Specialty care in the maternity journey: Midwives improve outcomes through quality care

People on their family-building journey need support and education as they progress through fertility treatments, pregnancy, the birthing process, and postpartum care. Midwives play an important and increasingly popular role in women’s health, improving outcomes by supporting birthing parents during their pregnancy journey and beyond. More and more parents are recognizing the benefit of working with midwives — midwife-attended births in the US have increased by 11% between 2003 and 2018. As organizations begin to expand their benefits ecosystem, employers should know the role midwives play in the family-building journey and understand how they can help drive better outcomes and lower costs for their employees.

What do midwives do?

Midwives are trained experts in women’s health and pregnancy care who can provide a wide range of health services, including annual checkups, birth control, and menopause care. “The word midwife means ‘with women,’ so as midwives, we guide women through their health journeys and share in that journey with them,” says Beth Przybylski, CNM, WHNP. “We serve as primary care providers for women who have started their periods, all the way up through the end of menopause.”

Midwives are most commonly known for their work around fertility, pregnancy, birth, and postpartum care. They often work closely with OB-GYNs and family doctors to meet a birthing parent’s full spectrum of needs in-person or through virtual appointments, including providing education and advocacy throughout the family-building journey, conducting pre- and postnatal visits, and offering culturally humble care to patients.

“I think there’s a lot of myths around midwives, but certified nurse midwives are highly trained medical providers who commonly work alongside physicians in the hospital,” says Susana Vega, MSN, CNM. “We have the medical education and clinical hours needed to provide high-quality clinical care to women.”

Types of midwives

Midwives can receive different levels of certifications, which enables them to provide different levels of care to their patients. The three common types of midwives are:

• Certified nurse midwives (CNM), who graduated from nursing school and received an additional graduate degree focused on midwifery. They can provide primary health care; facilitate births in hospitals, birthing centers, and homes; and write prescriptions. They are able to practice in all 50 states.
• Certified midwives, who have the same graduate degree in midwifery as CNMs, but have a background in a field other than nursing. Certified midwives are only licensed to practice in Delaware, Missouri, New Jersey, New York, Maine, and Rhode Island.
• Certified professional midwives (CPM), who have completed coursework, an apprenticeship, and a national certifying exam outside of graduate school. They do not work in hospitals and operate exclusively in birthing centers and at home. They are licensed to practice in 33 states.

How do midwives differ from OB-GYNs or other physicians?

Midwives and OB-GYNs often work in tandem to provide the best, whole-person care to expecting parents. While both are trained healthcare professionals, OB-GYNs are medical doctors who have completed medical school, residency, and fellowships, and midwives receive the training listed above. In addition, several factors differ between the two specialties:

• Risk level of pregnancy: OB-GYNs can manage low- and high-risk pregnancies, while midwives focus on low-risk pregnancies and births or partner with an OB-GYN to provide additional support for high-risk pregnancies. 
• C-sections: Midwives are not licensed to provide C-sections, while OB-GYNs can perform scheduled, unplanned, and emergency C-sections. 
• Location of births: OB-GYNs deliver babies in hospitals, while midwives can facilitate births in hospitals, at birth centers, or at home.

What are the benefits of working with a midwife?

Improved outcomes for mother and baby

The US has some of the worst maternal health outcomes among developed countries, and midwives have been proven to make a positive impact on outcomes for the birthing parent and the baby. A study examining all 50 states found that the states with the highest integration of midwives into the healthcare system had more births without the aid of medication, fewer obstetric interventions, and fewer negative outcomes to the baby.

Midwives have also been shown to increase the likelihood of vaginal birth and reduce C-section rates, and women who work with midwives are less likely to experience preterm birth, death of the fetus before and after 24 weeks, and infant death.

Increased education and empowerment during pregnancy

Many women in the U.S. did not receive comprehensive sex education and are often navigating their pregnancy, birth, and post-birth journeys without science-backed information about the processes. Midwives can serve as a trusted, accessible source of information for birthing parents, educating them on the birth process and health implications. “Midwives offer supportive, soft-touch care,” says Przybylski. “We’ll ask questions about other factors that may influence the pregnancy, like nutrition, and take the time to educate patients on all the things that can impact their health and their pregnancy.”

Midwives can provide parents with the resources and education they need to design a birth journey that works best for their unique needs, giving parents a greater sense of agency over their pregnancy journey. “Midwives view the process of pregnancy and birth as a normal process, not as a pathological disease,” says Vega. “That’s important because we allow women to operate from an empowered state, and we’re there to support them, give them objective information, and remind them that they are empowered to make their own decisions.”

Improving maternal health outcomes through family benefits

Midwives, as a part of the larger maternity care village, contribute to the modern birth journey. In tandem with other specialty providers like doulas, infant sleep coaches, lactation consultants, and more, their inclusion in care plans for expecting parents can drive better outcomes for all and ensure families can start on firm foundations for the future.

Maven offers families 24/7 access to a robust network of midwives and other specialty providers through an easy-to-use telehealth platform that covers everything from prenatal care and fertility to maternity and postpartum care. To find out how Maven can help families in your organization, contact us today.