Midwifery Today
The power of birth reclaiming a women's dignity and choice.
This is a blog to give you the consumer or the professional information about Certified Nurse-midwives and all other midwives that provide care to women. The purpose of this Blog is to survey men and women in all economic or educational areas of Butte County and surroundings areas as to their views and interest concerning midwifery. At the end of this blog are several surveys specific to your professional interest. Please take the time to respond. Instructions at the bottom of the page. If you are a Physician I ask that you do the survey then read the information. I hope this provides information that will help make your next birth or someone you know a one of choice.
Here some links describing Midwifery!
Just click and you be at the site, to get back to Blog just the back arrow at the top of you computer.
The power of birth reclaiming a women's dignity and choice.
This is a blog to give you the consumer or the professional information about Certified Nurse-midwives and all other midwives that provide care to women. The purpose of this Blog is to survey men and women in all economic or educational areas of Butte County and surroundings areas as to their views and interest concerning midwifery. At the end of this blog are several surveys specific to your professional interest. Please take the time to respond. Instructions at the bottom of the page. If you are a Physician I ask that you do the survey then read the information. I hope this provides information that will help make your next birth or someone you know a one of choice.
Here some links describing Midwifery!
Just click and you be at the site, to get back to Blog just the back arrow at the top of you computer.
Choices and the Midwifery Model of Care:
LACE for CNMs and DEMs:
Cost of Maternity Care and Birth Centers:
· Myth: All midwives practice illegally.
o Most people do not understand that there are five different kinds of midwives, and associate the word midwife with “lay midwives” or “granny midwives”. Certified nurse-midwives practice legally, and have prescriptive authority, in all 50 states, the District of Columbia, American Samoa, Guam, and Puerto Rico. Federal law considers CNMs to be primary care providers.
· Myth: Midwives are uneducated.
o Starting in 2010, the minimal requirements for entering into practice as a CNM/CM are a graduate degree. Approximately 82% of CNMs have a master’s degree, and 4.8% are prepared at the doctorate level.
· Myth: Midwives only do home births.
o Of the CNM/CM attended births in 2009, 96.1% occurred in hospitals, 2% took place in free-standing birth centers, and only 1.8% occurred in homes.
o Midwives offer reproductive and primary care also.
· Myth: You must go “natural” if you choose a midwife.
o Midwives may encourage alternatives to pain medication during labor, however each patient is encouraged to seek the best pain management option for them.
o If your plans for birth were at home or a free-standing birth center, making the decision to receive and epidural will mean being transferred to the hospital. In most cases, your midwife will be allowed to stay with you for support.
For one-on-one personalized care of the healthy woman and pregnancy, choose a midwife!
· Birth centers are home-like structure that may be free-standing, or located within an existing health care system, that offers care to low-risk women throughout pregnancy, labor, and delivery. Their program of care is based on the wellness ideology of pregnancy and birth being normal
· Birth centers offer family-centered care of the healthy woman before, during, and after normal pregnancy, labor, and birth. Some of these facilities have their own laboratory services, offer child birth education, home visits, extra office visits if needed, and the initial newborn exams
· Birth centers, through studies, have proven to have comparable intrapartum and neonatal mortality rates to those of low-risk hospital births. Birth centers are responsible for meeting regulations of the state in which they are located for licensure. These centers must follow stringent rules found in the National Standards for Birth Centers, through Continuous Quality Improvement Program for Birth Centers, and they must be accredited by the Commission for the Accreditation of Birth Centers.
