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Why don’t more doctors encourage midwives during labor?
Q: In reading articles I notice that doctors favor high-intervention birthing. Why don’t they see the importance of a certified nurse midwife, with a back-up obstetrician, for the low-risk birth? Midwives save mothers and babies from unnecessary interventions. I was a recipient of a very knowledgeable hospital-based midwife who saved me from a Cesarean or other interventions that a doctor in a rush probably would have performed.
Jen Maine
A: Midwives are a wonderful option for mothers with low-risk pregnancies, and I’m delighted that you had a good experience with your birth. I have worked closely with hospital-based midwives for 20 years, and have benefited from having midwives as teachers and colleagues.

The midwifery model is based on the fact that pregnancy and birth are normal, healthy events. Some advantages are the emphasis on respectful, personalised care for a woman and her family, and the strong educational component of care. Most midwives offer lengthy, informative prenatal appointments and include emotional and social support as well as physical care. They encourage the involvement of family and friends during the birthing process and may be particularly sensitive to social and cultural issues that may impact labor. A midwife may provide ample hands-on assistance during labor and support the normal flow and rhythm of labor, preferring to minimize interventions.

Midwives may need to refer women with complicated pregnancies to a physician, and will not be able to provide all obstetric services (such as Cesarean sections). There is an enormous variation in the training and experience of midwives. In my opinion, you chose an ideal midwife: one who is licensed as a CNM (certified nurse midwife), who is experienced in hospital care and who has the support and back-up of a skilled physician.

Laura E. Stachel M.D. Obstetrician & Gynecologist