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Do I need a midwife?
Q: I have noticed that many of the obstetric practices in my community have been hiring midwives to deliver babies. My doctor just brought a midwife into the practice, and I'm not sure I'm comfortable with the idea.
A: Midwives have been around for thousands of years. They offer excellent supportive care during pregnancy and delivery. They're nurses who have taken extra training to be able to offer prenatal care and delivery of uncomplicated pregnant patients, as well as common gynecological care. Many midwives have independent practices with a physician available for difficult maternity cases.

There is an increasing trend for obstetricians to work in collaboration with midwives in states with high malpractice insurance premiums. In these new arrangements, the obstetrician supervises the midwives' deliveries and cares for high-risk patients and patients requiring Caesarean sections. In some parts of the country, this arrangement is becoming the rule rather than the exception.

I suspect that the malpractice crisis has triggered the change in your community. You may want to speak with your doctor to understand the role of the midwife in the practice.

Craig L. Bissinger M.D.