18-45 years of age from across the United States to find out about the services and resources that are, and are not, meeting women’s health care needs. Check back often to read up on new findings and to use this information to find the health care provider who best meets your needs and preferences.

What Women Are Saying About Their Health Care

In an August 2012 survey, the large majority of women (85.4%) said they are somewhat to very satisfied with their care, yet most say they are not getting many of the services they want. For example, although most women (65%) would like guidance and information on birth control or family planning options after a previous birth, 87% of women did not discuss this with their provider. This lack of conversation can have serious health implications for women. Although 40.3% do not want an episiotomy during childbirth, in 2004 nearly 1 in 4 women underwent this procedure.

Midwifery Myths Set Straight

The profession of midwifery has evolved with today’s modern health care system. But there are many myths about midwives in the United States based on centuries-old images or simple misunderstandings. You might be surprised to learn the truth about some of these common midwifery myths.

True or False?
Midwives have no formal education.

FALSE. Most midwives in the United States have a master’s degree and are required to pass a national certification exam. There are many different types of midwives, each holding different certifications based on their education and/or experience. Certified nurse-midwives (CNMs) and certified midwives (CMs) attend approximately 93% of all midwife-attended births in the United States, and as of 2010 they are required to have a master's degree in order to practice midwifery.

True or False?
Midwives and physicians work together.

TRUE. CNMs and CMs work with all members of the health care team, including physicians. Midwifery care fits well with the services provided by obstetrician/gynecologists (OB/GYNs), who are experts in high risk, medical complications and surgery. By working with OB/GYNs, midwives can ensure that a specialist is available if a high-risk condition should arise. Likewise, many OB/GYN practices work with midwives who specialize in care for women through normal, healthy life events. In this way, all women can receive the right care for their individual health care needs.

True or False?
Midwives only focus on pregnancy and birth.

FALSE. Midwives have expert knowledge and skill in caring for women through pregnancy, birth, and the postpartum period. But they also do much more. CNMs and CMs provide health care services to women in all stages of life, from the teenage years through menopause, including general health check-ups, screenings and vaccinations; pregnancy, birth, and postpartum care; well woman gynecologic care; treatment of sexually transmitted infections; and prescribing medications, including all forms of pain control medications and birth control.

True or False?
Midwives can prescribe medications
and order tests.

TRUE. CNMs and CMs are licensed to prescribe a full range of substances, medications, and treatments, including pain control medications and birth control. They can also order needed medical tests within their scope of practice and consistent with state laws and practice guidelines.

True or False?
Midwives cannot care for me if I have a chronic health condition or my pregnancy is considered high-risk.

FALSE. Midwives are able to provide different levels of care depending on a woman’s individual health needs. If you have a chronic health condition, a midwife still may be able to provide some or all of your direct care services. In other cases, a midwife may play a more of a supportive role and help you work with other health care providers to address your personal health care challenges. In a high-risk pregnancy, a midwife can help you access resources to support your goals for childbirth, provide emotional support during challenging times, or work alongside specialists who are experts in your high-risk condition to ensure safe, healthy outcomes.

True or False?
Midwives offer pain relief
to women during labor.

TRUE. Midwives are leading experts in how to cope with labor pain. As a partner with you in your health care, your midwife will explain pain relief options and help you develop a birth plan that best fits your personal needs and desires. Whether you wish to use methods such as relaxation techniques or movement during labor or try IV, epidural, or other medications, your midwife will work with you to help meet your desired approach to birth. At the same time, your midwife will provide you with information and resources about the different options and choices available if any changes to your birth plan become necessary or if you change your mind.

True or False?
Midwives only attend births at home.

FALSE. Midwives practice in many different settings, including hospitals, medical offices, free-standing birth centers, clinics, and/or private settings (such as your home). In fact, because many women who choose a midwife for their care wish to deliver their babies in a hospital, many hospitals in the United States offer an in-house midwifery service. And because midwives are dedicated to one-on-one care, many practice in more than one setting to help ensure that women have access to the range of services they need or desire and to allow for specific health considerations. In 2010, about 90% of births attended by midwives in the United States were in hospitals.

Frequently Asked Questions

What do I need to know about normal, healthy childbirth?

Click here to find a useful document, easy to download, that answers many questions about how women achieve normal, healthy childbirth.

Is midwifery care safe?

Midwifery is grounded in evidence-based practice and professional standards, along with a deep understanding of the normal, natural events in a women’s lifespan. Midwives approach women’s health care based on researched evidence and clinical expertise, while also considering a woman’s own values. The American College of Nurse-Midwives (ACNM) has joined with other national health care organizations to develop and endorse principles for client safety in childbirth. These principles promote care based on scientific knowledge, respectful coordination of care between different members of the health care team, active involvement of clients and their families in care practices, and a commitment to improving the quality of care. Together, these principles help promote the highest standards for quality and safety in maternity care in the United States.

Will my midwife provide the pain relief options
and medical procedures I want to have during labor?

Your midwife will partner with you on making decisions around pain relief techniques, such as use of epidural during labor, and make sure that you receive the type of pain relief you need and want. Whether you wish to use methods such as relaxation techniques or movement during labor or try IV, epidural, or other medications, your midwife will work with you to help meet your desired approach to birth. At the same time, your midwife will provide you with information and resources about the different options and choices available if any changes to your birth plan become necessary or if you change your mind.

Most midwives favor an approach to pregnancy, labor, and birth that is based on normal, bodily processes rather than on the use of medical procedures: an approach that is strongly supported by current research. The midwifery model of care does not support routinely using medical procedures if there is no clear reason for them or if their use is not supported by research. For example, scheduling a labor induction or a cesarean birth without a clear reason is not supported by research and can often lead to unwanted problems. However, when a medical procedure is necessary, your midwife will work with you to ensure you have all the information you need to make an informed decision about your care and to be sure you are aware of any options or alternatives that may also be available.

What role will my partner play
during my midwife-attended birth?

Giving birth is a family event and your midwife will work with you to create a birth plan that meets your individual desires and needs as a family. You and your partner/family will decide on the level of involvement that’s best for you. Your midwife will encourage you to have the people who are important to you with you and around you during labor and birth. Your midwife may ask your partner/family to comfort you, provide emotional support, give you a massage, provide drinks and food, adjust the lighting, or support you as your move around the birth room.

Will my insurance cover the care of a midwife?

Thirty-three states require private insurance companies to pay for services provided by certified nurse-midwives (CNMs), and Medicaid coverage for CNMs is required in all states. In states that do not require private insurance coverage, many insurance plans still cover CNM services. Before choosing any new care provider, check to be sure that your insurance will cover the service and make sure the provider accepts your specific insurance plan.

How can I become more involved with
Our Moment of Truth™ and help spread the word?

There are several resources available for getting involved and spreading the word about Our Moment of Truth™. The first step is to take a pledge to make Your Health Promise. Then share your new commitment to your health by clicking on the button that will allow you to spread the word through Facebook and Twitter to your friends and family.

Also consider sharing My Moment of Truth—the moment you made the decision to learn more about your women’s health care options, considered the care of a midwife, or realized that midwife-led care was right for you—by submitting a testimonial.

Midwifery Information Resources

Learn more about the high-quality, individualized care of a midwife by visiting MyMidwife.org.




8403 Colesville Road, Suite 1550 • Silver Spring, MD 20910 • Phone 240-485-1800 • Fax 240-485-1818www.midwife.org
© American College of Nurse-Midwives. All rights reserved.

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