43. What is a Midwife?
"Understanding that pregnancy is not just a physical transition but one that affects every aspect of your life, a midwife creates time to dive into how the pregnancy is going. You are seated in a comfy chair and genuinely asked "how are you coping with this pregnancy?" A midwife plans to spend 30 to 60 minutes providing childbirth education, checking in on your whole pregnancy experience and answering any questions you may have."
Depicting what a midwife is and does is quite difficult. The answer is a combination of who they are and how they care for their patients/clients. The role and responsibilities listed in their job description does not encompass their day-to-day tasks nor the true essence of their care. Midwives practice the midwifery model of care; offering equitable care, an ethical lens, and a trauma-informed approach to healthcare. The heart of a midwife centers their deep respect for the intricacies of pregnancy, birth, postpartum and all reproductive events.
Simply put, a midwife is a skilled clinical provider who specializes in low-risk reproductive events like pregnancy and physiological birth. Yet, midwifery care is so much more than supporting a pregnancy or attending a homebirth. Choosing to become a midwife is beyond understanding the risks of childbirth. A midwife is someone who trusts the body, can identify abnormalities and acknowledges how all areas of life affect reproductive health. Thus, they incorporate nutrition, movement, stress-management, bodywork, and trauma-informed care alongside their clinical competency of reproductive health.
Midwives are present in all settings of maternal care. From administrative roles, global initiatives, homebirth and abortion clinics. They can bring the essence of midwifery care to any situation. Although they do not perform surgeries or specialize in high-risk reproductive health, midwives do collaborate with obstetricians and MFMs (maternal fetal specialists) all the time to ensure continuity of care in all circumstances.
The basic components of the clinical side of midwifery care may not be new to many. However, unless you have experienced the compassion and attentiveness that is woven into the art of being a midwife, it is hard to envision how different “care” truly is with a midwife.
To capture this, let’s paint the picture of a typical prenatal appointment in a midwifery practice. Understanding that pregnancy is not just a physical transition but one that affects every aspect of your life, a midwife creates time to dive into how the pregnancy is going. You are seated in a comfy chair and genuinely asked “how are you coping with this pregnancy?” A midwife plans to spend 30 to 60 minutes providing childbirth education, checking in on your whole pregnancy experience and answering any questions you may have. Time is then spent holding space for the answer and offering practical solutions. There are many new bodily sensations that may be concerning or just uncomfortable, so midwives share local resources for bodywork through their trusted community.
As rapport is built, you may ask more questions at each appointment. The midwife may even have a talking point relevant to your gestation period or share information about an upcoming prenatal test or procedure. Offering you and your support person(s) time to think about your preferences and ask more questions until you can make an informed decision.
In the remaining time, the clinical magic happens. Your blood pressure and pulse is taken, your baby’s position and heart rate is assessed, and any applicable lab work may be collected.
By comparison, for a typical OB visit, you may spend 30-60 minutes waiting to be seen only to experience 5-7 minutes of facetime with your actual provider. A lot of factors play into this truth, in defense of my OB friends, but we can all agree that the obstetrical system can be improved.
In my humble opinion, midwifery care is the gold standard for maternal care. It is care that centers compassion, trust, and an informed experience. You can choose a midwife for any birth setting or work with an OBGYN who truly embodies a midwifery spirit.
Jessica is a Licensed Midwife working in a solo practice in Los Angeles. She’s been a doula and reproductive health educator since 2012. The training, her mentors, and ultimately, her first birth as a doula honed her interest in reproductive justice and empowering education. Jessica supports people and families through well-person care, home birth services, and conception support. When she’s not talking about birth and bodies, she loves hosting dinner parties, eating, and devouring a good book.