Although midwifery is an ancient profession, the way midwives practice is different in different parts of the world. In the United States, there are two types of midwives, nurse midwives and direct entry midwives.
Midwives who are known as nurse-midwives are registered nurses who specialize in obstetrics and gynecological care. The qualifications of Nurse-midwives are quite specific. Almost all possess a master's degree in nursing along with their registered nursing license. In almost all states, Nurse-midwives are allowed to write prescriptions. They work in all areas, including hospitals, clinics, birth centers and homes. A nurse-midwife often works with a physician to care for a high risk pregnancy as a consultant and assistant.
Direct entry midwives can have a wider variety of training and certification than a nurse-midwife. There are a variety of colleges and schools that offer midwifery courses. Additionally, a prospective midwife can become a Certified Professional Midwife though the North American Registry of Midwives.
A midwife practicing in the United States will help deliver babies in a variety of places. While many do work in hospitals, many also work at home. Some also work in birth centers with a group of other midwives. The laws concerning the practice of midwifery are different in each state.
Midwives offer an alternative to what has become the norm in modern society, births taking place in a hospital, surrounded by doctors. Midwives believe that birth is a natural process and act to facilitate a birth in the home environment, seeking extra medical help only when it is required for the health of mother and/or baby.
An experienced midwife is well-accustomed to the cycle of pregnancy and the many variations different women can experience. Midwives are able to guide woman through their pregnancy, which can be a frightening time for many women.
Midwives are thoroughly involved in their client's prenatal care. In this way they become attuned to what is normal for each woman and are able to detect quickly if there is any sort of problem.
More and more woman are having caesarian section births. Often times this is not a choice they have made. The increase in caesarian section births is based on hospitals being sued for malpractice. In many cases, a doctor will perform a caesarian section just to be on the safe side, however, this may be ultimately traumatizing for the mother.
Midwives, who work with a client from the beginning of her pregnancy, strive to instill confidence in the mother-to-be. By building a relationship of trust and educating the woman as to what is happening, they lower the chance of difficulties during labor.
Many midwives are pushing for action on the increasing number of births by caesarian section. They believe that this is a failure of the medical profession and a medicalization of a natural process. These midwives, who are involved so intimately with the birth process see this as unnatural and detrimental to the mother.