Wednesday, May 14, 2008

Need More Midwives

Recently, Florida’s birthing atmosphere has experienced a major epidemic. Due to the rising costs of medical malpractice, OBGYNs are increasingly nitpicking patients in order to decrease their chances of litigation and maximize their profits. Some OBGYNs are even discontinuing practicing obstetrics simply because it carries too many risks of litigation and not enough compensation. Medical students are afraid to go into the obstetric field because they’ve heard all the bad stories surrounding medical malpractice suits and insurance premiums. For more details on this issue, you may read the article “More S. Florida obstetricians stop delivering babies” in the Sun Sentinel (,0,6542600.story).

Enter midwifery. Two midwifery schools here in Florida are the Florida School of Traditional Midwifery in Gainesville and the International School of Midwifery in Miami. However, more programs are being offered in other locations around Florida as the need arises for more midwives. For starters, did you know that midwives can offer care to many patients who currently see OBGYNs? If patients began seeing midwives, more OBGYNs could get back to their basis of their practice – caring for high-risk pregnancies. Not only would this take pressure off of the obstetricians, but this would also offer many women the wonderful opportunity to experience the midwifery model of care. You can read more about the midwifery model of care at the Citizens for Midwifery website (

Midwives come in a variety of settings and types. To start with, midwives practice in hospitals, birthing centers, and even your own home. Depending on your wants and needs, a midwife can definitely accommodate your desired location. Next, midwives in Florida practice as either Licensed Midwives (LMs) or Certified Nurse Midwives (CNMs). Much in the way you would choose among a Family Practitioner, Obstetrician, Perinatalogist, or Maternal-Fetal Specialist, you have a choice of what type of midwife you’d like to attend your birth. An excellent explanation of the differences among these types of midwives can be found here ( This source also cites the wonderful fact that midwives can care for more than just low-risk patients. Even women with prior c-section deliveries can receive care from a midwife.

As far as becoming a medium or high risk patient, it is still very possible to receive both prenatal care from a midwife and visit a specialist for whatever may ail you. For example, having gestational diabetes does not necessarily risk you out of a midwife’s care – she can simply send you for visits with a perinatalogist from time to time while still maintaining you as a patient. Women with prior c-sections generally do not need a repeat c-section as most causes for the previous c-section do not reoccur in subsequent pregnancies. Many women have gone onto have success homebirth deliveries after a c-section with both mother and baby turning out happy and healthy.