More than a maternity provider: Midwives in your health care

 

By Whitney Suckstorf, MSN, ARNP, CNM

When I was 14 years old, I was having problems with my menstrual health. My intense cramps caused me to double over in pain, and it made going to school difficult while I was on my period. My mother didn’t know how to talk about it. She took me to see a midwife, someone she knew could talk with me about my personal health concern.

The midwife listened to the symptoms I was experiencing and together we formed a plan to help stabilize my periods. The midwife advocated for me and listened to me. That pivotal moment helped me realize I wanted to become a midwife; to provide a safe place for women to talk about their health needs without fear or judgment.

What is a midwife?

The word midwife literally means “with woman.” You don’t need to bounce from one provider to another. You can have one consistent person throughout your life. Midwives are with women through all stages in their lives, whether it’s:

• A woman’s yearly pap smear.
• Helping with period problems.
• Postpartum care.
• Transitioning through of menopause.

A midwife can help educate in depth from period pains, infertility, pregnancy, labor and delivery, cysts and fibroids, dryness and more.

What to know about postpartum depression

Differences between a midwife and OB/GYN

While both midwives and OB/GYN providers focus on women’s health care, they differ in a few ways. The medical training required is different. An OB/GYN is a doctor who goes through medical school, a surgical residency and then picks OB/GYN as their focus. Midwives receive their nursing degree and spend a few years in the nursing field, then go back to school for a master’s degree in nurse midwifery.

Another major difference is that OB/GYN providers can perform surgeries. While midwives can’t, they do have partnerships with those who can do surgeries.

The role of a midwife

The unique role of a midwife is to be a chameleon. Whether you are going through puberty, pregnancy, perimenopause or menopause, a woman’s health has complex needs that a midwife can help navigate and manage.

During puberty and adulthood

Midwives can provide basic care starting early on. A lot of common reasons adolescents and young adults see a midwife is for:

• Pap smears.
• Period pains and issues.
• Preventive screenings.
• Ultrasounds.
• Well-woman exams.
• Yeast infections.

Midwives also look at family history and help develop a care plan if there’s something to keep an eye on. Midwives are also a great place to start if you are noticing changes and aren’t sure what is happening or where to get help.

It’s also very common for you to come in if you decide you want to have a child. Midwives help create a plan, educate on pregnancy, labor and delivery and postpartum. And when she does get pregnant, she can continue seeing her same provider.

Pregnancy, c-sections and postpartum

When you find out you’re pregnant, you can either see an OB/GYN provider or a midwife based on who is best for you. There are a lot of misconceptions on a midwife’s role, like a midwife only delivers at home or only promotes unmedicated birth. Midwives help you with the birth plan you want. If you want to be completely unmedicated or if you want to be induced and have an epidural – we are there for you the whole time.

It’s also a common misconception that if you need a cesarean section that you can’t see a midwife. While midwives don’t perform surgeries, we work with and have partnerships with providers that do. If you know you’re going to have a repeat c-section, we’ll be there for you for all your health care needs during the pregnancy and we’ll be there for you in the surgery talking you through what’s happening and advocating for you the whole time.

Another aspect of a woman’s health related to pregnancy is postpartum depression. The hormonal change can be a very sharp and drastic to experience. Screening for postpartum depression begins during pregnancy, directly after delivery and throughout the first year after birth. Those screenings are one of several tools we use to help monitor and care for new moms. We work hard to make sure when you come to see your midwife you feel safe and supported. Some things we encourage to help with postpartum depression are:

• Asking help from support system.
• Breastfeeding if able.
• Eating nutritious foods.
• Getting outside.
• Seeking behavioral health support.
• Socializing with friends and family.
• Staying hydrated.

Postpartum visits are important. During pregnancy, you might see your midwife anywhere between 10 to 14 times. Postpartum, you might only see your provider a handful of times, but that is when you need the support. That’s why keeping that relationship with the midwife is so important. If you need me, I am there. We all need a little extra help sometimes. It is completely normal.

Perimenopause and menopause

There’s a lot of change in a woman’s body as she gets older. Perimenopause is the time during which a woman’s body transitions to menopause. This transition often starts in the 40s but can begin earlier. The focus during this stage of life is heavily on education and managing symptoms.

One common thing during this life stage is incontinence, especially around 10 to 15 years after you’ve had your last child. After a simple pelvic exam, we may recommend therapy to focus on strengthening the muscles in your pelvic floor. There are also specific surgeries we can discuss.

The most important thing is to remember is that you are not alone. Postpartum depression, incontinence, bone loss, and all the other things unique to a woman’s health are real and natural occurrences, and we have the education and therapies to help our patients live their best lives.

What is incontinence?