Factors to Consider When Choosing a Midwife
A home birth is feasible if the pregnancy progresses normally and there are no high risk factors.
In this case a qualified lay midwife can serve as a coach during the birthing process with no hospital stay.
In the case of a complicated pregnancy a midwife may still be an option, but in this case the choice would be for a Certified Nurse Midwife (CNM) who works in a hospital setting.
Insurance Considerations Because insurance usually treats pregnancy and childbirth as an illness, the services of a midwife are often excluded.
This does not mean a midwife is not an option, but it may be a limiting factor.
A lay midwife will have a prior arrangement with a doctor for licensing purposes and to ensure of assistance and hospital care in the event of a breech or other complication during the process.
Verify that this arrangement fits within insurance parameters before committing to a midwife.
This is a very important factor in avoiding nasty financial surprises in the future.
Two Types of Midwife - CNM or Lay Midwife There are two primary types of midwives.
The CNM, or Certified Nurse Midwife, and the lay midwife.
An CNM is available in a hospital setting, has specific classroom training and can be a great support in the delivery of a baby.
If insurance allows for a midwife, this is most likely the choice of midwife that is allowed.
Often CNMs will work as a group and any one of them may assist in the delivery.
The lay midwife acts as a guide during the birthing process in the home environment and emphasis is placed on birth as a natural process.
The lay midwife serves an apprenticeship and is regulated differently depending on the state.
Most lay midwives will work without insurance and this can be an effective way to manage expenses in a normal birthing process.
Contingencies and Post-Natal Care Not every birth goes as planned and it is better to decide ahead of time about attitudes toward pain management.
In a home birth with a lay midwife the process is managed with breathing and other stress management techniques.
An episiotomy is often avoided, but an epidural is also not an option.
In a hospital setting most CNMs will facilitate access to an epidural, but an episiotomy is much more likely.
Understand the fundamental attitudes of any prospective midwife about these issues and find one that is compatible.