What types of birth options are available to women in east Idaho?
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IDAHO FALLS — Earlier this year, a woman named Katie Clay unexpectedly went into labor and gave birth to a healthy baby boy in a parking lot. At first, the emergency seemed like it had ended and ended happily. But then, the woman continued to feel labor pains.
Alarmed, she and her mother drove to the birthing center where Clay, much to everyone’s surprise, delivered a second baby. Another boy. She had never known she was pregnant with twins, or that her pregnancy was high-risk.
In east Idaho, pregnant women have multiple birthing plan options. They can choose to see an OBGYN, or, like Clay, opt for what she called the “old-fashioned” way and select a midwife instead.
But what are the differences in the pre-natal and birth experience? What is the difference between a midwife and a doctor? For those women beginning the journey into parenthood, it is important to find out.
In Idaho, there are two official types of midwives.
The first is a Certified Nurse Midwife (CNM), which requires extensive education. Anyone who qualifies as a CNM has to be a registered nurse, obtain a bachelor’s degree, and complete a two to three year master’s degree program in midwifery or nursing with a focus on midwifery. CNMs are able to prescribe medication, and they generally help their patients give birth in hospitals.
Natalie Taylor, a Certified Nurse Midwife at Rosemark Women Care Specialists in Idaho Falls, began her professional practice over a decade ago.
“I was a labor and delivery nurse for 12 years. I’ve been in the field of birth and women’s healthcare for a really long time,” Taylor explained. “Certified Nurse Midwives do full scope women’s healthcare. We do everything from adolescents who are having heavy periods to I have women in their 80s who are coming in for their annual check-ups.”
One of Taylor’s main focuses, however, remains the prenatal and birth process. “The way I best describe it is midwives are the specialist in normal labor and birth and normal pregnancies. We take care of low and moderate risk women,” Taylor said. “Ultimately, our philosophy is we want the woman to have the birth experience she wants to have.”
The second type of midwife Idaho recognizes is called a Certified Professional Midwife or a Licensed Midwife. Although Idaho does require a license to become a Certified Professional Midwife, it does not require any formal education. Instead, these midwives are trained through experience and apprenticeship. They are not able to prescribe medication, and they do not have hospital access.
“CPM’s typically schedule a one-hour visit window per client, allowing midwives to get to know clients’ concerns, challenges, and focus more on preventative care including proper diet, exercise, education, and supplements often including herbs and other more natural remedies,” explained Angela Geurts, a Certified Professional Midwife working at Generations Home Birth in Pocatello. “Midwives’ holistic approach to maternity care prioritizes supporting a woman in the mental, emotional, physical, and spiritual transformations inherent in the journey to motherhood.”
Although the number of women who choose to give birth with a midwife is growing in Idaho, the vast majority still choose to have their child with a doctor at a hospital, according to the Idaho Department of Health and Welfare.
In 2018, there were 21,406 live births, according to the Idaho Department of Health and Welfare’s Natality Annual Report. Of those, 18,423 babies were delivered by a physician, 2,234 were delivered by a Certified Nurse Midwife, and 483 were delivered by a Licensed Midwife.
Misty Gordon, a labor and delivery nurse at Madison Memorial Hospital, has worked with both doctors and midwives throughout the birthing process.
“Both OB-GYN and Midwives strive to ensure patients have an exceptional experience throughout pregnancy and delivery,” Gordon explained. “The biggest difference is the management of high risk pregnancies and managing complications that can arise during delivery. High risk deliveries are ultimately managed by an OB-GYN.”
Taylor agreed that everyone’s ultimate goal is the best interest of the mother and child. “It’s not an us against them mentality,” Taylor said, referring to the relationship between doctors and midwives. “We work together really well.”
In fact, in most Idaho clinics any birth overseen by a CNM also requires a doctor to be assigned, just in case any complications arise during the birthing process. In contrast, a Licensed or Certified Professional Midwife generally does not have that requirement. Instead, they offer a variety of more personal services.
“Choosing a Certified Professional Midwife for your maternity care provider is a choice to be the informed decision maker in your own home,” Geurts said. “The power differential is more balanced, and the care provided is typically mutually agreed to if at all possible. This means more responsibility on each couple to prepare for an unmedicated birth with childbirth education classes, relaxation, and a dedication to diet and life style that best supports low risk birth. I often think of myself at a birth similar to how we view life guards and swim coaches at a swimming pool. They are there to provide safety, and maybe some direction and encouragement, and only interfere when there is a problem.”
However, if a patient’s delivery begins to show signs of complication, a Certified Professional Midwife should still refer the case to the hospital.
“Midwives are adept at recognizing signs that either mother or baby is in need of a higher level of care and transporting to the hospital if the situation indicates wisdom or necessity in doing so,” Guerts confirmed.
Taylor echoed that ethic. “One of the hallmarks of being a good midwife is knowing when something’s not right and when you need to transfer that care,” she said.
Regardless of whether an expectant mother chooses a doctor or a midwife, Idaho’s birth rates are on the rise, and the percentage of safe deliveries has remained consistently high, according to the Idaho Department of Health and Welfare.