Happy National Midwifery Week!

We are so thankful for and in awe of all midwives do. Great midwives can literally make all the difference. Statistical evidence shows that they can help you have both better birth experiences and outcomes.

Meagan and Julie break down the different types of midwives including CNMs, CPM, DEMs, and LPM as well as the settings in which you can find them. They talk about the pros and cons of choosing midwifery care within a hospital or outside of a hospital either at home or in a birth center. 

We encourage you to interview all types of providers in all types of settings. You may be surprised where your intuition leads you and where you feel is the safest place for you to rock your birth!

Midwifery-led Care in Low- and Middle-Income Countries

Evidence-Based Birth Article: The Evidence on Midwives

Article: Planning a VBAC with Midwifery Care in Australia

The VBAC Link Supportive Provider List

Needed Website

How to VBAC: The Ultimate Prep Course for Parents

Full Transcript under Episode Details 

Meagan: Hey, hey, hey. You guys, we’re talking about midwives today, and when I say we, I mean me and Julie. I have Julie on with us today. Hello, my darling. 

Julie: Hello! You know, sometimes you’ve just got to unmute yourself. 

Meagan: Her headphones were muted, you guys. 

Julie: Yeah. That’s amazing. 

Meagan: I’m like, “I can’t hear you.” 

You guys, guess what? This is our first month at The VBAC Link where I’m bringing a special subject. Every month we are going to have a week and it’s usually going to be the second week of the month where we are going to have a specific topic for those episodes of the week and this is the very first one. It is National Midwives’ Week so I thought it would be really fun this week to talk about midwives. We love midwives. We love them. We love them and we are so grateful for them. 

We want to talk more about the impact that they leave when it comes to our overall experience. 

Julie: Yes. 

Meagan: The overall outcomes and honestly, just how flipping amazing they are. We want to talk more and then we’ll share of course a story with a midwifery birth. 

Okay, Julie. You have a review. I’m sticking it to her today to read the review because sometimes I feel like it’s nice to switch it up. 

Julie: Yeah. Let’s switch it up. All right, this review– I’m assuming “VBAC Encouragement” is the title of the review.” 

Meagan: Yes. 

Julie: “VBAC Encouragement”. It says, “My first birth ended in an emergency Cesarean at 29 weeks and I knew as I was being rolled into the OR that I would go for a VBAC with my next baby. Not long after, The VBAC Link started and I was instantly obsessed.” I love to hear that. 

“I love the wide range of VBAC and CBAC stories. Listening to the women share honestly and openly was motivating and encouraging. As a doula, this podcast is something that I recommend to my VBAC clients. I’m so thankful for the brave women sharing the good, bad, and ugly of their stories and I’m thankful for Meagan and Julie for holding space for us all.” 

Aww, I love that. 

Meagan: I do too. I love the title, “VBAC Encouragement.” That is what this podcast is here for– to encourage you along the way no matter what you choose but to bring that encouragement, that empowerment, and the information from women all over the world literally. All over the world because you guys, we are not alone. I know that sometimes we can feel alone. I feel like sometimes VBAC journeys can feel isolating and it sucks. We don’t want you to feel that way so that’s why we started the podcast. That’s why I’m here. That’s why Julie comes on because she misses you and loves you all so much too and we want you to feel that encouragement. 

Meagan: Okay, you guys. We are talking about midwives. If you have never been cared for by a midwife, I think this is a really great episode to learn more about that and see if midwifery care is something that may apply to you or be something that is desired by you. I know that when I was going along with my VBAC journey, I didn’t interview a midwife actually at first. 

I interviewed OB after OB after OB. Julie did interview a midwife and it didn’t go over very well. 

Julie: No, it was fine. It just didn’t feel right at that time. 

Meagan: What she said didn’t make it feel right. What I want to talk about too and the reason why I point that out is because go check out the midwives in your area. Check them out. Go check them out. Really, interview them. Meet with them but guess what? It’s okay if it doesn’t feel right. It’s okay if everyone is like, “Go, go, go. You have to have a midwife. OB no. OB no.” That’s not how we are in this podcast. We are like, “Find the right provider for you.” 

But I do think that midwives are amazing and I do think they bring a different feel and different experience to a birth but even then sometimes you can go and interview a midwife and they’re not the right fit. We’re going to talk about the types of midwives. This isn’t really a type. We’re going to be talking about CPM, DEM, and LPM. 

Julie: In-hospital and out-of-hospital midwives, yeah. 

Meagan: Yeah, but I also want to talk about the word “medwives”. We have said this in the past where we say, “Oh, that midwife is a ‘medwife’” and what we mean by that is just that they may be more medically-minded. Every midwife is different and every view is different. Like Julie was saying, in-hospital, out-of-hospital, you may have more of a ‘medwife’ out of the hospital, but guess what? I’ve also seen some out-of-hospital midwives who act more like, ‘medwives’, really truly. 

Again, it goes back to finding the right person for you. But can we talk about that? The CPM or DEM? CPM is a certified professional midwife or direct entry midwife, right? Am I correct?

Julie: Right. It’s really interesting because all over the world, the requirements for midwifery are different. You’re going to find different requirements in each country than in the United States, every state has its different requirements and laws surrounding midwifery care. In some states, out-of-hospital midwives cannot attend VBAC at all or they can as long as it’s in a birth center. 

Or sometimes CNM– is a certified nurse midwife which is the credential that you have to have if you are going to work in a hospital but there are some CNMs who do out-of-hospital births as well. There is CPM which is a certified professional midwife which a lot of the midwives are out-of-hospital. That means they have taken the NARM exam which is the national association of registered midwives so they are registered with a national association.

Meagan: Northern American Registry of Midwives. 

Julie: Oh yes. They have completed hundreds of births, lots and lots of hours, gone through the entire certification process and that’s a certified midwife. Now, a licensed midwife which is a LDEM, a licensed direct-entry midwife just simply means that they hold licensure with the state. 

Licencsed midwife and certified midwife is different. Certified means they are certified with the board. Licensed means they are licensed with the state and usually licensed midwives can carry things like Pitocin, Methergine, antibiotics for GBS and things like that which is what the difference is. Licensed means they can have access to these different drugs for care. 

Meagan: Like Pitocin, and certain things through the IV, medications for hemorrhage, antibiotics, yes. 

Julie: Right, then CPMs who are certified, yeah. There are arguments for both. And DEM, direct entry midwife means that they are not certified or licensed. That doesn’t mean that they are less than, it just means that they are not bound by the rules of NARM or the state. 

Now, there are again arguments for and against all of these different types. I mean, there are pros and cons to holding certification, holding licensure, and not holding certification and not holding licensure. Each midwife has to decide which route is best for them. Certified nurse-midwife obviously has access to all of the drugs and all of the things. They are certified and licensed. You could call it that but they have to have hospital privileges if they want to deliver in the hospital. You can’t just b