We need to talk about midwives...

Midwives are a crucial part of healthcare teams around the world - where I’ve worked all over the US, where I currently work in New Zealand, and practically every other country on the planet. However, the confusing regulation (or lack thereof) of midwifery in the United States is downright dangerous. If I, a board-certified obgyn who regularly worked with midwives all the time in the US, am confused by the patchwork of regulations, laws, and titles among midwives in the United States, how are patients supposed to figure out which providers will help them have a safe pregnancy and birth? Let’s discuss.

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** The information in this video is intended to serve as educational information and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/advanced practice provider. **

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[MissyAmy]

As a Norwegian nurse it baffles me that "Midwife" is not a protected title. It should be a single certified profession as it is in Europe. In Norway if you are a Midwife that means you are a certified nurse who has a masters degree in midwifery. No one else is a midwife. Almonst everyone who gives birth in Norway does so with the help of midwifes. You can be sure that they have both the experience and knowledge needed. The US is backwards with so many things when it comes to healthcare.

[zainab]

It's hard to discuss midwifery in America without spending some time on the historical fact that, in the course of the 19th century, midwifery as a profession was simply obliterated in the US, even while the rest of the world developed top-quality specialized training. So the US had to rebuild everything from scratch.

[Becks-and-books]

My original life plan was to be a midwife. In Sweden it is 3 years for a nursing degree, 2 years work experience, and then a 2 year advanced midwifery degree. So 7 years in total to become a midwife. To me midwife should be a protected title that only people with a specific qualification should be able to call themselves. Others can be doulas, midwife assistant, birthing assistant… extra eyes and ears and hands

[Kiki-sfem]

My daughter was born with a certified nurse midwife and she was amazing. I originally thought she would just be assisting an OB but she handled the entire delivery. At some point my daughter’s heart rate dipped a bit and an OB was paged and came in but by that point her heart rate was back up and the OB just said “looks like I’m not needed!” and left. My midwife was so calm, cool, and collected and was the perfect mix of encouraging without being infantilizing. With her support, I pushed my daughter out in less than an hour.

[snowgal]

I had a certified nurse midwife in canda. Absolutely positive experience. 4 hospital births with them but they do homebirth as well and transfer if needed. And screened, hired and paid for by public health care I felt more in charge, they also did home visits the first few weeks which was a-mazing

[gwendofrendo]

LONG comment but I want to express how much your channel has changed my life. When I first started watching your channel in 2019, I was passionate about birth work and was planning on becoming a certified midwife who did exclusively home births because that's all I had experienced and been taught that was the only right way. My mom had 8 births (7 live births) and I (her eldest child) was the only one who was planned to be born in the hospital. The majority of her births ended up having to be transferred before or immediately after delivery. I think only one or two of my siblings were actually born at home with no complications, as well as one still birth. I was probably six or seven at the time and too young at the time of the stillbirth to know the details and if that baby could have been saved if she had been born in a hospital. That being my background, I wanted to be the type of midwife my mom used. I attended one of her births when I was 15 and she delivered my 12 pound 11 oz brother at home and immediately began hemorrhaging after he was delivered and she was rushed to the hospital. Most terrifyingly, the midwife did very little medical intervention (aside from telling my stepdad to call an ambulance) and just prayed for my mom and told her to will her body to stop bleeding. Luckily, both my mom and my little brother were/are okay. And yet this was so normalized to me that I held onto my dream of being a midwife for 5 more years after that experience. When I started watching your channel, I felt defensive about your attitude towards midwives (in the way that I knew them) but the way you demonstrated care and compassion towards all people and how passionate you were for your work kept me engaged. Your channel is a big part of the reason I ended up moving away from that career. While there were other reasons (i.e breaking away from evangelicalism, the pandemic giving me space to reevaluate, and doing my own research into science, gaining more trust in medicine in general, etc) I don't know that I would have had the capacity to open my mind to other options without the information and education your provided. I am very appreciative of your work and I wanted you to know that you made a difference in my life. While I never did go down the obgyn/nurse midwife field (I just completed an education in occupational therapy and am happier than ever), Obstetrics and gynecology have still continued to be special interests for me and I am still very excited when I see a new upload from you! Thanks MDJ!

[jumpstarto]

I LOVE how it actually comes down to the American health insurance system...again.

[mxclaireharris]

I'm in the UK. I have antiphospholipid syndrome, I always delivered my babies earlier, I had a multidisciplinary team during pregnancy (specialist obstetrics, immunology, haematology and rheumatology) but all the time I was midwife lead through pregnancy and birth. My doctors only saw me when it was necessary.

Our midwives are highly trained and it's a protected title.

