"Midwife" is a Middle English term meaning "with woman". It expresses several hallmarks of contemporary midwifery including; the promotion of family-centered care, the education of the patient through the provision of information and resources to allow her to participate in the decision-making process of her care, and the facilitation of natural processes of birth with the least amount of intervention within the realm of safe patient care.
Midwifery is an internationally recognized profession with practitioners around the world. In the U.S., nurse-midwifery was officially recognized by the American College of Obstetricians and Gynecologists and the Nurses Association of the American College of Obstetricians and Gynecologists in 1971. These two organizations recognized the valuable contribution nurse-midwives make to the obstetrical and gynecologic care of women, and are working with the American College of Nurse-Midwives to support the development and utilization of nurse-midwives.
The two professions of nursing and midwifery began their merger in the early 1920s. The Shepard-Towner Act of 1921, gave money to the Children's Bureau to provide better maternal-infant care in this country. Health care professionals, especially public health nurses and physicians, were trained to provide care to women and children, and to educate immigrant midwives who were already tending to births at homes in their communities. In the late 1920s, the Lobenstine Midwifery School began this country's first nurse-midwifery training program. By comparison, medical schools began including obstetrical training in their curriculum in 1912, but it was not until 1930, that obstetrics became an established medical specialty in this country.
Nurse-Midwives licensed to practice in the U.S., have been educated in both the disciplines of nursing and midwifery, and have passed The American College of Nurse-Midwives Certification Council exam. Many have been awarded Masters degrees upon completion of their educational program.
A Nurse-midwife's scope of practice includes gynecologic, obstetrical and newborn care, and family planning. It follows the continuum of a woman's life from puberty through menopause. Nurse-midwives manage a woman's health care independently, but within the health care system allowing for consultation, collaborative management, or referral as indicated by the health status of the patient. The majority of nurse-midwives perform deliveries in the hospital setting, although other acceptable delivery sites include the home and specialized birthing centers.
In sum, nurse-midwives are specialists in a wide array of women's health concerns with a focus on the areas of health promotion, disease prevention, and childbearing.
Denise Ramp, CNM