When you think midwife, you might think home birth.
While there are licensed midwives who do deliver babies at home, there are a growing number of certified nurse midwives, or CNMs, that deliver babies in hospitals Valley-wide. And though OBGYNs still handle the majority of deliveries, many are welcoming these nurse midwives into their practice. That's a big deal if you want a midwife to deliver your baby.
If you’ve never had a baby or seen one being born, watching a movie like the 2012 comedy, “What to Expect When You’re Expecting,” can, well, color your perception of the birthing process.
"But we kind of don’t know what goes on behind closed doors," Tiffany Jackson is a certified nurse midwife with MomDoc, an OBGYN practice in the East Valley. "And with the TV all you see are these dramatic versions of what labor and birth is like."
So the idea of having a baby, Jackson says, can be scary. She holds an advanced practice nursing degree with a focus in midwifery care. Those credentials, plus the fact that she works in partnership with the OBs at MomDoc, means she has hospital privileges, too. Jackson can admit a woman in labor, tend to her and when the time comes, deliver that baby. Alone. With no OB present.
"We love our model," she said. "We feel like we can offer women the best of both worlds. For those normal, healthy, low-risk women, we’re perfect. You don’t need our counterparts: the OBs. Their specialty is high risk, it's surgery and they're amazing at those sorts of those things."
Jackson says that model is a growing trend spurred on by women who want a different kind of birth experience. The midwifery model of care is high touch and takes a more holistic approach.
That’s not to say a woman can’t have an epidural. She can.
But a lot of time is also spent educating the patient about what to really expect when it finally comes time to have that baby. A CNM may use massage or aromatherapy during labor, she may also avoid certain tethers like an IV, which can restrict a woman’s ability to move or shift positions, and is not necessarily needed for a low-risk mom.
Emily Tarazi is the only certified nurse midwife at Banner University Medical Center Phoenix.
"So, women are becoming more informed consumers when it comes to their maternity care and they have choices," she said.
Tarazi arrived at that facility about a year ago. Over the past few years, Banner Health has started to welcome more CNMs at their other facilities throughout the Valley. To date, they’ve extended privileges to nine other CNMs.
Banner says it plans to expand the program because, to Tarazi’s point, most expectant moms know what they want and what they don’t want.
"It's been news the last several years about how high our C-Section rates are in this country, and you hear other stories about women having post traumatic stress syndrome from their birth experience, or coming out of their labor and delivery experiences feeling like it didn’t go well with how things went," she said.
One of those women was Katherine Fujii. She was in labor for 48 hours before welcoming her 9-pound, 1-ounce baby boy. Fujii was not classified as high-risk.
Still…"My husband thought it looked like a crime scene," recalled Fujii.
Fujii says it took four weeks before she could comfortably walk. Eighteen months after Fujii’s first son was born, she became pregnant again. This time, she went to a CNM.
Fujii says the experience was night and day, from the moment she walked into the provider’s office to when she left the hospital with her newborn.
Tiffany Jackson from MomDoc says about half of her patients come to her when they’re pregnant with their second child. The reasons vary, but one could be the difference in models of care. Jackson says the medical model tends to view pregnancy, labor and delivery as an accident waiting to happen. And that can lead to interventions, some of which may be unnecessary.
Amy Yates is the Director of Women and Infant services at Banner Ironwood. She’s not a midwife, but she has worked with them throughout her career.
"If we let nature take its course and we’re a little bit more patient with the process, most women have that innate ability to deliver their baby without very much intervention," said Yates.
Yates helped spearhead Ironwood’s midwifery program and says a big reason for its success are the doctors themselves.
"They have to buy into that model of care to allow for delineation of privileges to be built and to allow for midwives to gain privileges to practice inside the hospital, and it really needs to be a partnership."
Yates says in 2015, just under 30 percent of births at Banner Ironwood were performed by CNMs. At Mercy Gilbert, where Tiffany Jackson and other CNMs deliver, an average of 25-30 percent of babies are born via midwife each month.
