What Is a Midwife?

Expecting a baby is a super-exciting time, but it also comes with a lot of choices. One of the first choices you have to make is deciding who will care for you during pregnancy and delivery. While many pregnant parents select an OB/GYN for their care, others might consider using a midwife, particularly if they are looking for a more low intervention, birthing person-centered approach to labor and delivery.

If you are considering going with a midwife for your pregnancy care, you likely have several questions. You may want to know what midwives do and how they are different from OB/GYNs. You probably also want to know where you can give birth if you use a midwife, as well as what medical procedures midwives are able to perform.

A midwife is a healthcare professional who provides obstetrical and gynecological care, especially during pregnancy, childbirth, and the postpartum months. Midwives may also provide general gynecological health care, including pap smears, pelvic exams, and birth control counseling. Midwives usually take a patient-centered approach to care, and work primarily with people who are in good health and considered to have low-risk pregnancies.

We reached out to credentialed midwives in the field to learn more so that you can make an informed decision about whether to use a midwife for your pregnancy needs.

What Does a Midwife Do?

If you are looking for a provider who takes a patient-focused, empowering approach to birth, a midwife might be a good choice for you, says Rebekah Mustaleski, CPM, certified professional midwife and Motif Medical compression director. “Midwives have a foundational belief that birth is a normal, physiological process that usually doesn’t need any outside help,” says Mustaleski. “Midwives prefer fewer interventions and take a more hands-off approach to labor and delivery.”

While many people think of midwives as delivering babies (“catching babies,” as it’s often described), midwives actually help throughout the reproductive health years and are able to provide a full spectrum of care services.

“Midwives are educated to take care of people starting in adolescence, through menopause, and whenever pregnancy or gynecologic care is needed,” says Kate Woeber, Ph.D., CNM, certified nurse midwife and associate professor-in residence at University of Nevada, Las Vegas. Midwives can perform pap smears, breast exams, offer family planning counseling, screen for infection, and provide prenatal and postpartum care, Dr. Woeber says.

Midwives vs. OB/GYNs

Midwives are able to take on much of the same medical care as OB/GYNs, but they tend to work with lower risk patients, and there are some medical interventions that they can’t perform. 

Specifically, midwives don’t manage high-risk pregnancies and aren’t able to perform C-sections, says Katelyn Rasmus, CNM, certified nurse midwife and Midwifery Clinical Director at Saint Peter's University Hospital and the Mary V. O'Shea Birth Center in New Brunswick, NJ. However, she notes, midwives are able to repair simple post-birth vaginal lacerations.

Some people might worry that if they receive midwifery care, they won’t be able to get an epidural during labor. But midwives support both epidurals and other options for managing pain, says Dr. Woeber. “While many of our laboring patients use epidurals, we are prepared to assist with other options to manage pain, such as hydrotherapy (bathtubs), massage, and positioning.”

Above all, midwives are a great choice if you are looking for a birth with fewer potential interventions, and studies support this. A 2019 study published in Obstetrics and Gynecology found that, for low-risk parents, midwifery care is linked with fewer C-sections, and decreased forceps and vacuum-assisted vaginal births.

Where Do Midwives Practice?

One of the best things about giving birth with a midwife is that you have more choices in terms of where you can give birth. Midwives practice in various locations, says Dr. Woeber. While the majority practice in a hospital setting, some are found in birthing centers or attend home births.

The location where a particular midwife practices will determine the type of care and medical options that may be available. “Birth care inside a hospital may include pain medicine and epidurals, but it may also include non-medical options like bathtubs, heat, massage, positioning, etc.,” Dr. Woeber explains. “Care in birth centers and homes focuses on the non-medical options, and on changing options in response to whatever the patient needs during different stages of labor.”

Dr. Woeber emphasizes that if you give birth in a birthing center or at home, you must be healthy and at low risk of complications.

Types of Midwives

“There are several paths to becoming a midwife,” says Rasmus. The most widely recognized type of midwife is a certified nurse-midwife. “A certified nurse-midwife (CNM) is a registered nurse that then obtains an advanced degree in midwifery—usually a master’s with the option for a doctorate,” Rasmus explains. Certified nurse-midwives are licensed to practice in every state in the U.S., according to the American College of Nurse-Midwives.

But nurse-midwives aren’t the only credentialed midwives out there. “Depending on your state, you may also see a certified midwife (CM) or a certified professional midwife (CPM),” Rasmus says. These are also highly trained midwives who can work in a variety of settings. However, while certified midwives can work in all settings including hospitals, certified professional midwives (CPM) can only work in birthing centers, homes, or healthcare offices.

Who Is a Midwife Good For?

Again, midwives are usually best for healthy people who do not need specialized or high-risk care. When it comes to labor and delivery, midwives are ideal for those who are not expected to face childbirth complications.

Still, even people with some less serious risk factors can benefit from midwifery care, says Rasmus. “There are certain instances where someone’s risk factors may completely opt them out of midwifery care, but most risk factors just mean that midwives collaborate with partner physicians to ensure each patient is safe,” she says. “If you are looking for a physiological birth with minimal intervention, then I would suggest looking into finding a midwife near you.”

Midwifery care may also be a good option for someone hoping to give birth outside of a hospital setting, says Dr. Woeber. Most out-of-hospital birthing care is done by midwives, she says. “Although many people receive excellent care in hospitals, some people seek care outside the larger health care system—legitimate because that system’s statistics reflect an overuse of medical treatment...and racial disparities reflecting differential treatment due to bias and racism,” Dr. Woeber describes.

How Can I Find a Midwife?

You can find a certified nurse-midwife by searching the directory from the American College of Nurse-Midwives. You can also call your insurance to get a list of covered midwives. You can also ask your OB/GYN for a recommendation, or do an internet search for local midwives near you.

There is probably nothing better than a personal recommendation when it comes to a midwife. “Ask your community for reviews and recommendations to find a midwife who aligns with your birth philosophy,” Mustaleski recommends. Most importantly, always interview a provider before selecting them for your care.

“Everyone has their own views and opinions about birth that will impact your options during pregnancy and delivery,” Mustaleski points out. “You’ll receive the best care if you and your provider are on the same page about the things that are important to you, so take a list of questions and talk about these topics before you begin working together.”

A Word From Verywell

It can feel overwhelming when you have to make so many choices about your pregnancy and birth. You want what’s best for your health, but you also want to have an experience that aligns with your emotional needs. For some people, that means giving birth with a more medicalized practitioner like an OB/GYN, but for others, giving birth with a midwife is the kind of support that feels best. Either way, you should feel empowered to make the choice that feels right for you.