There are no free-standing birth centers in Chico, California, but there are 10 in California
- Your Birth Day Place, CGMC ABC
319 Mall Drive, Suite 101, Hanford, CA 93230
Tel: 559-867-4416
Tel: 559-867-4416
- Santa Barbara Birth Center
2958 State Street, Santa Barbara, CA 93105
Tel: 805-770-3700
Tel: 805-770-3700
- The Birth Center, A Nursing Corporation
5440 Laurel Hills Drive, Sacramento, CA 95841
Tel: 916-344-1860
Tel: 916-344-1860
- Baby Buddies Birth Center
1908 N. Beale Rd - Ste E, Marysville, CA 95901
Tel: 530-743-6888
Tel: 530-743-6888
- Natural Birth Center & Women's Wellness (Accredited)
9209 South Colima Road, Ste 4100, Whittier, CA 90605
Tel: 562-696-2313
Tel: 562-696-2313
- Women's Health & Birth Center (Accredited)
583 Summerfield Rd, Santa Rosa, CA 95405
Tel: 707-539-1544
Tel: 707-539-1544
- Inland Midwife Services
1200 Arizona Street, Suite A-5, Redlands, CA 92374
Tel: 909-335-6241
Tel: 909-335-6241
- South Coast Midwifery & Wmn's Hlth Care (Accredited)
4650 Barranca Pkwy, Irvine, CA 92604
Tel: 949-654-2727
Tel: 949-654-2727
- Beachside Birth Center (Accredited)
24902 Moulton Parkway, Suite 120, Laguna Hills, CA 92637
Tel: 949-215-7575
Tel: 949-215-7575
- Best-Start Birth Center (Accredited)
3343 4th Ave, San Diego, CA 92103
Tel: 619-299-0840
Tel: 619-299-0840
S Safety and outcomes of CNM care
- The American Journal of Public Health published a statement that births attended by CNMs are as safe as those attended by physicians.
- Women receiving care from physicians are three times more likely to receive an episiotomy and twice as likely to receive induction medications and/or cesarean sections than women being care for by midwives.
- The Cochrane Pregnancy and Childbirth Group found that midwife-led care is associated with several benefits for mothers and babies and had no adverse effects.
- In matching study populations, midwives provide outcomes as safe as physicians with a lower rate of cesareans, use of oxytocin and epidurals as well as a lower rate of low birth weight infants.
Why do we need to add midwifery?
- A Healthy People 2020 goal is to improve the health and well being of women, infants, children and families. Having a healthy pregnancy and breastfeeding are two of the interventions mentioned in HP2020 that midwifery care has been shown to have a positive impact on.
- Improved access to midwifery care can help in achieving this goal as a few of the Hallmarks of Midwifery Care include health promotion, disease prevention and health education, promotion of family centered care, and facilitation of healthy family and interpersonal relationships.
- Currently in Chico, California there are seven Certified nurse-midwives providing primary care to women across their lifespan, not just pregnancy care.
- The average cost of a homebirth with a CNM is about 68% less than a comparable hospital birth. Cost of Midwifery Care
- In 2007, the national average cost of giving birth in a birth center was $1,872, the average cost for an uncomplicated birth in a hospital was $8,316. Transforming Maternity Care
“Why Choose a Midwife?" Why Choose a Midwife?
How is midwifery care different than obstetrician care?
- Midwives focus on normal pregnancy and birth and are the best option for healthy women whereas obstetricians focus on the potential for pathology and are therefore the better option for women with a very complicated health history or pregnancy.
- Midwives care for the whole woman and consider all aspects of her personal and family life as vital pieces of information.
- Midwives seek to create a partnership with the woman, viewing her as a unique individual and educating her to help her become the expert on her own body, promoting health and encouraging the woman to have an equal voice in her own care decisions.
- Obstetricians seek to “manage” a woman’s care as they often consider themselves to be the expert. When relating to pathologic conditions, they are the experts and an essential part of the care team, but they often fail to recognize normalcy,over-emphasizing the potential for pathology.
- Midwives seek to minimize the use of pathology oriented interventions whereas obstetricians tend to rely on them on a routine basis.
- Women receiving care from a midwife are more likely to experience: no intrapartum analgesia/anesthesia, attendance at birth by a known provider, spontaneous vaginal birth, initiation of breastfeeding, and a higher perception of control during labor.
- While not representative of each and every provider, this short, comical video demonstrates the general differences in the OB/GYN model versus the Midwife led model of care. OBGYN v. Midwife
Licensure, Education, Accreditation, and Certification of Midwives
How are midwives licensed?
