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Midwives: Guardians of Normal Births

By Olympia Franklin, LM, CPM

Throughout history in each society and community, it is midwives who have attended the births of babies. These women were called upon to watch over new mothers and assist them in the personal and cultural rituals that helped them to give birth.

Midwife means with woman and is influenced by the word to mediate. In many communities, the midwife has maintained a role as traditional healer. Now, the range of choices that midwives in regard to how they develop their role and where they practice has created a variety of paths for those in the practice. In California, as in many other states, there are several types of midwives who practice in a variety of settings- homes, birth centers and hospitals. While most midwives are women, there are also a handful of male midwives. Sorting out what the varying acronyms and midwifery credentials mean can be confusing so here is a quick guide:

Direct Entry Midwives (DEMs)
Direct Entry Midwives, also known as “lay” midwives, are the most undefined roles. These are women who have not attended any formal midwifery program. Instead, they may have learned through self-study, experience, and/or the traditional apprenticeship.

Certified Professional Midwife (CPM)
A CPM, as defined by the North American Registry of Midwives (NARM), “is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards of certification set by NARM and is qualified to provide the midwives model of care.” The CPM is the only international credential that requires knowledge about and experience in out-of-hospital setting.

California Licensed Midwife (LM)
The California Licensed Midwife successfully completes a three-year postsecondary midwifery educational program accredited by an organization recognized by the United States Department of Education, Division of Accreditation, and successfully completes a comprehensive licensing examination adopted by the California Medical Board. These Midwives are licensed to care for clients through pregnancy, birth and postpartum as well as to offer well-woman care through out the life cycle.

Certified Nurse-Midwife (CNM)
Certified Nurse Midwives are registered nurses who have advanced training in midwifery and have passed an examination administered by the American College of Nurse-Midwives. Most CNMs work under the supervision of a physician in hospitals and birthing center.

The Midwives Model of Care is based on the fact that pregnancy and birth are normal life events and includes: monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle; providing the mother with individualized education, counseling and prenatal care; continuous hands-on assistance during labor and delivery and postpartum support; minimizing technological interventions; and identifying and referring women who require obstetrical attention. The application of this model has been proven to reduce the incidence of birth injury, trauma and cesarean section.

Key Points in the Midwifery Model of Childbirth Care:
-The woman maintains power and authority over herself.
-Responsibility is in the hands of the woman herself, shared with her midwife.
-The goal is to assist the woman toward self-care as a healthy person in a state of normalcy.
-The mother and baby are a unit whose medical and emotional needs are complimentary; what meets the needs of one meets the needs of both.
-The woman’s body is a well-functioning home for herself and her baby. Its needs and workings are best known by the woman herself.
-The emphasis is on pregnancy and birth as times of physical/psychological/emotional growth for mom and fetus.
-Childbirth is seen as an activity that the healthy woman engages in.
-The midwife guides and educates the woman during her experience.
-Childbirth is seen as a normal event in the of the woman and her family members. The woman’s active birth-giving is enhanced by education, support, and skilled care. Midwifery is safeguarding the natural process of pregnancy, labor and birth.

Olympia Franklin is a midwife practicing with Vital Roots Birth Services, a four midwife practice offering complete preconception, prenatal, labor and post-partum care, as well as a variety of women centered classes. Vital Roots offers homebirth, waterbirth, and doula services.Our service area ranges from Petrolia to Bridgeville, Benbow to Eureka. Please contact them to learn more. Olympia 223-5322 Laura 223-1638