Birth Plans? Choosing a Midwife for the Journey

Choosing who will attend to your delivery is a highly personal decision. While obstetricians have traditionally been the go-to professionals for delivering babies in the United States, midwives are growing in popularity.

What is a Midwife?

In Texas, two kinds of midwives are available to support you through your birth experience: Certified Nurse-Midwives and Certified Professional Midwives/Licensed Midwives. Today’s Certified Nurse-Midwives are independent healthcare providers who have received a bachelor’s degree in nursing and either a master’s or doctorate degree in midwifery. Certified Professional Midwives are licensed providers who are not required to be nurses. Their training is acquired through an apprenticeship with a qualified midwife or by attending a midwifery program or school.

If you determine that a midwife is the right birth plan for you, know that you will receive special support in your journey through a healthy pregnancy and birth. CNMs even provide ongoing well-woman and well-newborn care if desired. Plus, they are qualified to order tests, provide treatments for common pregnancy issues, and prescribe epidurals and other pain relief medications when attending hospital births.

Although midwives specialize in natural childbirth, the common myth that they only provide home births is far from true. Certified Nurse-Midwives can attend births at home, in a birth center or at a hospital. Findings from a 2014 study by the American College of Nurse-Midwives actually showed that as many as 94 percent of CNMs attended hospital-based births. CPMs attend home and birth center births. Depending on the midwife you choose, you may have the option for a birth that’s unmedicated, medicated, in water or a vaginal birth after cesarean. Many midwives manage twin births as well.

Midwife vs. OB vs. Doula

When considering a midwife for your baby’s delivery, it’s important to understand the midwifery approach to care says Adrienne Jones, MSN, RN, and Certified Nurse-Midwife for the Midwifery & Family Wellness program at Texas Health Presbyterian Hospital Dallas. Midwifery emphasizes the importance of individualism and a care plan tailored to a client’s life experiences and desires, according to Jones.

“As a midwife, my goal is to help women take control of their health and wellness by encouraging them to become active participants in their care,” she said. “Women who actively participate in their care are more invested and generally more satisfied.”

The Midwifery model of care focuses on cultivating life-long partnerships with clients and their families. This can be a little different from what an obstetrician might offer. Jones points out that a midwife relationship focuses on giving women and their families the tools they need to be well-educated and healthy throughout their lives.

“Midwives specialize in normal births and are trained to identify when a situation may be veering away from what is expected or typical. Barring a medical necessity, most midwives prefer watchful waiting and non-intervention over induction. Respecting the birth process through the use of positioning, movement and ‘natural’ methods to encourage labor are components of classic midwifery care. Therapeutic listening is a hallmark of midwifery care used when learning how to best support you through pregnancy and birth. This is why more and more women are finding midwifery to be a better fit for their pregnancy needs.

Midwives and doulas often share similar mentalities regarding physical and emotional support during labor, but they have very different roles on your birth team. A doula is a non-medical team member who is trained to provide continuous physical and emotional support to families before, during and after childbirth. The midwife is the healthcare provider on the team and, although she will also support you physically and emotionally, her role is clinical. She is trained to pay attention to how your body and your baby adapt to labor. Her primary focus is to make sure you both remain safe throughout pregnancy, birth and the postpartum period. A doula is an invaluable member of the birth team but is not a substitute for a midwife or doctor,” she added.

A Continuum of Care

If your midwife has the ability to attend births in the hospital and your pregnancy becomes high-risk, your care will likely be co-managed between your midwife and her supervising physician. If your midwife only attends out-of-hospital births, she will coordinate the transfer of your care to a physician who can provide in-hospital care.

Texas Health Dallas’ Midwifery & Family Wellness is a unique program that can provide prenatal and family care at any stage of a woman’s life, from adolescence to after menopause. To learn more about the program and Women’s Services available through Texas Health Resources, visit 

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