Christina Graham, Certified Nurse Midwife

If you had told me when I was growing up that I would be a Nurse-Midwife, I wouldn’t have believed you.  But now, after practicing midwifery for 6 years, I can’t imagine doing anything else.  When people find out you are a midwife there is a certain look that you get.  And then you inevitably get a plethora of similar questions.  Even amongst those in the medical community there isn’t a good knowledge of what a nurse midwife is or what exactly we do.  So here’s a rundown of the most common things I get asked about when people learn what I do for a living.

1.) Why are there so many kinds of midwives? 

The entry into the field of midwifery can vary. A Certified Nurse Midwife (CNM) (like the ones that practice at Methodist Hospital with HealthNet) all have nursing degrees and then continue their education by getting a masters degree specializing in nurse-midwifery.  They are licensed by the State of Indiana and can write prescriptions.  They are regulated by the American College of Nurse Midwives.  For more information about CNMs click here.

A Certified Professional Midwife (CPM) is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the Midwives Model of Care. The CPM is the only midwifery credential that requires knowledge about and experience in out-of-hospital settings.  If you’d like to read more about CPMs visit http://narm.org.

A lay midwife may not have any formal education.  Instead they are educated through an apprenticeship model of learning.

2.) What? You have a male midwife in your practice? 

Contrary to popular belief, a male midwife is NOT called a ‘midhusband.’  While the presence of men in obstetrics and gynecology has traditionally been accepted in the role of physician, midwifery does still remain female dominated.   In the United States approximately 0.6% of midwives are men.  Additionally, 90% of midwives are white females.  We are fortunate in our practice here at HealthNet to have a wonderful male midwife!  He brings a much-needed balance to our female dominated practice.  If you’d like to read more about the evolution of males in midwifery a very interesting article can be found here.

3.)  You do more than deliver babies? 

Certified Nurse Midwives are considered experts on normal, well woman care from the time that women start menstruating through menopause.  We perform annual well woman exams, pap smears, and birth control consults, and address common gynecological issues.  This is all in addition to being able to take care of pregnant women from the time of conception through delivery!  At Methodist Hospital we are fortunate to collaborate with physicians who love working with CNMs and are available to us whenever a problem or need may arise.   For more about what CNMs can do click here.

All deliveries by a HealthNet midwife take place at Methodist Hospital’s Maternity Center. We do not offer home births. All HealthNet midwives are registered nurses with additional education in midwifery and national certification by the American Midwifery Certification Board. For more information about our midwifery program, click here or call us at (317) 957-2000. 

Paige McDaniel, Certified Nurse Midwife

In honor of National Midwifery Week, we met up with Paige McDaniel, one of HealthNet’s many excellent midwives! Paige recently traveled to Liberia, West Africa to conduct a needs assessment and help nursing staff in Liberia update protocols. Check out Paige’s incredible story about her trip to West Africa and delivering twin baby boys!

Q: Tell us about your recent trip to Liberia, West Africa?

A: I was in Monrovia, the capitol of Liberia for two weeks at the beginning of September with my faculty advisor from IU’s School of Nursing, getting started on the required Inquiry Project for my DNP program. I hope to transition my career into global midwifery education and development, and for this project, I plan to implement a midwifery education intervention around the issue of postpartum hemorrhage management. Liberia has one of the highest maternal mortality rates in the world because of bleeding during and after childbirth, so the need is very great.

Q: Walk us through a day in your shoes in Liberia.

A: For this first trip, I was working under my advisor as part of her larger USAID-funded grant to develop nursing and midwifery education in Liberia. My purpose on this visit was to conduct a clinical practice needs assessment pilot study to assess the clinical knowledge of the hospital nurses and midwives, and help the nursing staff there begin to refine outdated institutional protocols and identify clinical areas where new protocols need to be developed. I was not there as a patient provider per se, and much of my time was spent working with nursing and midwifery leadership at the country’s only tertiary facility, John F Kennedy Memorial Hospital. Specifically, I worked with midwife and nurse leaders to develop modules to assess staff competencies in three clinical areas, including a simulation involving postpartum hemorrhage for the hospital midwives.

Q: What was the most satisfying part about your trip?

A: I think the most satisfying part of my time in Monrovia was simply the relationships I built with the nurses and midwives at the hospital, as well as other Liberians I was privileged to meet. The country recently emerged from a brutal, 13 year Civil War so in addition to having to completely rebuild the country’s infrastructure, many people are still quite reserved and often guarded. Everyone I met was always welcoming and hospitable, but by the end of the two weeks, I knew that I had made some genuine friendships.  I will be back in Monrovia a few more times for this project, so truly getting to know some of the people there was very important to me.

Incidentally, I also had the surprise pleasure delivering twin boys as I was pulled into the delivery room one day during my first week by one of the midwives! This is something many CNMs practicing in the United States don’t have the opportunity to do, so I very much enjoyed this professional “first”! 

Q: What is the one thing you wish you could tell others about being a midwife?

A: Being a midwife is absolutely the most rewarding profession that I can imagine for myself. Regardless if I ultimately find myself in direct clinical care “catching babies”, educating a new generation of midwives in the classroom, or working in public policy to help strengthen health care for women and children, I will be forever honored to stand next to my sister midwives as we engage in the work of our hearts.

For more information on HealthNet midwives, please click here or call a location near you.

Why did you become a Nurse Midwife?

Lisa: I was always interested in women’s health.  When I had the chance to start shadowing other nurses in OB programs while at Illinois, I noticed that they were missing out on a BIG piece of a woman’s pregnancy, THE BIRTH! To spend almost an entire pregnancy with a patient and to not be in the room for that special moment made me feel as if I’d be missing on some closure in the process.

What is the most satisfying part of your job?

Lisa: Being a part of that special moment.  Seeing the culmination of teaching a mother about pregnancy, what to expect and healthy lifestyle choices is very rewarding.

What is the biggest challenge you face when dealing with a patient?

Lisa: When someone comes to us uneducated about healthy lifestyle choices, it makes it really hard to get them to make new ones.  Change is hard for EVERYONE, but learning about the changes that need to be made can be even harder.  It is a challenge to get the new information to sink in when a patient already has set habits.  But it is awesome to see them succeed!

What do like best about National Midwifery Week?

Lisa: I like Midwifery Week because I get a lot of questions directed my way about what exactly a midwife does.  I enjoy educating others, even some IN health care, and dispelling some of the old stereotypes that some may have about midwives.

If you could sum up your goal, in one sentence, to make sure a pregnancy is a success, what would it be?

Lisa: I would tell the mother-to-be, “Your birth experience is YOURS, I am here to give you THAT experience in the best way possible with a healthy mom and a healthy child as an end result.

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HealthNet Midwifery Services is the largest midwifery practice in the state, assisting in the birth of more than 2,436 babies each year at IU Health Methodist. The program’s 23 nurse midwives work with the 11 OB/GYN physicians and 4 women’s health nurse practitioners on staff to provide prenatal care, postpartum care, well-woman care, family planning and more for women at HealthNet’s six community health centers and one OB/GYN care center. The program celebrates its 21^th year this year.

To learn more about Nurse Midwives at HealthNet, stay tuned to our Twitter feed and Facebook page to get statistics and tidbits all week!