The definition of midwife means “with woman.” A Certified Nurse Midwife (CNM) is a Registered Nurse, often with many years of nursing experience, and an advanced level of education. All have a Master’s Degree and some have their Doctorate in Nursing Practice or PhD’s. Midwives sit a board exam and are then accredited by the American Midwifery Certification Board (AMCB) to practice.
Many people associate midwives with obstetrical care. However, midwives are trained to do a wide range of healthcare for women, from adolescence to menopause. This includes:
- well woman exams
- disease prevention
- birth control consults
- STD checks
- breastfeeding assistance
Midwifery philosophy of care
Midwives believe in watchful waiting and non-intervention in normal processes. When there is a need for intervention it will be used appropriately and judiciously. Midwives consult, collaborate and refer to other members of the healthcare team to provide the best care.
Your visit with a midwife
A midwife will work with you at every visit to discuss your pregnancy and birth. A large part of your prenatal visit is on education. It is woman-centered, meaning you are an integral part in the decision making process of your care.
As you attend each prenatal visit you will get to know your midwife. This is a time to discuss any current issues and to work towards planning for your labor and birth. As a woman you should feel empowered to ask any questions about your birth and to understand every facet of the labor.
Midwifery care during labor
Midwives are known for their hands-on approach to labor and birth. When a woman goes into labor, it is key that she have support throughout this process. Evidence shows that when a woman feels safe in labor, she progresses well, has a shorter labor, requires fewer interventions, her risk a cesarean goes down and she often needs no pain medication. A woman who is well supported though labor is more likely to breastfeed, breastfeed longer and have increased bonding with her baby.
Midwives have excellent outcomes that result in:
- fewer cesarean births
- lower rates of induction of labor and augmentation
- significant reduction in third and fourth degree lacerations
- lower use of epidurals
- higher rates of breastfeeding
Support in labor
The focus of a midwifery led care in labor is seeing the birth process as normal and minimizing the use of any interventions. Midwives do not see themselves as “delivering the baby”. Instead it is about assisting your birth, because you do all of the work.
Women can be supported in many different ways in labor. A key element to any birth is to try to be mobile. Gravity is our greatest aid in birth. This means walking, getting on the birth ball, and frequent position changes in the bed if walking is too difficult.
Being in warm water is a great way to relieve some of the intensity of the contractions. Sometimes adding a drop of lavender oil into the water will help create a calming environment. You are welcome to bring any other oils you enjoy.
Massage is another great pain reliever. Some women can have intense back labor so pressure and massage of your back will help with this. Some women like light touch between contractions to help calm them.
Eating protein snacks during labor is important to help sustain energy for the labor. Small snacks of protein bars, crackers, cut up fruit, frozen grapes, hard boiled eggs or anything that you enjoy. Avoid spicy and high fat, as this may not sit as well during labor.
Lisa Malmquist, CNM
Women's Center Gresham
Lisa Malmquist attended nursing school in Southhampton, England. She earned a BSN from University of Phoenix, in Hawaii, then completed her MSN at Frontier University in Kentucky. She is certified by the American Midwifery Certification Board.
Lisa began her career as a nurse working in neurology ICU. Her passion has always been working with people and providing OB care. Lisa began working as a labor nurse in 2002. The experience of working with laboring women led her to pursue a career as a midwife. Lisa seeks to empower women during labor and help them realize their potential.
Lisa believes that, given time, women can have natural, vaginal delivery. Low intervention is needed for most OB care. Being with the woman through childbirth is the key to safe and effective labor.
In her free time Lisa enjoys going to the gym for zumba, kickboxing and weight training. She also enjoys reading, monitoring the stock market, spending time with her daughter and traveling in her RV.
Can I still have pain medication with a midwife?
Yes! Midwives work with all healthcare team members. This includes anesthesia. If a patient requires an epidural, a midwife can order one for her patient. In addition, a midwife is able to prescribe pain medications, should they be needed.
What if I have a problem in labor?
Midwives are trained to recognize problems with both you and the baby during the course of your labor. Certain situations will require a consult with an obstetrician and your midwife will be in close contact with the physician on-call. If the need arises during labor, your midwife can utilize the same technology and interventions an obstetrician would.
Can I do a home delivery?
Unfortunately we cannot provide a home delivery. All of our midwives deliver in the hospital but keep interventions at minimum.
Can I bring a doula to the hospital with me?
Yes. A doula can help you from before the time you go into labor all the way through to after you have the baby. Again, evidence shows that this type of support for a woman can have a huge impact on her labor process. A doula is welcome into the hospital to provide non-medical care for a woman and her family. We have had some great doula’s working with our families and they are very much welcome.
Reference: ACNM (Association of Certified Nurse Midwives)