Midwife Is Equal Parts Nurse, Coach, Advocate

Midwives offer expectant mothers guidance, support
Krista with family

Many women looking for a more personal and intimate birthing experience choose a midwife instead of an OB-GYN and the conventional doctor-patient relationship that goes with it.

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Krista Afumbom, 34, had a water birth with her first child and is preparing to labor in water with her second baby in April. Both times she chose a midwife to help her through her pregnancy.

“They get to know you on a personal level,” she says. “When I have appointments with my midwives, it’s like visiting friends.”

Weighing the options

Personalities definitely come into play when you’re deciding who you want to guide you through pregnancy and your baby’s birth. In general, midwives offer a more personal experience. However, you may find midwives who are not “warm and fuzzy,” and obstetricians who take the time to know you well. It’s a good idea to interview both doctors and midwives to help you decide.

Also think about these questions:

  • Do I have a serious medical condition that may influence treatment?
  • Do I want to give birth at home, in a birthing center or in a hospital?
  • Is mine a high-risk pregnancy?
  • Do I have a specific birth plan that would require a less routine approach?
  • What will my insurance pay for?

Respecting the birth plan

Determined to have a natural, drug-free birth, Ms. Afumbom interviewed obstetricians and midwives to find medical practitioners who would support her plan. She felt most comfortable with the women at Cleveland Clinic Midwife Services (at Lakewood Hospital).

“They get to know what you, as an individual, are comfortable with,” she says. “I just really appreciated the comfort of the women who were with me when I was in labor at the hospital.”

Nurses with specialized training

The hospital has four certified nurse-midwives (CNMs) who are advanced practice nurses with master’s degrees in nursing or a master of science in nurse midwifery, with specialized training in the areas of pregnancy and gynecology.

Along with labor and delivery guidance, CNMs see patients for:

  • Pre-conception and maternity care
  • Annual exams
  • Contraceptive exams
  • Counseling
  • Screening and treatment
  • Medication recommendations
  • Peri-menopausal and post-menopausal exams and consultation

Guidance and support

At some places, hospitalists work 12-hour shifts to deliver babies. Joy Sedlock, one of the CNMs who worked with Ms. Afumbom, prides herself on having an established relationship with her patients. “There are different dynamics with a physician. A midwife acts as a guardian to help the woman have the baby. Some women just love the rapport, the patient education. There’s a lot of chemistry between the patient and her midwife.”

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Besides providing medical care, many midwives support alternative labor and birthing options, such as water labor, for their patients. Ms. Sedlock said she and her colleagues are there to help women stay calm and manage their pain during labor by encouraging them to move around, use an exercise ball, etc.

Some patients want natural, drug-free births, but some do get epidurals. No matter what each woman wants, the midwives help them feel some sense of control, she said.

A special bond

With Ms. Afumbom’s first baby, Ms. Sedlock was there through her first hours of labor, while her colleague Fran Jackson helped Ms. Afumbom take an active role when her baby was born.

“I labored on my hands and knees,” Ms. Afumbom recalls. “When my baby was crowning, Fran had me turn so I would be able to bring her out. Fran said, ‘Her head’s out. Her arm’s out.’ And then I delivered my own child!”

Guiding a woman through pregnancy, labor and delivery establishes a special bond between the expectant mother and her midwife.

“I’m like a member of their family,” Ms. Sedlock says. “I’ve been invited to baptisms and birthday celebrations. I’m in a place of honor. These women have chosen me for their delivery and it’s so incredible. I’m humbled.”

To hear more of Krista’s story, please go to this post.

krista-afumbom updated bio box

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