- Certified nurse-midwives (CNMs) are licensed through their state’s board of nursing, midwifery board, or medical oversight board. Nurse-midwives in California is registered nurse that has received a certificate from the Board of Registered nurses,she is then able to attend cases of normal childbirth, prenatal care, intrapartum, postpartum and immediate care of the newborn this includes family planning and primary care throughout a women lifetime. ACNM: Our Credential
- Nurse-midwives obtain an California license through submission of an application and a small fee to the California Board of Registered Nursing ( BRN). Proof of an active, unrestricted registered nursing license, graduation from an accredited nurse-midwifery program, and successful passing of the national certification exam is required. Once obtained, licensure must be renewed every two years. A second way to obtain a certificate is to complete a program in nurse-midwifery that is not borad approved remediation of requirements may be required. A third way is to be certifed by a state or national organization/ association whose standards are equivalent to that of the California Board of Regulations. BRN.
- Licensure varies for direct entry midwives (DEMs). Currently, twenty-one states offer licensure or regulation to DEMs. Generally, these states have a midwifery board that oversees and licenses DEMs. Requirements for licensure vary state to state and may include certification through the North American Registry of Midwives, graduation from an accredited midwifery program, and continuing education. Midwives Alliance of North America Legality of DEMs
How are midwives educated?
- CNMs are first registered nurses. They must complete a graduate level, accredited midwifery program with supervised clinical experience in at least one birth setting: hospital, birth center, or home. The nurse-midwifery program at Frontier Nursing University, for example, requires nine terms of didactic and clinical education with a minimum of 675 clinical hours in practice. Frontier Nursing University
- DEMs may come from many educational backgrounds such as apprenticeship, accredited non-nurse-midwifery programs, correspondence programs, or self study.In states where DEMs are licensed, education requirements are decided by each state’s licensing body.
Are midwifery programs accredited?
- Accreditation for midwifery programs is granted and maintained through the Accreditation Commission for Midwifery Education (ACME). ACME accredits both CNM and direct entry midwifery programs and is recognized by the U.S. Department of Education. Currently, the University of Indianapolis is the only accredited nurse-midwifery program in the state of Indiana. There are several online, accredited programs available to Indiana residents, including Frontier Nursing University, the oldest and most prestigious nurse-midwifery school. ACNM: Accredition
- Accreditation is offered for direct entry midwifery programs through the Midwifery Education Accreditation Counsel. These programs prepare DEMs to pass the exam and skills testing required for certification through the North American Registry of Midwives. MEAC
How are midwives certified?
- The American Midwifery Certification Board (AMCB) awards and maintains certification for nurse midwives in the United States. Initial certification is obtained by passing the national certification exam that tests candidates on antepartum, intrapartum, postpartum, newborn, well-woman gynecology, primary care, and professional issues. ACMB
- In order to sit for the exam, candidates must provide proof of a registered nursing license active within the United States, have fulfilled the requirements of a graduate level nurse-midwifery education program accredited by ACME, and have a letter of verification from their program’s director. Nurse-midwifery candidates must pass the national certification test within 24 months of graduation with a maximum of four attempts.
- Once initially certified, nurse-midwives must recertify every five years through AMCB. Nurse-midwives must complete three continuing education modules covering three practice areas: antepartum/intrapartum, postpartum/newborn, and gynecology/primary care. In addition to the practice modules, nurse-midwives must complete two continuing education units equal to 20 hours of study.
- Certification is available for DEMs. Some states in the U.S. recognize the Certified Professional Midwife certification offered through the North American Registry of Midwives. Certification requires documentation of clinical experience in an out of hospital birth setting and passing of a written exam and skills demonstration. NARM: Certification
What is the scope of practice for midwives?
