Today this tradition continues in the form of nurse-midwives who provide medical care and support to women. This care ranges from routine OB/GYN exams to postnatal care. The term midwife means “with a woman,” a guiding principle that means women receive the special care that another woman can provide. Nurse-midwives call on obstetricians and other physicians for assistance if complications during pregnancy or delivery develop. Many women looking for a medical “alternative” to reproductive care find that midwives provide a nurturing way to ensure that they have the childbirth experience they want.
“Nurse-midwives are focused on the whole being of the patient,” says Jacqueline Eldridge, R.N., patient care manager for the Labor and Delivery Unit at Sinai Hospital. “In the BirthPlace, we try to promote the kind of birth experience a woman envisions.” According to Eldridge, the nurse-midwife philosophy is one that emphasizes that pregnancy and birth are normal life processes, not illnesses or diseases.
Nurse-midwifery is a professionally regulated field. Certified nurse-midwives (CNMs) are registered nurses with degrees from university-affiliated nurse-midwife programs.
Many, but not all CNMs, hold master’s degrees. Nurse-midwives can write prescriptions and provide a variety of care in addition to assisting with all facets of childbirth. This care includes routine OB/GYN care such as Pap smears, family planning assistance and even menopausal management. In short, nurse-midwives help care for women throughout their entire reproductive life-cycle. 
“Nurse-midwives provide not only a nursing background, but also offer the supportive relationship that so many women want,” notes Sandra Seff, Ph.D., a certified nurse-midwife at Sinai Hospital. The majority of midwife-assisted births occur in hospitals, so that if complications arise, a physician or other specialist is nearby to provide assistance. Sinai Hospital’s fetal monitoring specialists also are available should a pregnancy turn out to be high-risk.
For most routine deliveries, nurse-midwives work with women to minimize technological or pharmaceutical interventions such as the application of epidural injections or the use of drugs. “A lot of mothers don’t want a lot of medical intervention,” says Lynn Harris, R.N., BSN, manager of the Mother-Baby Unit at Sinai Hospital. “Our nurse-midwives not only provide medical support, they also nurture the mother and her baby.”
Mothers and Babies First
“When I had my first child, I didn’t feel like I was having my baby on my terms,” says Juliet McGuirk of Bel Air. “For my second child, I wanted something different.” That “something different” led McGuirk to Hilles Whedbee, a certified nurse-midwife at Sinai Hospital.
For McGuirk, the care provided by Whedbee included lots of talking about what her pregnancy and delivery would and would not include. “As an older mother, my nurse-midwife helped to calm my jitters,” continues McGuirk. “Hilles was very in-tune with my needs. Now I don’t see any reason not to go to a midwife."
Saying “I Do” to a Doula
In addition to midwives, doulas (from the Greek word meaning “woman’s servant”; pronounced doo-la) also provide nurturing, hands-on care for mothers-to-be. Perhaps less well-known than midwives, doulas are becoming increasingly popular as holistic adjuncts to women’s birthing experiences. The goal of the doula is similar to that of the midwife: to help a woman have a safe and satisfying childbirth.
For women who want extra support and guidance during labor and delivery, doulas provide yet another option for personalized care. Doulas are lay women with special training in supporting a woman through labor as well as offering postpartum care in the home. Doulas do not replace midwives; rather, they supplement and enhance that care.
While doulas do not perform clinical tasks, they can assist women with other care such as prenatal massage, practicing relaxation and breathing exercises during labor, applying hot and cold packs, assisting mothers with pushing during delivery and, perhaps most important, providing emotional support for the family.
“Doulas don’t leave the mother’s side for the duration of her labor,” observes Feigi Oberstein, R.N., of Sinai Hospital, where doulas have been a part of the hospital’s BirthPlace for the past two years. “As a liaison between families and the rest of the medical staff, doulas greatly help both parties.
For Deena Mael of Pikesville, using a doula during her labor helped to keep her focused on staying relaxed and provided moral support. “My doula was so easy to get along with,” says Mael, who had initially considered going back to her native Canada before hearing about Sinai Hospital’s doulas. “I would definitely use a doula again.
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