Who is a midwife?

A midwife is a health care provider who cares for women during pregnancy, childbirth, postpartum care, and for other health needs throughout their adult life. Only New York Licensed midwives may practice in New York State. Midwives have collaborative relationships with physicians. Licensed midwives are independent practitioners with expertise in the care of healthy women. Midwives collaborate with physicians and will consult with them immediately if complications arise at any time during the childbearing process. This insures safe care and continuous support for the woman and her family.

Who is eligible for midwifery Care?

Any healthy woman is eligible for midwifery care. As birth is an extremely powerful experience for the mother as well as everyone present, it is important that both mind and body be healthy. Both physical and emotional issues must be addressed in order to achieve a safe and satisfying experience. Women with pre-existing medical problems such as heart disease, hypertension, diabetes, etc. must be under the expert care of a physician.

Do midwives care for women with disabilities?

Yes. Ask about any accommodations you may need.

How is a midwife-attended birth different?

The midwife serves as a trusted provider of care, educating and supporting the mother, while being watchful for any deviation from normal. The mother takes responsibility for preparing her body, mind and spirit for pregnancy, labor, birth and parenting.

What are the mother's responsibilities?

During pregnancy: good nutrition, exercise, relaxation training and positive thinking are of utmost importance.

During labor and birth: the mother and her support person(s) are educated through prenatal classes to trust the wisdom of the body and learn to respond intuitively to the normal physiologic process.

During postpartum period: the family is an inseparable unit; with breastfeeding and family support insures confidence in parenting abilities.

How is safety in birth insured?

As pregnancy and birth are normal physiologic functions of a woman's body, non-intervention, careful monitoring and joint involvement in decision making are some of the hallmarks of safety in birth. Parents take responsibility for maintaining an optimum level of health before, during, and after pregnancy. A physician is always available for consultation if ever a problem arises.

Do you cut episiotomies?

Rarely. An episiotomy is a surgical incision to enlarge the vaginal opening. As a routine, the perineum is supported to prevent tearing as the baby makes a slow emergence which allows the tissue to stretch. Local anesthesia is used in repairing tears should they occur.

Do you perform routine internal exams in late pregnancy?

Rarely. Pelvic exams are done if there is a medical indication, patient request, for initial labor assessment and as seldom as possible during labor.

What do you recommend for premature rupture of membranes without labor?

If the pregnancy is at term (37 weeks), waiting up to 72 hours for the onset of labor may be acceptable. The mother's temperature must be taken, infections prevented (no internal examinations, intercourse, or tub baths) and natural augmentation of labor is encouraged (long walks or rides, castor oil, breast stimulation, herbs and homeopathics).

What would you advise if I were in labor for a long time without progress?

Natural means of labor augmentation as mentioned above would be used more aggressively, and eventually physician consultation would be requested for options such as pitocin stimulation in the hospital.

How do you feel about VBAC (vaginal birth after Cesarean)?

Every mother who has a lower segment (transverse) incision has the right to labor and birth naturally.

What would you do if my baby were breech?

In pregnancy, breech tilt exercises would be recommended if the baby is not head down by the 32nd week. In late pregnancy 37+ weeks), physician consultation for an external version in the hospital would be considered. During labor, hospital birth would be required to promote optimum safety for the baby. However, the breech baby can deliver itself.

How would you handle twins?

Twins, or multiple gestations, are best accomplished in the hospital to provide optimum safety for both mother and babies. However, if previously undetected, a surprise twin delivery can be managed at home.

How do you feel about the use of technology for birthing?

Technology is a tool used when there are medical indications, as an important adjunct to quality care.

What is your policy on postdates?

After the 42nd week of pregnancy, physician consultation is required. Non-stress testing and biophysical profiles are technologies used after 42 weeks. If natural means of induction have not been effective, pitocin induction in the hospital may be necessary.

Do you recommend vitamins or herbs?

As pregnancy is a time of nutritional stress for the body, vitamins and herbal preparations as well as homeopathic remedies may be helpful. However they are only supplements, and should always be taken in addition to (not in place of) a good diet.

Can midwives prescribe medications?

Yes. Licensed midwives can prescribe medications, as related to the practice of midwifery. They can also order tests to help diagnose problems. Where do midwives work? Midwives practice midwifery and assist births where birth occurs and health care is rendered - hospitals, birth centers, client's homes, and professional offices. No matter where care is rendered, licensed midwives seek to offer safe and personalized care.

If I plan a home birth, what is your provision for physician and hospital backup?

A physician and hospital backup are always available. A backup system closest to your home is most ideal and this will be discussed at your initial visit.

What emergency equipment do you bring to a birth?

Oxygen, intravenous equipment, Pitocin to control hemorrhage, and resuscitative equipment for the baby are brought to every birth. They are rarely used.

What credentials does a New York licensed midwife have?

New York licensed midwives have graduated from a State-approved program that includes classroom training and clinical experience. Studies include courses in maternity and pediatric care, pharmacology, well-woman care, neonatal care, and family planning and gynecological care. This training may build on a nursing background or may follow a preparatory program designed for those who do not have a background in nursing. New York midwives must display a current New York registration certificate; this certificate lists the professional's name, address, and dates of the registration period. Midwives must re-register every three years to practice in New York. Some professionals also display their original New York license, diploma, licenses for other states, and membership certificates. You may verify license here.

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