[leesiemoo]

Kiwi here - I had about 6 midwives through pregnancy, birth, and aftercare due to being considered "complex" . They were all fabulous and I felt so very cared for. Bonus being free on our public health system.

[rebeccaburrow]

Texas here. My midwife for my first baby is the only independent cnm for a hundred miles. She is amazing and has been in practice so long she has pretty much trained all the cpn and lm in the whole area. Here in texas there are conditions that will graduate you out of independent midwifery, like gestational diabetes, high enough blood pressure, and other conditions. Then you are referred to an obgyn because you are higher risk. But honestly, most women are not high risk. I had all three of my babies at home with my midwife, fast, no complications. (You could also do the birthing center.) She carries pitocin for haemorraging, oxygen, pretty much everything a hospital would have outside of the surgery ward. She has not lost a mother or baby in 30 years. No bones about it, she is one of the best in her field and the midwives that train under her are fantastic too. Sadly, she was not covered by my insurance, so we paid out of pocket. But her fee was the same as what it would have been at the hospital after insurance! And my insurance didnt cover the first six weeks of care after the baby was born, but she did. Such intimate and personalized care. No regrets, 10/10 would do again. I wish every woman could use a midwife and give birth at home (i know that isnt always possible but i wish!). You are not treated like a problem waiting to happen. You are let to do what your body is designed to do and supported in every way. At least, that is my experience. My midwife appreciated the pancakes my dad made too. 😂

[kaylaboland]

As a New Zealander it's wild to me that it's not the norm to have a midwife (fully trained and qualified) for a pregnancy!

[mainstreammutant]

I have never been (and hopefully will never be) pregnant so I had absolutely no experience with midwives before. I was at my obgyn getting my annual exam and my doctor got called away to deliver a baby. The office staff asked me if I would mind having my pap with the nurse midwife on staff and I said sure. Seriously, what a great experience! I've been getting annual paps for about 16 years and it has always been handled rough and it hurt a little (that was just the way i thought it had it be, i have seen many different obgyns and it was always the same) but this nurse midwife was so kind and gentle that there was no pain at all. Midwives are under rated. I had no idea you could even have a pain free pap

[melissaf]

I'm in Ontario and had a midwife for my 1st birth in March. It's very comforting knowing exactly what training they have. Even if you give birth in a hospital (which I did) they come out to your home multiple times to check on you and baby! Don't know what I would have done without them during that time.

[taylorbarnett]

I work in the medical field and I had midwifery care and I couldn’t agree with you more! The lack of oversight, requirements and such is concerning and not safe for patients .. it’s also a shame that CNMs don’t attend births at home because of the hospitals rules. Insane

[lauracohen]

I love midwives. Both of my children were delivered with midwives, and I'm very grateful they were. They took time with me and listened to what I wanted and did not want. Excellent care.

[eliseb]

I'm in the UK and all woman receive prenatal care from midwives. I was technically high risk and consultant (OB/GYN) led, however my checkups were all done by midwives, a midwife was my first point of contact for any issues during my pregnancy and a midwife delivered my babies (in hospitals where there was an OB/GYN in the building, but i never saw them!)

Edit - just got to the part where you mentioned the system in NZ, its very similar to how we work in the UK by the sounds of it

[sarahp]

Thank you for talking about this. I loved my certified nurse midwives. For me going to the birth center and having a home-like birthing experience was amazing and comforting. I wish more people had the chance to have a birth like mine if that’s what they want. I was allowed to eat. They encouraged me to drink water the whole time. I got to labor in a tub and got to cuddle up in a queen size bed with my baby and husband afterwards.

[ourgeckos]

I had a midwife with 2 my youngest children...along side my OBGYN. She assisted in their deliveries, BOTH ended up being C-sections... One was an emergency, the other was a planned section with a tubul ligation also. My midwife was able to get to do her first tubal ligation on me❣️ A few years later, she herself had twins... I remember she was one of the first Midwives allowed in the OR here in Hawai'i 💕❣️ ✨I should edit this to say our youngest son will be 21 this month 🥰❣️✨ 💞 ALOHA FROM HAWAI'I 💞🌹 LYSSA 🌹

[sarahharris]

If we in the US had the same infrastructure/system around midwifery and hospital care as other countries do, I'd probably consider a home birth! But in the current US system it's just not a safe option in my mind and that's really a shame.

[TeaAddict]

The difference between countries is astonishing. Midwifery is a full degree here in Australia and labour wards are generally staffed primarily by midwives, with doctors (OBs) called in as required.
I loved all of the midwives who attended me during my first birth experience and I look forward to being looked after by them again with baby #2!