More women are opting for nurse midwives, who offer “high-touch, low-tech” care at every stage of life

More women are opting for nurse midwives, who offer “high-touch, low-tech” care at every stage of life

MORGANTOWN, W.Va. – When you hear the term “midwife,” does it conjure an image of a home birth by candlelight with no pain relief medications in sight? If so, you might be surprised to learn what today’s nurse midwives are all about. Betsy Miller, C.N.M., M.S.N., a certified nurse midwife at WVU Medicine Children’s with 24 years of experience, shares what a modern-day midwife does and why women choose them for their birthing experience.  

Betsy Miller, C.N.M., M.S.N.
Betsy Miller, C.N.M., M.S.N.

What is nurse midwifery?
Nurse midwives are primary care providers who specialize in women’s reproductive health and childbirth. They have similar roles to obstetrics/gynecology (OB/GYN) physicians and offer a high-touch, low-technology approach. Nurse midwives provide holistic care for women at every stage of life.

WVU Medicine Children’s has seven certified nurse midwives. “All of us are registered nurses with master’s-level training in nurse-midwifery,” Miller said. “Last year, we delivered almost 300 births at the WVU Medicine Children’s Birthing Center, and we are on pace to deliver even more babies this year.” The nurse midwives also provide prenatal care and other women’s health services at many locations in and around Morgantown. 

Why do women choose to see a nurse midwife?
Many women choose a nurse midwife because they feel heard. Nurse midwife appointments are longer than typical doctor appointments, allowing extra time to get to know patients and understand their needs. “Women often bring expectations into their pregnancy, labor and delivery — ideas about what they want the experience to be like,” Miller said. “We listen carefully and do all we can to meet their expectations while providing a safe delivery.”

Some pregnant women are more comfortable seeing an OB/GYN just in case a serious complication arises, or they need surgery during childbirth. “We are fortunate at WVU Medicine to have such experienced, caring OB/GYNs — I can’t recommend them highly enough,” Miller said.

Do you ever have to transfer patients to an OB/GYN during pregnancy?
Transfer of care to an OB/GYN usually isn’t necessary. Nurse midwives and OB/GYNs at WVU Medicine Children’s work together as a team. 

“Let’s say one of my patients develops high blood pressure or gestational diabetes — these conditions are concerning because they pose a risk to mom and baby,” Miller said. “I will refer the woman to an OB/GYN for a consult when this happens. In most situations, the doctor and I will co-manage that patient for the rest of the pregnancy.” The patient sees the nurse midwife for prenatal visits, and the OB/GYN will monitor the more high-risk aspects of her care. Midwives attend the delivery, and the OB/GYN is available if problems arise. 

There are a few situations where a woman will transfer her care to an OB/GYN or Maternal-Fetal Medicine specialist. This can happen when the woman develops severe preeclampsia or hard-to-manage diabetes. Another is when a woman plans to have a Cesarean section — nurse midwives don’t offer that procedure.

What are some misconceptions about nurse midwifery?
The biggest misconception about midwifery is that women can’t get medication to lessen or block pain during childbirth. “Even though we emphasize natural childbirth techniques, our primary goal is to provide women with the childbirth experience they want,” Miller said. “And if they want pain relief meds, we will make sure that happens.”

Another misconception is that if a woman wants a vaginal birth after a C-section, she shouldn’t see a nurse-midwife. “This isn’t the case. Our team has had a lot of success with vaginal birth after Cesarean (VBAC).”

What do you enjoy about being a nurse midwife?
Miller said, “I feel like I’m making a difference in women’s lives and helping them, and their babies get off to a great start together. I have been a nurse midwife for so long that some babies I helped deliver are adults who now see me for gynecologic care. It’s such a good feeling to be part of their lives.”

To learn more about the nurse midwives at WVU Medicine Children’s, visit https://childrens.wvumedicine.org/services/specialty-care/midwifery-services