- The scope of practice for CNMs includes primary care of women from adolescence through menopause. Gynecological care is provided, including family planning, preconception care, treatment of sexually transmitted infections for women and their partners. Comprehensive maternity care is provided including prenatal, antenatal, postpartum, and newborn care up to 28 days. CNMs order and interpret diagnostic tests, prescribe medications, perform complete physical exams, and manage care. ACNM: Our Scope of Practice
- The scope of practice for the a Certified nurse-midwife is defined within the state of California to provide prenatal, intrapartum, and postpartum care, including intreconception and family planning. The nurse midwifery certificate authorizes the CNM to attend cases of normal childbirth as her or his own responsibility as well as the immediate care of the newborn. This includes preventative measures and detection of abnormal conditions of the mother or child. A CNM cannot assit a birth with artificial, forcible or mechanical means or perform versions of the fetus. BRN: General information: Nurse Midwife practice
- In order to have prescriptive authority in California, nurse-midwives must proof of successful completion of 45 hour of a graduate level pharmacology class or have taken a advanced pharmacology course consisting of 3 semester units or 5 quarter units. Controlled substances may be prescribed after obtaining an California controlled substances registration and federal registration with the Drug Enforcement Administrationn . BRN: furnishing number
- The scope of practice for direct entry midwives may be defined by the state in which they practice. It is usually limited to maternity services as prenatal, antepartum, postpartum, and limited neonatal care. DEMs cannot prescribe medications or order diagnostic tests.
History of Midwifery in the US
· Beginning – Midwives have been catching babies in the United States since before it officially became the United States!
o Midwifery was a respectable profession valued by colonists, settlers, Native Americans, and African slaves.
o Many midwives (as well as doctors) trained as apprentices, by watching and learning from other midwives.
o Prior to the late 1700’s birth was considered normal and was only attended by doctors if there were complications. Often there were no doctors available even if there were complications.
o No licensure or specific training required until 1716 and even then only in a few cities.
· Changes
o In the late 1800’s midwives were still attending the majority of births.
o Most doctors were only delivering babies of wealthy white women in urban areas, often using forceps and drugs such as opium and laudanum.
o By the 1950’s hospital births became the norm with doctors delivering the majority of babies in the U.S.
o Midwifery practice was almost abolished, with medical leaders portraying childbirth as a perilous condition and midwives as being incompetent.
· Growth
o As traditional midwifery practice decreased in the U.S. a new form of midwifery began to emerge with nurses acquiring additional education and training to become nurse-midwives.
o Nurse-midwifery programs in the 1930’s, such as Frontier Nursing Service and midwifery programs created by Indian Health Services, lead the way to the re-growth of midwifery in the U.S.
o By the 1960’s women became vocal about their discontent with the medicalization of childbirth as nurse-midwives developed an organization to standardize their profession.
o The 1970’s saw the opening of the first freestanding birth center in the U.S. with midwives offering women a choice other than giving birth at home or in a hospital.
o Certified Nurse-Midwives have grown in numbers in the U.S. from 275 in 1963 to over 7,000 today and growing.
· Current
o Internationally
§ The majority of women in most industrialized nations choose midwifery care for childbirth, including Austria, Sweden, the United Kingdom (UK), the Netherlands, Australia, and New Zealand.
§ Midwives are the primary childbirth attendants in most third world countries as well.
§ Midwives attend 70% - 80% of births in Sweden, the UK, and New Zealand.
o Nationally
§ Midwives attend 8% of all births in the U.S.
§ CNMs attend over 11% of vaginal births in the U.S.
§ CNM’s practice in all 50 states and the District of Columbia.
§ CPMs/CMs/LMs practice legally in 29 states.
o Locally in Butte County, California
- CNM attended 25 home births for 2010 ( no data for 2011)
- Enloe Medical center with 7 Obstetricians and no CNM's had 880 for 2011
- FeatherRiver Hospital with 4 Obstetricians and 4 CNM's had 927 births for 2011
- Oroville Hospital with 4 Obstetricians and no CNM's had 435 for 2011
Birth Choices
§ General Practitioner offering obstetrical services
§ Obstetrician
FeatherRiver Hospital ( Paradise, Ca)
Ronald E. Ainsworth, MD; Paradise. 771-AA Buschmann Rd. (530) 877-8640.
Deborah J. Anderson, MD; Paradise. 771-K Buschmann Rd. (530) 877-2243.
