Nurse-midwives deliver with care

Nurse-midwives deliver with care

Births attended by nurse-midwives have jumped significantly in recent years, accounting for 11.7 percent of all vaginal births done in the U.S. in 2011. More and more expectant mothers are choosing nurse-midwives – and with positive results.

From pregnancy to nursery

Nurse-midwives are advanced practice registered nurses (APRN) who hold a master’s degree or higher and have advanced education and training in the art of midwifery. They provide care for mother and child through pregnancy, birth and the postpartum period.

“Nurse-midwives offer complete care for low-risk mothers,” says Katherine Austinson, a certified nurse-midwife (CNM) at University Hospitals MacDonald Women’s Hospital. This includes:

  • Prenatal visits
  • Prescription medicine
  • Attendance at vaginal births
  • Counseling for infant feeding

Though nurse-midwives are licensed independent providers, they are able to consult with their physician collaborators for more complicated or higher-risk pregnancies. Most nurse-midwives are usually employed by a hospital or doctors’ practice. In 2011, 97.5 percent of all midwife-attended births occurred in hospitals and birthing centers. But, Austinson adds, “If a woman’s pregnancy and birth are uncomplicated, she may never even need to see a doctor.”

Successful, low-tech pregnancies

Research shows that mothers and babies fare as well with nurse-midwives as they do with doctors. Women who receive care from nurse-midwives also report high satisfaction rates with their overall care and knowledge received from their provider.

“A nurse-midwife may be a good choice for women who prefer to limit medical tests and procedures,” explains Austinson. According to Austinson, women under the care of nurse-midwives are less likely to have a cesarean section. They also are less likely to receive:

  • Induced labor
  • Electronic fetal monitoring
  • Epidural anesthesia
  • An episiotomy, or a small incision to enlarge the vaginal opening at birth

Women who seek midwifery care often want fewer interventions and look for other birthing alternatives, such as water birth. Women may also seek midwifery care if they desire a vaginal birth after cesarean (VBAC), as they want a provider who will be supportive and advocate on their behalf.

Make sure to choose a nurse-midwife who is certified by the American Midwifery Certification Board and licensed to practice both nursing and midwifery in his or her state.

As the largest midwifery division in the Cleveland area, our certified nurse-midwives attend almost 30 percent of all births at UH MacDonald Women’s Hospital annually. In 2013, our nurse-midwives attended almost 1,100 births and their primary cesarean section rate was only 8.9 percent, while their vaginal birth after cesarean (VBAC) success rate was 72 percent. Both of these statistics are significantly better than the national averages.

Nurse-midwives care for women throughout their lifespan

The Division of Nurse-Midwifery at UH MacDonald Women’s Hospital serves not only expectant mothers, but also provides comprehensive well-woman care at all stages of life. Our services include:

  • Annual exams
  • Preventive services, including mammograms and Pap tests
  • Discussing and prescribing birth control
  • Providing perimenopausal and postmenopausal care

Discover more about the Division of Nurse-Midwifery, including personalized pregnancy services, at Our nurse-midwives also now see patients in Westlake. To schedule an appointment at this or another convenient community location, call 1-866-UH4-CARE (1-866-844-2273) or visit

Katherine Austinson

Certified Nurse-Midwife, UH MacDonald Women’s Hospital
Clinical Instructor, Case Western Reserve University School of Medicine

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