A quick Google search will tell you that a midwife is someone who is trained to assist childbirth. This definition, though accurate, is extremely limited. A midwife is much more than just someone who assists childbirth. Many are individuals who are deeply dedicated to preserving and protecting the sanctity of pregnancy, childbirth, and postpartum. Midwives, particularly those who attend home births, see pregnancy and childbirth as something natural and normal, not as a medical event that needs to be overly managed in order to function properly (in fact, quite the opposite is true the majority of the time).
So, can all midwives attend home births and work in the hospital? Well, not in the United States. In the U.S. there are different types of midwives: there are Certified Nurse Midwives (CNM) who may practice in the hospital or in an out-of-hospital (OOH) setting; there are Certified Professional Midwives (CPM) who practice exclusively OOH (either in birth centers, or attending home births); and there are traditional midwives (direct entry midwives), who may be unregulated, and practice exclusively OOH. CNMs and CPMs are also Licensed Midwives (LM). All midwives are trained, though the training they receive differs depending on which type of midwifery they practice. Unfortunately, midwifery is not legal in every state (and/or it may be heavily regulated), strictly limiting pregnancy and birth options for women and pregnant individuals. In Texas, midwives are licensed to provide prenatal care, attend births, and provide care for up to 6 weeks postpartum.
To be under the care of a midwife, and to have your baby at home or in a birth center, your pregnancy must be considered medically low-risk. Midwives are trained to identify when things deviate from normal (prenatally, during labor, and postpartum); when referral or transfer from care is warranted, appropriate action is taken.
So, what is care with a midwife like? The answer likely depends on where you ultimately plan to birth your baby. Among home birth midwives, prenatal appointments generally last 45-60 minutes. Visits occur monthly until 26-28 weeks; every two weeks up to 36 weeks, then weekly until birth. During prenatal visits much of our time is spent talking. We discuss your pregnancy, family, nutrition, any physical or emotional issues, answer questions, and run labs when appropriate (and, of course, children are always welcome). We monitor for pregnancy induced complications, measure your fundal height, palpate (assess the baby’s position, size, and growth using our hands and what are known as Leopold’s Maneuvers), and listen to the baby (everyone’s favorite part). For the birth, midwives generally arrive when you are in active labor, and stay until (at least) 2 hours after the birth and everyone is stable. Postpartum care takes place mostly in the home, at 2 days and 2 weeks, with frequent texts and phone calls in between (and additional visits, if indicated), with a final visit at 6 weeks. If you are planning a hospital birth, prenatal visits tend to be shorter. And postpartum care likely happens at the office.
Midwifery care is about time, connection, trust, and the relationship between client and midwife. It is about pregnancy and birth being fundamentally natural and normal physiological states. It is about honoring the journey of pregnancy into parenthood, and the growing of families. It is about pregnancy, birth and postpartum not being strictly physical and physiological, but also deeply spiritual and transformative life experiences. And, it’s about individuals being able to choose the type of care and location of birth that is best for them, as well as having a practitioner that walks with them and holds space, on this incredible, life-altering journey.
Ulrike Schmidt, CPM; LM, Heart of Gold Midwifery
After the birth of her second daughter (both of my daughters were born into the capable and loving hands of midwives), inspiration struck for Ulrike. She began the Midwifery Training Program through the Association of Texas Midwives in 2012, completing the program and her apprenticeship at the tail end of 2016, graduating and becoming licensed in early 2017. Ulrike trained for 4.5 years under a single preceptor who has been a midwife for almost 35 years. During her training, she attended approximately 115 births. Ulrike is a Licensed Midwife (LM) and Certified Professional Midwife (CPM) (2017), through NARM (National Association of Registered Midwives). She is a registered member of the Association of Texas Midwives and is certified in both CPR and Neonatal Resuscitation. Ulrike received her B.A. in Anthropology from Drew University in 2000.