[gkelly]

hi there. i'm a final midwifery student in dublin, ireland. i love my job, and love being with mothers in labour and the actual delivery of the newborn. i do watch programmes on childbirth from the US and it seems to me that most babies are actually delivered by doctors? i'm wondering if this is a realistic portrayal of what actually occurs, or are there still practising midwifes, who do the actual delivery? i'm not talking about complicated cases, but in the case of normal cephalic presentations... would love to know.

[EricEnfermero]

Here in the US, physicians (primarily obstetrician-gynecologists) deliver the vast majority of babies. I looked at a few different sources and it seems that physicians are the primary provider at about 90% of deliveries. Most of the births attended by certified nurse midwives (CNM's) occur in the hospital as well, although both CNM's and lay midwives do provide home birthing services to a small percentage of women.

[SmilingBluEyes]

WHO?

Primary/family care doctors (some)
Specially-trained Nurse Practioners
Specially-trained Physician Assistants
Obstetricians
Certified Nurse Midwifes (in hospitals, birthing centers and in some homes)
Certified Midwives (usually outside the hospital arena)
Lay Midwives (outside the hospital arena-----not legal in all states)

The statistics do vary by state and even city. In some cities, more and more patients/clients are seeking the services of a midwife to attend their deliveries, esp in the hospitals.

[DonaldJ]

Obstetricians, Certified Nurse Midwives, and family physicians deliver babies in the clinical setting in the U.S. Lay Midwives/Direct Entry Midwives may only deliver babies in the home or in birthing centers. Additionally, CNM's may only be the primary attending if the pregnancy and delivery is uncomplicated.

[mandana]

Originally Posted by SmilingBluEyes

The statistics do vary by state and even city. In some cities, more and more patients/clients are seeking the services of a midwife to attend their deliveries, esp in the hospitals.

I agree - I think there is huge variability by location. I know in my area it's becoming more common for children to be born at home/in birthing centers with midwives attending and even more common for midwives to attend hospital births. My OB group just hired a midwife which really surprised me because while very up on the literature, they tend to be fairly conservative overall. Generally though, the hospital with an OB/GYN is the "norm".

Amanda

[colter517]

The hospital that I gave birth to my twins at has approximately 500 births a year. 27% of those births are attended by a midwife, the one I had. She is the only midwife at that hospital. In this area of the US, midwives are becoming more popular.

[hski]

I am a labor and delivery nurse in Missouri. I LOVE MY JOB!!! BUT, it is true that in this country, physicians attend most all deliveries...and believe it or not, it is mainly OB/GYNs, not even family practice docs.
The reason that I felt compelled to answer your post is that I would love to be a nurse midwife, because I too, love delivering babies. I am currently going to school to be a Women's Health Nurse Practitioner, because midwifery is almost unheard of in this state. On the east and west coast there are midwife clinics, but not around here. I wanted to go to school to become a midwife, but no one around here would let me have delivering privledges, so I settled for an advance practice nurse in women's health. I am hoping that by doing things this way, I will develop a good working relationship and trust with my physicians that could one day allow me to become a midwife and perform low-risk deliveries with their backing. Does that make sense?
I hope I answered your questions. I know it sounds rediculous...women have been having babies since the beginning of time...but for some reason in this country, there is a belief that it just "can't" be done without a physician!!!

[SmilingBluEyes]

The reasons why there are not more Midwives and other non-Obstetricians delivering babies in the USA, can be a separate thread in itself. One need only avail him/herself of some history books/articles regarding the subjects of nursing, midwifery, birthing and medicine and medicine's deliberate growing influence in this country over the last 150 years or so------ to gain some insight and understanding as to why things are as they are, today.

[StNeotser]

Originally Posted by hski

?
I hope I answered your questions. I know it sounds rediculous...women have been having babies since the beginning of time...but for some reason in this country, there is a belief that it just "can't" be done without a physician!!!

The thing is, I know that a lot of OB nurses must "catch" babies when the physician doesn't make it in the US. So of course it can be done.

Having given birth in the UK and only done OB clinical rotations in the US I can say that it seems a lot different in my limited experience. I preferred the midwife approach but it doesn't happen so much out in the US.

[labcat01]

It is a very regional thing. In the city I live in there is only ONE CNM and she is in very high demand.