A Midwife's a Midwife's a Midwife.... Right?

Perhaps you're nearly as confused as I was about what a “midwife” does (versus what a “doula” or your “mother-in-law” might do to support you during labor). Let me spell it out for you in super plain English.

Homebirth Midwives:  Are able to practice well-woman care, like pap smears and exams, and attend the births of healthy women carrying healthy pregnancies. They do not prescribe prescription medication, nor do they offer medical pain relief methods or procedures. Most often their care includes visits to your home before and after baby is born. Appointments with home birth midwives tend to be longer and more frequent than with other birth attendants.

Certified Professional Midwife
This woman has trained for years in both an academic and practical setting and then passed two grueling exams: one on paper, another eight-hour practical exam. It is the only credential that requires experience delivering babies both inside and outside of hospital settings. Legally, CPM's can practice in 26 states (although each state sets the standards for who may or may not practice in a medical setting like a hospital or birth center).
http://www.nacpm.org/what-is-cpm.html

Registered Midwife (in Colorado)
This woman has trained for years in a variety of settings, from academic to apprenticeship. She must register with the state of Colorado and is the only birth professional permitted to attend home births. They must either take a training program through a recognized school or provide proof of equivalent experience and education.
http://www.coloradomidwives.org/registered-midwives-and-certified-nurse-midwives

Hospital Birth Midwives Somewhere between a homebirth midwife and an OB/GYN, a hospital birth midwife frequently works with healthy women carrying healthy pregnancies, but is also trained in the medical model and may offer medical interventions like pharmaceutical drugs and minor surgical procedures. Hospital birth midwives work in a medical office and do not travel to your home before or after baby is born. Their appointment times are often longer than the appointments of an obstetrician seeing a healthy pregnant woman.

Certified Nurse Midwife
This individual (the majority of whom are women) has a bachelor's degree in nursing and then a post-graduate degree (two years) in labor and delivery. She must practice within the scope of an obstetrician, meaning her philosophy of care is supervised/directed by a physician.
http://www.midwife.org

There are a whole host of organizations that offer credentials to midwives, and that is because there did not used to be a single organization. Each state had to define their own rules regarding midwifery care. Your midwife may carry a credential that is not listed here, and she may still be an excellent caregiver.

Regardless of the midwife you choose, you should know that your midwife is NOT a DOULA, or a person who is dedicated as a labor support person. Midwives provide perinatal health care, but will not arrive at your labor as soon as it begins. Typically, you make several phone calls to your midwife as your labor progresses and s/he evaluates when to meet you at your house/hospital. Some home birth midwives are also trained as doulas, but they will not perform both functions at once. In the event you need or choose to transport to a hospital, your home birth midwife may serve as a doula depending on her training and scope of practice.  

Clear as mud? Great. Have a conversation with your provider about what services they offer and whether you'd like to invite a doula to assist you or work with the assistance of a family member/friend.

Interested in learning about whether a doula is right for you?

---