An independent midwife is one who does not operate in association with any particular hospital or conventionally used labor and delivery center. The midwife may attend patient visits and births in-home, or work from a privately owned birthing center. Training and licensing may depend on the individual midwife and the area where he or she conducts business. In most cases, midwives can aid expectant mothers through their prenatal care, birth, and postnatal visits.
In most areas, the independent midwife either has to have a nursing degree followed by continued education in childbirth and pregnancy, or she must go through a strenuous training period that is often followed by an apprenticeship with a practicing midwife. Midwifery is not legal in every area of the United States, but most European countries have a high percentage of mothers in the care of midwives as opposed to medical doctors. In fact, nearly all industrialized nations other than the U.S. have a higher rate of mothers with midwife-attended births than doctor-attended births.
Although the safety of midwifery care has been called into question by many, there is no data supporting the idea that the care of a competent independent midwife is in any way inferior to the care received by a doctor. For mothers with low-risk pregnancies, midwives generally offer longer visits, more one-on-one care, and the freedom to labor and deliver in the way most comfortable for the mother. This results in fewer medical interventions, such as cesarean deliveries and episiotomies.
Many midwives attend births at the patient’s home. Visits may be conducted at the home, or in an office setting depending on the independent midwife. Births are generally allowed to progress naturally, with medical interventions being used only when absolutely necessary. Pain medication is usually not available, and often discouraged, for a woman who is laboring normally. Breathing techniques and childbirth classes may prove beneficial.
An independent midwife may also offer additional care aside from prenatal care and delivery. Well baby check-ups can usually be performed by the midwife for a period of time. Many midwives also offer nutritional guidance and support, as well as lactation consultations for mothers who need help breastfeeding.
In most cases, midwives are paid one flat fee for all services. These generally include prenatal care, the baby’s delivery, and postnatal follow-up. Lactation assistance and extended well-baby visits may cost extra, but fees are generally much small than those charged by a medical doctor. Women who are considered high risk due to pregnancy complications or a preexisting condition may be advised to have their labors attending by a licensed obstetrician.
