I know this is going to differ based on what country you’re in, and where in that country you’re located.  Midwifery regulations are so different all over the world.

I’m in the United States so my experience of midwifery care is different than what a woman will experience in Canada, the UK, or elsewhere.

But here in the US midwives come in a few different varieties.  There are certified nurse-midwives who go through nursing school and then get additional training in birth.  There are also some states that license midwives based upon guidelines the state has determined; often these midwives are “lay midwives” meaning they’ve not gone through nursing or medical school.  They have, however, trained extensively.  There are also midwives who are not licensed and are lay midwives.  Some of them seek and independent certification which makes them certified professional midwives.  To get this certification they must pass rigorous testing (learn more at The North American Registry of Midwives).

So what are my thoughts on this?  I definitely think that women called to be midwives should not be required to go through nursing school first.  I  may be biased because neither of my midwives have gone the nursing route.  But in reality, in the US at least, most women who choose home birth are going to give birth with a “lay midwife” because most certified nurse-midwives deliver only in hospitals or birth centers.  Very few attend births at home.

I think that a lay midwife can and (in general) will know birth as well as a certified nurse-midwife.  They train extensively under midwives in the oldest way to learn a trade – apprenticeship.  A midwife will have attended many, many births before she begins to see clients on her own.

As for my thoughts on licensing:  I do not think a woman must be licensed to be a competent midwife.  However, I am in favor of licensing such as the Certified Professional Midwife licensing.  I believe it gives a level of assurance to the family seeking a midwife’s services.  It causes the midwife to keep current with studies, techniques, and literature.  It shows accountability and professionalism.

State (or national) licensing varies and at times it can be a hindrance – some states may say that women seeking a VBAC (vaginal birth after cesarean) cannot attempt a home delivery with a state licensed midwife.  Others say no twins.  A midwife who doesn’t follow state protocols for things could be penalized severely.  However, in general state licensing again provides a measure of reassurance to the family.  It creates accountability for the midwife, and can help bring midwives together into a unified network.

I am, in general, in favor of licensing midwives and I feel good about midwives who seek to be licensed in some way.  There are sometimes restrictions placed on these midwives that they (or their clients) would rather not have.  But in general licensing is a good thing from the viewpoint of the client.

Of course there will always be unlicensed lay midwives.  There will always be unassisted childbirth.  Women have the freedom to choose what they want.  But I do think that licensing is generally a good thing for families, and a good thing for midwives.

If you have an opinion (if you’re a woman using/considering a midwife, or if you’re a midwife) feel free to comment on this thread or contact me

But to sum it up you often find that doctors give quick appointment.  In, a quick physical check, a few questions, and then you’re out again.  I hate to say it but I often felt like I was being sent through a cattle run when I was in my OB’s office.  A midwife often takes a more lengthy approach – she checks the physical things but she also spends time talking to you and discussing what’s going on with you mentally and emotionally.  In fact a midwife is often a very good person to see if you’re stressed during pregnancy or even if you’re trying to work through past abuse before you give birth to your baby.

Now there are doctors that do this. And there are midwives that don’t give you much time to talk.  But I think it’s important to have someone to talk to through pregnancy.

Today I talked with my midwife from my first three babies.  You’ll probably remember I made a big move at the beginning of 2008 and thus moved away from my first midwife.  I’ve found a new midwife here that I really like, but I also enjoy talking to my first midwife.  We’ve had a friendship develop and she knows me so well after three pregnancies I feel I can talk to her about things going on and get valuable advice.

So today it was nice just to talk and to hear her feedback on some things I’ve been thinking over.  It’s really enjoyable to get that other point of view from someone you really trust.  Perspective – sometimes it’s good to have another’s perspective.

Midwives are good listeners.  And sometimes I think that’s what women really need.  Someone to listen while you work through things to prepare for pregnancy and birth.  Someone you can share your fears with, your hopes with.  Someone who will help guide your mind in the right direction, so you can get yourself ready for birth.  Your mental and emotional preparation for birth is just as important as the physical preparation.  I think a lot of women in our modern day are missing that.  And that midwives bring that back to women is one of the reasons they are such a blessing and an asset to modern maternity care.  I hope to see midwifery and the “midwifery model of care” continue to grow – and I hope more women learn just how important it is to have a care provider that is willing to help them through all of the issues pregnancy brings.