Certified nurse midwives are registered nurses who have completed a nurse midwifery education program accredited by the Accreditation Commission for Midwifery Education. The job duties of a nurse midwife are not limited to pregnancy and delivery. Nurse midwives provide gynecological care as well. Certified nurse midwives play an essential role in women’s healthcare providing by serving women during pregnancy, childbirth, and menopause. The essay examines three key factors that patients should consider when they are choosing between a midwife and a physician for delivery. Additionally, the essay explains why these factors are important, and how they might differ for patients who are in two different social situations.
One of the three factors that patients should consider when they are choosing between a midwife and a physician for delivery is emotional support. Certified midwives usually spend more time with patients during prenatal meetings in comparison with certified physicians. Certified midwives pay more attention by considering patient counseling than physicians do. If providing emotional support is an important factor while deciding to use a midwife for childbirth, then one should consider childbirth under the midwife’s control.
Another important factor is that a certified midwife in comparison with certified physician providers fosters a better individual approach to the delivery issue. A certified midwife provides better opportunities to deliver in a more natural non-hospital environment including home birth with the presence of a spouse and other members of the family.
The third factor when someone decides whether to use a midwife or a physician for birth is the presence of risk during pregnancy. If one observes a normal pregnancy, then certified midwife’s skills will be enough to cope with such pregnancy. However, in a case when a patient deals with a high-risk pregnancy, certified midwife’s skills will not be enough to manage such pregnancy. In this case, physician’s help is necessary because only physicians have relevant skills and experience to cope with high-risk pregnancies and perform surgeries.
If someone needs an individual approach, special care, individual counseling, and spending more time with certified nurses to establish the emotional connection with them, it is important to consider the first factor of providing better emotional support by midwives. According to Nilsson, Thorsell, Wahn, and Ekstrom (2013), first-time mothers characterize the presence of a midwife during childbirth process as a positive reason of support. Due to emotional support, first-time mothers can better cope with childbirth.
Considering the second factor is important because home birth has positive and negative aspects. A pregnant woman should be aware of the outcomes of home birth. Despite the fact that home birth is characterized by fewer maternal interventions in comparison with the standard hospital birth, home birth is connected to the increased risk of perinatal death. In turn, home birth has the tendency to be characterized by the higher risk of neonatal seizures or serious neurological complications (The American College of Obstetricians and Gynecologists, 2016,). The factor of home birth providing possibility has a crucial meaning in those cases when patients do not have access to hospitals and medical centers because of the distant location. However, those women who have access to high-quality care may prefer home birth because they choose the intimacy of home birth experience or they want to avoid hospital experience.
Considering the third factor is important because midwives often have less experience with episiotomies to know how to stitch a patient up properly. Birth with the help of midwife is not recommended for those patients who have high-risk pregnancies. However, if the patient experiences a normal and low-risk pregnancy, then she is eligible for a midwife. The examples of high-risk pregnancies might involve breech presentations and placenta previa issue. Placenta previa is a complication that causes painless vaginal bleeding in the third trimester of pregnancy and leads to serious medical conditions.
According to Datta, Kodali, and Segal (2010), placenta previa is classified into three groups such as complete previa, partial previa, and marginal previa. Complete previa implies “the internal os that is completely covered” (Datta et al., 2010, p. 305). The second group refers to the case when “the internal os is partially covered” (Datta et al., 2010, p. 305). The third group refers to the case when “part of the internal os is encroached on by the placenta” (Datta et al., 2010, p.305). Patients should be confident that their midwife is licensed to practice in the healthcare sphere. It is important to consider whether the midwife is certificated by the American Midwifery Certification Board or the North American Registry of Midwives and whether the midwife completed an accredited midwifery education program.
To examine how the three key factors might differ for patients in two different social situations, it is necessary to observe the major difference between the privileged and underprivileged patients. For instance, a pregnant woman who belongs to the upper social class can prefer using a midwife for birth because she has the desire to give birth in natural nonclinical circumstances in the presence of her family. The woman does not want to be present in the clinical environment; she requires more comfortable and relaxing environment. Therefore, in this case, the abovementioned factor is justified by the necessity for a relaxing home environment.
In the case with an underprivileged pregnant woman who has no access to healthcare centers and hospitals, other reasons will be important. The main reason will be the same, namely the necessity for a relaxing home environment. However, in such a situation, the pregnant woman will prefer a midwife because she has no possibility of birth in the distant clinical centers. Therefore, the important element is the fact that a certified midwife fosters the home environment for birth.
Regarding a privileged pregnant woman who requires special individual counseling and healthcare, another factor will have a crucial meaning. In this case, some patients who occupy the top social position might require better emotional support from healthcare providers. Therefore, these patients tend to choose midwife’s care rather than physician’s care because of the fact that physicians do not have the opportunity and tendency to spend as much time with their patients as midwives. In the situation with underprivileged pregnant women, in most cases, these patients do not require a special individual approach, lasting visits, and strong emotional support.
In conclusion, the first factor that patients should consider when they are choosing between a midwife and a physician for delivery is emotional support. Due to emotional support, patients can better cope with childbirth. The second factor is the individual approach to the delivery issue and the possibility to provide delivery in a more natural non-hospital environment. The third factor that patients should consider in their choice is the presence of risk during pregnancy. If one observes a normal pregnancy, then the person can choose a midwife because her skills will be enough to manage such pregnancy. Otherwise, the patient should consider a physician for delivery because certified midwife’s skills will not be enough to deal with the high-risk pregnancy. Three key factors can differ for patients in two different social situations. For instance, patients who occupy the higher social position might require better emotional support from healthcare providers in comparison with those patients who belong to the lower social class.