Midwives Provide Advice, Care, and Support for Women

The role of the midwife in the care and support of women and their families is very important and one that we value at Burdett Birth Center. To provide a little more information and insight on exactly what these roles are, we decided to have a Q&A with Margaret Holcomb, DNP, CNM, a licensed midwife at Burdett Birth Center. She became a certified nurse midwife in 1996 and has, since then, enjoyed working with women and their families at Burdett and throughout the Capital Region.

In your own words, what is a midwife?

A midwife is a healthcare provider with advanced education and training in women’s health and although most people think of obstetrics as the midwife’s area of expertise, midwives are in fact skilled in well women care from adolescence to post menopause. Midwives provide obstetrical and gynecological care as well as primary care to women throughout the lifecycle.

What credentials must a New York State licensed midwife have?

In New York State (NYS), a midwife must have graduated from an accredited midwifery education program, passed the American Midwifery Certification Board exam and be registered and licensed by New York State Education Department (NYSED).

What is the relationship between licensed midwives and physicians?

In NYS, licensed midwives are licensed independent practitioners.  They do not need to be employed by, or supervised by, a physician. However, a collaborative relationship with multiple medical providers is essential to providing quality care to women. Midwives practice as part of a team that forms a continuum of care.

Where can licensed midwives’ practice in New York State?

Licensed midwives can practice in a variety of settings including home birth, independent midwifery practice, as part of a physician practice group, birth center or large medical system.

What does prenatal care with a midwife look like? 

The hallmark of midwifery care is found in the meaning of the word which is ‘with women.’ Midwifery is a partnership between the woman, her family and the midwife.  Prenatal visits are similar to traditional OB/GYN visits; however, the emphasis is on education and shared decision making throughout the pregnancy.  Midwives also champion alternative obstetrical models such as group prenatal care.

What happens if there is a complication in a pregnancy?

In the event of a complication, midwives will consult with either an OB/GYN or a maternal-fetal medicine physician. Midwives also consult with medical providers of other disciplines if appropriate.

Describe what labor might look like with a midwife?

The mechanism of labor is no different with a midwife but the interventions may be.  Midwives believe in the normal process of birth and focus on supporting a woman during this time and helping her make informed choices about the options available. These options include medical analgesia, hydrotherapy, epidural, nitrous oxide, aroma therapy, hypnobirthing and much more.

What happens if an expectant mother is overdue?

A ‘due date’ is an estimated date that a woman will be 40 weeks and is either based on her menstrual period of ultrasound.  Term is defined as 38 weeks to 40 weeks, post term to 42 weeks.  Everyone is different but the evidence supports a woman continuing pregnancy to 42 weeks with appropriate fetal surveillance.  Most woman who don’t go into labor by 41-41 1/2 weeks elect to have an induction of labor.

What happens if intervention is need during labor? 

If there is an emergency that requires immediate delivery then the midwife will consult with an obstetrician and appropriate interventions will be initiated. If needs are not emergent then the midwife will help the woman and her family choose the interventions that most meet her needs.

How do midwives care for mother and baby postpartum? 

Women continue care with their midwives for postpartum care as well as gynecological care.  Midwives also can provide newborn care for the first 30 days of their life.

We interviewed Margaret Holcomb, DNP, CNM as part of our series of blog articles about the doctors, midwives, nurses and other providers at Burdett Birth Center. Read her profile to get to know her a little better.


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