Midwives are most often known as healthcare providers who work with people during pregnancy and childbirth. As a midwife, I can say that most of us love this aspect of the work. But midwives do so much more–and in unique and wonderful ways. Midwives are educated and trained to be your lifetime partners in care and our approach to this role is a little different than other types of providers.
What is so special about the nurse-midwifery approach?
At the most basic level, WHA’s midwives are certified nurse-midwives who are trained in both nursing and nurse-midwifery. We all have master’s degrees (at a minimum) in nurse-midwifery from university-affiliated programs accredited by the American College of Nurse-Midwives and we are licensed in Oregon as nurse practitioners. Most of WHA’s certified nurse-midwives support birthing people in the hospital setting as independent providers for low to medium risk patients, meaning we are able to provide all the care needed for most laboring people from the time you are admitted to the hospital until you discharge. In the clinic we also have our own patients and see them in many different contexts. Some of our midwives work only in the clinic and often have specialized areas of expertise in addition to their general practice. While midwives primarily care for people assigned female at birth, this can include non-binary, transgender and gender-queer/gender-diverse people as well as cis women. All of this means that we often provide care that is very similar to OB/GYN physicians.
However, while the care midwives provide has many similarities to OB/GYNs, the midwifery model has a different guiding philosophy. We focus on providing holistic care, which means we consider the physical needs of our patients within the broader context of their mental, emotional and social wellbeing. Our practice centers on the individual and whatever life experiences, values, and preferences they are bringing into the room with them. We provide care with these things in mind and strive to mindfully care for the whole, complex human that you are.
Midwives are also often focused on providing low-intervention care wherever possible–recognizing that the body has been doing its thing for thousands of years and that medicine has, throughout most of history, over-treated and over-medicalized the female body. On the flipside, medicine has also historically dismissed the female body by not believing when women are in pain or by invalidating their lived experiences. We recognize that these issues continue to this day and do our best to, quite simply, do better. This is our approach to caring for people across the lifespan–not just during pregnancy and birth. We practice shared decision-making to help our patients understand all of their options and evaluate each in relation to their own bodies, needs, and goals.
As part of our education, nurse-midwives also receive training in trauma-informed and consent-based care that guides how we interact with our patients. We welcome both requests beforehand and feedback after the fact on how we can best provide care for you that feels comfortable and safe.
Why choose a nurse-midwife for ongoing care?
In selecting a career path, many midwives feel they answered a calling, or developed a passion rather than simply chose a job. Often, patients seek midwifery care because they are drawn to this specific ethos and our person-specific approach to care across the lifespan. Our care is not just for birthing folks–it could be people who have seen a midwife during pregnancy and appreciate being able to continue seeing that person outside of pregnancy as well. This ongoing relationship and continuity of care deepens the midwife-patient relationship and enhances our knowledge and understanding of a person’s life story. Our care is also for those who have never been pregnant and may never plan to be.
We all need to make reproductive health care decisions throughout our lives. Just like options and health considerations change over time, so do a person’s values and circumstances. This is why so many midwives love working with patients across the lifespan. We are by nature and training focused on the individual and helping them navigate their options, no matter how their needs and goals evolve.
What can a nurse-midwife help with?
Patients can seek care from certified nurse-midwives for all kinds of reasons outside of pregnancy. We provide routine preventative health care (i.e., wellness visits or annuals), including performing Pap smears and ordering mammograms. We can help with all types of contraception, including the insertion and removal of long-acting contraceptive devices such as IUDs and Nexplanons. We can provide fertility support if becoming pregnant is your goal. We assist with STI prevention, screening and treatment–and we can diagnose and medically treat many common gynecologic concerns (or simply provide assurance something is normal–which we all need sometimes!). We can also provide help in managing the symptoms of menopause. And so much more!
Some things are outside of a nurse-midwife’s scope of practice. This could include more complex gynecologic concerns, situations that require a procedure we are not trained in to better understand what’s going on, or if there is a surgical treatment option to consider. In cases like these, a nurse-midwife might talk a person through what that care could look like and then we’ll refer them to an OB/GYN physician in our practice who can offer options that we cannot.
Similar to physicians, many nurse-midwives have areas of focus or special interest and expertise, such as vulvar health, urinary incontinence and other pelvic floor health issues, menopause, transgender care, etc. For patients seeking something specific, we might suggest one of our midwife colleagues if it appears there could be a better fit. So be sure to communicate your needs and goals.
While midwives are known for the support we can provide throughout pregnancy and birth, that is just one aspect of the care we provide. We are here to help at every stage of your journey and look forward to building lasting relationships that evolve with your needs over time.