Per A. Dovre’, MD; Paradise. 6283 Clark Road #8. (530) 872-2229.
Donald Willis, MD; Paradise. 6283 Clark Road #8. (530) 872-2229.
o Certified Nurse-Midwife (CNM)
Lisa Catteral, CNM; Chico & Paradise. http://www.buttebabies.com/.
1617 Esplanade, Chico. (530) 345-4471.
771 Buschmann Rd. Ste L. (530) 872-7579.
Kerry Eldridge, CNM; Chico & Paradise. http://www.buttebabies.com/.
1617 Esplanade, Chico. (530) 345-4471.
771 Buschmann Rd. Ste L. (530) 872-7579.
Cheryl Struve, CNM; Chico & Paradise. http://www.buttebabies.com/.
1617 Esplanade, Chico. (530) 345-4471.
771 Buschmann Rd. Ste L., Paradise. (530) 872-7579.
Ann Wright, CNM; Chico & Paradise. http://www.buttebabies.com/.
1617 Esplanade, Chico. (530) 345-4471.
771 Buschmann Rd. Ste L., Paradise. (530) 872-7579.
Obstetricians for Enloe Medical Center, Chico, California
Joseph Brooks, MD; Chico. 1430 Esplanade Ste 3. (530) 345-5278.
Lindsey M. Cafferata, MD; Chico.www.chicoobgyn.com. 1665 Esplanade (530)895- 0423
Steven Lazaro, MD; Chico. www.chicoobgyn.com. 1665 Esplanade. (530) 895-0423.
Walter Mazen, Jr., MD; Chico. www.chicoobgyn.com. 1665 Esplanade. (530) 895-0423.
Scott Mellum, MD; Chico. 101 W 2nd Ave. (530) 894-8944.
Raleigh Unterseher, MD; Chico. 1315 Esplanade. (530) 332-9288.
Maurice Valcarenghi, MD; Chico. 635 W East Ave. (530) 343-2024.
Certified Nurse Midwife in Chico, California
Dena Moes, CNM; Chico. http://www.chicomidwife.com/. 689 E. 18th St.
(530) 828- 9435. Only Home Deliveries no hospital
Camille Panighetti, NP; Chico. http://www.chicoobgyn.com/. 1665 Esplanade.
(530) 895-0423. Only Office visit no deliveries
Karen Aronson, NP; Chico. http://www.chicoobgyn.com/. 1665 Esplanade.
(530)895-0423. Only Office visist no deliveries
o Certified Professional Midwife (CPM) in Chico, California
Paula Emigh, LM, CPM; Chico. 1198 Oakdale. (530)384-7994 Only home deliveries
o Certified Midwife (CM) none in Butte County
o Licensed Midwife (LM)
Paula Emigh, LM, CPM; Chico. 1198 Oakdale. (530)384-7994 Only home deliveries
Obstetrician in Oroville, California
Matthew Bazzani, MD; Oroville. 2721 Olive Hwy, Suite 4. (530) 532-8636.
Peter Bippart, MD; Oroville. 2721 Olive Hwy, Suite 4. (530) 532-8636.
Rigoberto Gutierrez MD; Oroville. 2809 Olive Hwy, Ste 370. (530) 538-9410.
Karl Johansson, MD; Oroville. 2721 Olive Hwy, Suite 4. (530) 532-8636.
Choices of birth place
- Hospital
FeatherRiver Hospital
Enloe Medical Center
Oroville Hospital
o Birth Center attached to hospital (none available)
o Freestanding Birth Center is in Marysville, California (Baby Buddies Birth Center )
o Home
Dena Moses CNM in Chico, Ca
Dena Moses CNM in Chico, Ca
Here are some links that may help you discover what choices are available to you and understand more about the midwifery model of care:
After reading this Blog please fill out survey and copy & paste into email to lactijoy@gmail.com thank you I hope you enjoy this information, if have question please email at the email given or post a comment, Thank you for your time.
Joy Humann is a nurse- midwife in training from Frontier Nursing University.
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