Midwives continue to serve mothers in the modern age of medicine

Some people can misconstrue midwives and their profession, mistaking them for mythical practices. However, midwifery is a modern discipline that requires additional education to serve women in hospitals and in birth centers.

Kathy Higgins, the division director of midwifery services in the UNC Department of Obstetrics and Gynecology, said about 96 percent of midwives practice in a hospital, 3 percent practice in a birth center and about 1 percent practice home births. Higgins' team delivers at UNC Hospitals.

“There’s a lot more interest today in women to have more say in their healthcare and more involvement in their labor and pregnancy,” she said. “For midwives, that is their basic philosophy, in providing education and supporting them in their desires for their pregnancy and birthing experience.”

She said midwifery does about 15 percent of birth deliveries at UNC. 

Before medicine became professionalized, midwives attended almost all home births in the American colonies. Later, in the antebellum South, African midwives arrived in America as slaves and attended the births of both Black and white women. The resurgence of midwives began in 1925 in the form of nurse-midwifery when Mary Breckinridge founded the Frontier Nursing Service.

Higgins said midwives only work with women who have low-risk pregnancies and labors because it allows the midwife to do what they’re specialized in — giving the mother the birth she wants. She said the birthing experience is one of the most important times in a woman’s life. 

“It’s successful to allow women to be more active during their pregnancy and to actively plan and obtain support for the way they want to have their birthing experience,” she said.

Certified nurse-midwives, who are registered nurses that have graduated from a nurse-midwifery program, are the only ones that have the authority to practice in North Carolina. Certified nurse-midwives and certified midwives — non-nurse midwives that have completed a midwifery education program — attended 8.3 percent of U.S. births in 2014, according to the American College of Nurse-Midwives.

At UNC Hospitals, students can take a community training course to become a doula, which are volunteers that emotionally and physically support women in labor, Senior Leah Daniel said. She said they help women cope with birth because it can be overwhelming. 

“It’s just to comfort someone that’s in a lot of pain they can’t get out of,” she said. “A lot of medicine is trying to fix the problem, but there is no fixing birth, it just happens,” she said. 

Daniel said most of the time they work with mothers who need the support because they are either young, alone, or have difficult life circumstances. She said it’s special to help these women during this challenging time because she can’t imagine anyone having to do without the proper support.

Maureen Darcey, the executive director and founder of the Women’s Birth and Wellness Center, said the midwife is going to have a relationship with the woman and follow her through her lifetime. She said they want to know more about the woman than just their bellies, such as what they eat, how much they exercise and what their home life is like. 

“They want to see a midwife because she’s looking at the whole picture — the psychological, spiritual, emotional and physical client that’s there, that’s embodied in the person sitting in front of you,” she said. 

Midwives educate their clients and give them the tools to practice the birth that they want, Darcey said. When they start pushing, they’re on the bed or in the tub next to them, she said. 

“We’re monitoring what’s physically happening, but we’re giving her the power to have control over her own birth and decide how she’s going to do it, who she wants in the room, and what’s going to be happening in her birth,” she said. “We’re not telling them how to do their birth, we’re trying to assist them on how to choose for themselves.”

Susan Holliday, a CNM with Regional Midwifery at Chapel Hill OB-GYN, said the reward of her job is seeing the joy on a family’s face when they’re successful with their birth process. She said she thinks there’s room for any type of birth that anyone wants because it’s about the woman. 

“It’s about touching the women, it’s about being allowed into that sacred space and our women’s power that we bring life forth — nobody else can do that,” she said. “I think there’s going to be an upsurge of what midwives have done in the past.”

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