This article, written by Jeri Zukoski, originally appeared in Birth Ways in June 2002

Certified Nurse Midwives and You

Imagine the celebrated birth of your child attended to in a peaceful setting by the midwife of your choice - a woman who will provide constant care and support during your prenatal exams, labor, birth and postpartum. For a growing number of parents today, Midwives are and excellent and attractive alternative to hospital-centered OB practices.

Today's Certified Nurse Midwife is a professional health care provider. She is a Registered Nurse (R.N.) who has graduated from one of the advanced education programs accredited by the American College of Nurse Midwives. In addition, nurse midwives must also pass a national certification examination and meet strict requirements set by state heath agencies.

Midwives can offer extensive teaching and emotional support during your regular check-up. While most OB visits only last 5-10 minutes, check-ups by a midwife last from 30 minutes to 1.5 hours! The secret of midwifery care is building trust, and this is accomplished be spending relaxed time with her client on a monthly and even weekly basis. This kind of compassionate, loving attention has been proven to reduce the need for operative delivery, pain medication and the occurrence of postpartum depression. It is crucial for a woman to trust her care provider and a midwife establishes this trust by taking time to get to know her client.

Care provided by midwives is characterized by distinctly low rates of cesarean births (8% vs 30% for most OB/GYNs), as well as low rates of infant mortality, technological intervention, induced labors and episiotomies. And medical safety? Numerous studies have demonstrated time and time again that women who are under a nurse midwife's care can expect the same level of safety as they can from a physician.

Personal attention and moral support are two reasons women choose a midwife. Because of this, mothers under a midwife's care tend to need less medical intervention. Hospital procedures tend to multiply and beget more hospital procedures. For instance: fetal monitoring confines a woman to bed, which can make her contractions exceptionally painful; that in turn make her more likely to require pain medication, which will make it more difficult for her when it's time to push. After all this the possibility of forceps delivery or even Cesarean increases dramatically. However, because a midwife stays by your side, supporting you, encouraging you to shift positions, offering suggestions of water therapy, massage, and other time-honored techniques, the cycle of unnecessary hospital interventions can be avoided.

"A thousand years ago the Chinese organized prenatal classes to guide a woman through pregnancy, believing that her emotions and biology together influenced the nature and future behavior and health of her child. The culture fostered her emotional tranquility as well as physical well-being. We too need a place that concerns itself not only with our bodies, but with our psyches and spirits,"

– Leni Swartz, The World of the Unborn

Today many midwives work in birth centers that are particularly geared toward childbirth (as a rule they don't offer epidurals) and have even more techniques at their disposal. Whirlpool baths are standard at Alta Bates, and for many women they make an enormous difference. During birth midwives encourage low light, skin to skin contact with other and baby to soothe and protect the newborn. Every effort is made to ensure that the mother and baby stay together at all times. Fathers are encouraged to participate or even help "catch" the baby. A father's presence is always respected, even if he only chooses to be present on an intermittent basis. If an emergency does arrive at a birth center, a midwide can often resolve the problem herself, or at least keep the situation stable until a doctor arrives.

Because midwives' clients experience warmth, creativity and balance in a setting where medical technology if needed is sensitively applied, it is not unusual for expectant mothers to discover they want midwivery care late in their pregnancy. Clients can easily switch from MD to Midwivery anytime during their pregnancy and still have insurance cover all costs.

Statistics prove that midwives are delivering more babies than ever, making the option of having a provider who you know and trust at your birth, one that can directly result in safer medical care, an invaluable cutting edge medical decision.

Jeri Zukoski, CNM, has 20 years experience specializing in VBAC (vaginal birth after cesarean section) and teenage pregnancy. After completing nurse-midwifery training at UCSF in 1986, she practiced in hospitals, home and birth center settings. As a member of the American College of Nurse-Midwives, Jeri is an approved clinical preceptor and has enjoyed teaching student nurse-midwives, student nurses, and pre-med students from UC Berkeley for the past 13 years. Jeri's clients may deliver at the Family Birth Center, at Alta Bates Medical Center in Berkeley, or at home. Her services are covered by Hill Physicians, Medi-Cal and almost all insurances, PP or HMO. Her calm style focuses on personalized, compassionate care involving the entire family, encouraging a holistic approach to pregnancy and childbirth. She is also a fitness specialist and has a background in dance and teaches private classes for her clients.

For more information contact,
Jeri Zukoski: 510-530-3374
Midwifery Today: www.midwiferytoday.com
The Amercian College of Nurse Midwives: www.midwife.org