Looking for Your Birth Team in Nashville? Doulas, Midwives, and OBGYN’s Explained

Are you in the process of building your ideal birth team and wondering which professionals are the right fit for you? Doulas, midwives, and OBGYNs play distinct roles in supporting families throughout pregnancy, birth, and postpartum. In honor of Midwifery Week, let's delve into the world of midwives 💕.

What is a midwife?

Midwives provide a wide spectrum of care, ranging from routine well-woman examinations and pap smears to fertility support, contraceptives, guidance during menopause, and continuous care throughout the stages of pregnancy, childbirth, and postpartum. In Tennessee, all midwives collaborate with OBGYNs to ensure appropriate care in the event of pregnancy or birth complications requiring specialized skills.

In many countries, midwives are actually the primary care providers for well-woman and pregnancy care. For instance, in some Northern European countries, midwives attend two-thirds of births.  In America, we are beginning to see more women opt for the care of a midwife for a lower intervention birth.  In 1990, only about 4% of births were attended by midwives, but in 2017 that number was up to about 9%. 

What is the difference between midwives and OBGYN’s?

Midwives are experts in normal birth processes and often provide holistic, patient-centered care. OBGYNs specialize in surgical procedures and high-risk pregnancies, but the division between high-risk and low-risk can be nuanced. Midwives can work with families facing some risk factors, such as gestational diabetes or high blood pressure. However, OBGYNs are essential for medical procedures like c-sections and repairing severe vaginal tearing.​

What is the difference between midwives and doulas?

Doulas are not medically trained but offer invaluable support in mental/emotional, physical, educational, and advocacy capacities. Their style of support can vary greatly, so it's essential to explore what resonates with you.  At 615 Doula Co, we are happy to share more about our intentional approach.

Types of midwives:

1. Certified Nurse Midwives (CNM) are registered nurses that have also completed a master's degree in nurse midwifery. The hospital-based CNMs even support patients that choose epidurals (common myth!).  Hospital and Birth Center Midwives in Nashville are all CNM's.  There are also a handful of homebirth midwives that are CNM’s in Middle Tennessee.  
   
2. Certified Midwives (CM) also have a master's degree in nurse midwifery, but their undergraduate degree is in a different area. Certified Midwives practice in the home birth space in TN.
   
3. Certified Professional Midwives (CPM) practice after passing a competency exam by the North American Registry of Midwives. CPM's are present in the home birth space here in TN.  ​
   

The Evidence-based Benefits of Midwifery: 

Numerous global studies have highlighted the benefits of working with a midwives, including improved maternal mortality rates, decreased need for a cesarean, lower rates of labor induction and augmentation, and decreased incidences of 3rd and 4th degree tearing (those are the severe, but luckily less common types of vaginal tearing). 

If you're a fan of data and research, you're probably familiar with the Cochrane review. While their findings are more limited, they are still compelling. In their analysis of hospital-based midwives, they found that women receiving midwife-led continuity models of care were:

• Less likely to receive epidurals
• Less likely to have instrumental vaginal births
• More likely to have spontaneous vaginal births
• More satisfied with various aspects of their care

Notably, the Cochrane review confirmed that there was no increased risk of adverse outcomes for women or their infants associated with midwife-led care.

Local to Nashville?​

• If you want to learn more about the OB and Midwifery practices at each Hospital and Birth Center in Nashville and Middle Tennessee, download our FREE Nashville Birth Place Comparison Guide. 
• If you're considering a homebirth midwife, we can recommend some great ones! Regardless of your preference, booking a consultation with us is a great next step. Let's chat about your needs and preferences for your care. We're excited to be your first stop on the journey to building your ideal birth team.

Sources // Cochrane Library / Evidence Based Birth / Healthline / American Pregnancy