Should you consider a midwife instead of OB/GYN?

We are so thankful that our partner, Adrienne Ruhf, CNM, took the time to share this important information about the differences between a midwife and OB/GYN.

Many women hear the word “midwife” and think immediately of childbirth. But did you know that Certified Nurse Midwives are trained to care for women across their lifespan? 

A nurse midwife’s role goes beyond that of delivering babies. Nurse midwives are trained to perform annual screenings and breast exams, treat menstrual disorders, address abnormal pap smears or infections, provide birth control options and help women plan their next pregnancies. A good rule of thumb is: if it falls within the realm of women’s health, a Certified Nurse Midwife (CNM) is often a great option for care.

Certified Nurse Midwives receive training from a nursing perspective, which means that we focus on direct patient care, education and support. All CNMs first become Registered Nurses and then continue their training to specialize in women’s health and pregnancy care. All CNMs hold a master’s degree in midwifery and many earn a Ph.D.

One of the main differences between a nurse midwife and other providers is that we are trained to see pregnancy and birth as a natural process rather than a medical condition or an illness that requires treatment. Nurse midwives are trained to support the natural processes that occur during pregnancy and labor, while also being able to identify higher-risk complications that may require medical intervention. We follow the same guidelines as physicians, we just come at it from a different perspective – and it’s that difference that inspires us to become midwives!

There are many “pros” to using a Certified Nurse Midwife. Research has shown that women cared for by CNMs during pregnancy experienced:

  • Lower rates of Cesarean birth
  • Lower rates of labor induction and augmentation
  • Significant reduction in the incidence of third- and fourth-degree perineal tears
  • Lower incidence of episiotomy
  • Less use of regional anesthesia
  • Higher rates of breast feeding.

Another key finding is that women who worked with a CNM felt an increased sense of control during the labor and birth experience.

If you are interested in exploring the option of midwifery care for your next pregnancy, here are some important questions to consider when choosing a provider: 

  • First, check credentials. Not all midwives are Certified Nurse Midwives. That means training, experience and privileges may vary depending on midwife’s certifications.
  • Second, learn where your midwife delivers and who you will be seeing during your pregnancy. Midwife practices vary in size. At a solo practice, you may see the same provider throughout your pregnancy. At larger practices, you may meet multiple midwives. Ask who you will be seeing during your routine visits. Even in larger practices, you can often opt to see one provider or to meet multiple providers and find the person who matches best with your personality. Many midwives, like physicians, work in group practices. The provider you are seeing in the office, may not be the provider who ends up being at the hospital when you go into labor. Ask up front who will be with you when you deliver and if you will have a chance to meet that provider during your pregnancy.
  • Third, be sure to get an understanding of the providers with whom your nurse midwife works in the case of a high-risk pregnancy or unexpected complications. For instance, at our practice, all our midwives are able to assist with C-sections. I love that – it means we are able to stay with our patients through their surgeries and continue their care post-partum. This allows us to serve as advocates for our patients, no matter how they deliver.
  • Lastly, be sure to talk with your midwife about the kind of birth experience you want. In our practice, we work with patients to design a birth plan. This helps us understand what our patients’ unique goals are so that we can assist in making their birth experience as personal as possible.

If you’re curious about getting care from a Certified Nurse Midwife, my practice offers meet-and-greet consultations. Call us at 303.873.5245 to make an appointment.

Adrienne Ruhf, CNM, works at Colorado Nurse Midwives and received her degree from the University of Illinois at Chicago. She is happy to provide full-scope midwifery care at both the Aurora and Centennial locations. Adrienne is committed to providing whole-health, evidence-based care to women of all ages, and she values working with her patient families from all backgrounds. Adrienne is experienced in obstetrics, gynecology, public health and medical anthropology. Outside of work, she enjoys watching and playing soccer, spending time with animals, and traveling. Call 303.873.5245 to make an appointment with her.


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