Sort of a POLL: Medwives or midwives?

[mitchsmom]

For those of you who work with nurse-midwives, would you say that they mostly follow the medical model like the docs or do they follow the midwifery model of care? Particularly the "minimizing technological interventions" aspect? And for those CNM's who don't follow the midwifery model, why do you think that is (pressure from patients for intervention, pressure from docs, their own decision, for convenience, etc?). I often hear that it's the patients who pressure them into higher rates of interventions - moms who want to be induced, etc.

Do you find that CNM's spend more time with the patient? Do you have any that are able to spend most of the labor time with the patient? Are they having better birthing results (less interventions & negative side effects)?

Would you recommend the midwives that you work with in general (I know there are a few bad seeds everywhere, but in general)?

I just always hear the medwife vs. midwife thing and I'm wondering what your experience is as L&D nurses (who I sometimes think of as the true "midwives" of today... after all the term does mean "with woman" and you guys are the ones that are "with" the woman!!!!!)

[L&D_RN_OH]

For those of you who work with nurse-midwives, would you say that they mostly follow the medical model like the docs or do they follow the midwifery model of care? Particularly the "minimizing technological interventions" aspect?

--generally, the midwife model. But they do have some pts who become high risk at some point during pregnancy and/or labor who require more intervention.

And for those CNM's who don't follow the midwifery model, why do you think that is (pressure from patients for intervention, pressure from docs, their own decision, for convenience, etc?).

--Besides when pt condition warrants intervention, I find it is the pt that pressures the CNM for intervention: induction,epidural, AROM, etc.

Do you find that CNM's spend more time with the patient? Do you have any that are able to spend most of the labor time with the patient? Are they having better birthing results (less interventions & negative side effects)?

--Yes, they do spend more time with their pts, especially their pts who are unmedicated. Two of our CNM's spend a large part of active labor offering labor support to their unmedicated Moms. Yes, I do think they have better results, minus the pts who ask for intervention, of course.

Would you recommend the midwives that you work with in general (I know there are a few bad seeds everywhere, but in general)?

--Yes, I would and I have. I LOVE them. I actually see them for my own care.

[fergus51]

Our midwives are not nurse midwives (midwifery is a separate program from nursing) and I find there are the two extremes. Either they want to force a completely natural birth and REALLY push for that, at times to the detriment of the patient or the baby (you don't want to know the horror stories I could tell you) or they are like mini-docs (I think they want to be doctors). Very few seem to practice in the middle ground. Those that do, I would use in a second.

I did prefer the nurse-midwives I worked with in the US. I think the fact that most of them have L&D experience as a nurse before entering the program gives them a good sense of when interventions are necessary and when they aren't. Most of them spent a fair amount of time with their patients. If I were to have a baby in the US I would use a CNM.

[bioniclewoman]

I'm not a nurse; I'm just taking prerequisites right now, but I wanted to comment.

I decided to see a CNM when I was pregnant with my son back in '99. I really wanted to be under the care of a midwife and have my son at home, but since it was my first child I was to nervous to do that, so I went with a group of CNM that delivered at the hospital. There were 5 CNMs and a DR that was there once a week. They had an office right next to the hospital and were very busy with tons of patients.

I thought since they were CNMs that they would be very supportive of me wanting a "natural" birth, but when I brought up the subject at 6 months pregnant I found that they weren't. I was very emotional about the whole thing (hormones). I had chosen a CNM because having a "natural" birth was important to me, and I didn't want to have to argue with an OBGYN about what I wanted.

I don't know how the birth would have been with my CNM since I developed PIH and had to be shipped off to an OBGYN (who I loved). Shockingly, the OBGYN seemed more supportive of the "natural" birth thing than the CNM was, although I eventually got so sick the "natural" birth thing flew out the window.

I think the reason the CNM group that I saw were so intervention happy was because that is what most of their patients wanted. Their patients saw them for basically two reason; lower cost than a DR and more attention than a DR usually gives not because they wanted to go natural.

JMO

For those of you who work with nurse-midwives, would you say that they mostly follow the medical model like the docs or do they follow the midwifery model of care? Particularly the "minimizing technological interventions" aspect? And for those CNM's who don't follow the midwifery model, why do you think that is (pressure from patients for intervention, pressure from docs, their own decision, for convenience, etc?). I often hear that it's the patients who pressure them into higher rates of interventions - moms who want to be induced, etc.

Do you find that CNM's spend more time with the patient? Do you have any that are able to spend most of the labor time with the patient? Are they having better birthing results (less interventions & negative side effects)?

Would you recommend the midwives that you work with in general (I know there are a few bad seeds everywhere, but in general)?

I just always hear the medwife vs. midwife thing and I'm wondering what your experience is as L&D nurses (who I sometimes think of as the true "midwives" of today... after all the term does mean "with woman" and you guys are the ones that are "with" the woman!!!!!)