Are you expecting a baby or planning to become pregnant? As soon as you have a positive pregnancy test – or even suspect that you are pregnant – you should make an appointment with a provider for prenatal care. Prenatal care is essential to health and well-being for both you and your baby. You may choose to see an OB-GYN or, if the pregnancy is low risk, a midwife or women’s health nurse practitioner.

What is a midwife?

Certified nurse midwives (CNMs) are advanced practice nurses who specialize in care during pregnancy, childbirth and the post-partum period, sexual and reproductive health, gynecologic health and family planning. Midwives can handle care for your needs from puberty through after menopause.

Midwives view pregnancy, birth and life transitions as normal life events, said Jessica Beitler, CNM, of Aultman Medical Group Women’s Health Services.

“We focus on education and lifestyle changes as the first line of care,” Beitler said. “For example, midwives are trained to recognize the difference between normal changes that occur with pregnancy and symptoms that require special attention.”

Certified midwives can independently manage and oversee prenatal care visits in a normal low-risk pregnancy.

When considering care with a midwife, be sure to ask about their credentials. A CNM is a registered nurse who receives additional training in pregnancy and childbirth and has a master’s degree in nurse midwifery.

Beitler, for example, had more than 20 years’ experience as a bedside labor and delivery room nurse prior to obtaining her master’s in midwifery. CNMs are certified by the American Midwifery Certification Board and are licensed in every state.

How do midwives and physicians work together?

At Aultman Medical Group Women’s Health Services, the advanced practice nurses work in close collaboration with the physicians.

“It is typical that patients being seen by the midwife or our nurse practitioner for the majority of their prenatal care will also meet the physicians on staff, even during low-risk normal pregnancies,” Beitler said.

If or when a need occurs, a certified nurse midwife can order medications, order tests and even treat common complications of pregnancy. However, the midwife and the physicians on staff at Women’s Health Services work together to manage the patient’s care.

“If a pregnancy becomes high risk, the plan of care is seamless because the patients are already known to the physicians on staff,” Beitler said. “The physicians can make any additional recommendations or take over care when necessary.”

How are midwives involved in parents’ choices regarding childbirth?

“At Women’s Health Services, we will choose the birth experience that is best for you based on your individual risk factors and wishes,” Beitler said. “That may mean spontaneous labor or an induction, natural nonpharmacological pain interventions, IV pain medications or even an epidural when or if you desire.”

Some women are interested in exploring trial of labor after cesarean (TOLAC) to deliver the baby vaginally after giving birth previously by cesarean section (VBAC).

“TOLACs and VBACs increase risk in delivery,” Beitler said. “For that reason, Women’s Health Services accepts them on a case-by-case basis. For TOLACs and VBACs, one of our physicians will be your primary provider. However, I can still see you for some prenatal care visits and even help in labor under the supervision of the physician.”

For Beitler, it’s important for a midwife to be present during labor and delivery. “I prefer to be hands on,” she said. “I like to see you often in the labor process and support your needs. I can give tips and tricks for breathing and position changes to help with comfort and fetal descent.”

Some expectant parents like to have a doula present during childbirth, as well. Doulas do not have medical training. Instead, doulas are trained to provide physical and emotional support to women and their families before, during and after childbirth. Doulas do not take the place of a certified nurse midwife or OB-GYN.

“Most labor and delivery units have rules and regulations regarding guests in the unit,” Beitler said. “But if a doula is permitted on the unit, we absolutely welcome their presence.”

To schedule an appointment at Aultman Medical Group Women’s Health Services, call 330-684-4797. You can request to see the certified nurse midwife, the nurse practitioner or a physician.