Midwifery offers women option to traditional childbirth

May 22, 2007
She calls them her “ladies.”

On a cold, blustery day Laura Schultz gently pulls their photographs one by one from a small, ornate cedar box. She calls aloud their names with a fondness usually reserved for family.

Rosy-cheeked and smiling with their wool-capped newborns in hand, they are women for whom nurse midwifery has become a childbirth option, an option facilitated by Schultz, a certified nurse-midwife, and others like her at New Hanover Regional Medical Center.

“The philosophy of nurse midwifery is based on the belief that pregnancy and birth are normal processes in a healthy woman,” said Schultz, who practices in Wilmington. “It is the belief that a normal pregnancy, labor and birth proceed best when they are minimally interfered with.”

Today more than 7,000 certified nurse-midwives practice in the United States, attending more than 200,000 births annually, primarily in hospitals. An alternative to traditional obstetrical care, modern midwifery has roots dating back thousands of years.

“Midwives are common in almost every society,” said Suzanne Wertman, a Wilmington certified nurse-midwife. “My primary role as a midwife is to cultivate a woman’s confidence through prenatal care and provide support not only through labor and birth experience, but into postpartum and beyond.”

“Personally, I think midwifery is the next best thing to sliced bread,” said Joyce Elliott, manager of NHRMC’s Labor and Delivery Unit.

Elliott said the mid-to-late 1990s saw a lull in midwifery at NHRMC, but that Coastal AHEC’s hiring of two certified nurse-midwives, Mary Slawter and Mary McBride, in recent years helped reinvigorate the practice.

“The concept and culture of low intervention – the idea that a woman’s body is meant to birth – is at the center of midwifery philosophy,” Elliott said. “For women who experience it, it’s often life-changing.”

Nurse-midwives are trained, licensed, master’s-prepared nurses with the ability to manage a woman’s entire pregnancy from start to finish, including using various diagnostic tests and medical monitoring technologies. All nurse-midwives are certified by the American College of Nurse Midwives and have a relationship with an obstetrician in case of complication.

“We know when we’re out of our scope of practice and may need to rely on the expertise of a physician,” said Mary McBride, a Coastal AHEC midwife. “For me, the heart of midwifery is letting a woman’s birth experience unfold through listening to a woman’s needs and trusting in her body.”

As with traditional obstetrical care, women desiring a midwife delivery have access to standard pain medications, including epidural blocks. The vast majority of deliveries by certified nurse-midwifes occur in a hospital or birthing center with only between 1 and 2 percent occurring in homes.

“Women know their bodies, how they work and what they need during pregnancy and at the time of delivery,” said Marianne Woessner, a Wilmington midwife. “If you want someone who will listen to you and address the specific needs you have during pregnancy, then midwifery care is something you should consider.”

Generally, midwife care costs less than traditional obstetrical care, with most major insurers participating. In addition, data reveal the rate of Cesarean sections, episiotomies, infant and maternal mortality, and low birth weight are often much lower than average among women being cared for by a nurse-midwife.

“The art of midwifery is found at the bedside of a laboring women who labors long into the night,” said Mary Slawter, a Wilmington midwife, now retired from Coastal AHEC. “In my retirement years, my life is still filled with the mystery of birth. There is so much more to birth than what we see.”

For more information on midwifery, please call NHRMC’s Women’s Services at 343.7000.