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Pregnancy

Whether you’re thinking about having a baby or are already pregnant, there are many decisions to make as you prepare for birth and motherhood. Having a midwife by your side will help you choose from the many options that come with this important time in your life.

Preparing for Pregnancy

Your midwife is a source of support as you juggle parenthood and career and understand the changes that your body goes through during pregnancy. As an expert in pregnancy and birth, your midwife will help you learn how your environment, lifestyle, and habits affect you and your baby. Your midwife will also help you through the physical, emotional, and sexual changes you may have during pregnancy.

Talk to your midwife about how best to prepare yourself for a healthy pregnancy and birth. Your midwife can offer resources on helpful topics, such as quitting smoking, avoiding alcohol, preparing for labor and becoming a parent, baby-proofing your home, and preparing for the costs of caring for your child. Your midwife can also help you manage stress during pregnancy and help you find other local resources such as childbirth education classes.

Your Midwife’s Role During Pregnancy and Birth

Becoming Pregnant

Every woman is different. Your midwife will work with you to determine your current health status and how best to prepare for pregnancy. As a first step, you can schedule a visit to talk about your typical periods and when you are most likely to become pregnant. Your midwife might also talk to you about other health topics to keep in mind as you try to become pregnant. This could include the importance of reaching a healthy weight before becoming pregnant, adding vitamins like folic acid to your diet, and making sure you are up-to-date on shots.

If you are having trouble getting pregnant, your midwife can review your situation and help identify why you may be having difficulty.

Achieving a Healthy Pregnancy

Your regular check-ups during pregnancy are good times to talk with your midwife about your health, your emotions, and the normal changes that come with pregnancy. At each visit, your midwife will review your and your baby’s health. This includes checking your blood pressure and weight, measuring the growth of your uterus, listening to your baby’s heartbeat, and ordering and reviewing needed tests. These steps help ensure that any problems are identified and treated early before they become serious. As you get further along in your pregnancy, your midwife will help you plan for labor and birth.

During your regular visits, your midwife will provide information and resources to help you decide how to improve your chances for a healthy pregnancy. These include eating nutritious food, exercising, and taking prenatal vitamins. Your midwife will also help you with the normal physical and emotional changes that may come with pregnancy. Many midwives also suggest childbirth education classes. These classes are a good way to learn more about labor, birth, caring for your new baby, breastfeeding, and becoming a mother.

Care During Labor and Birth

For the majority of women, pregnancy is a normal, healthy, low-risk, life event. Only a small minority of women experience problems that call for urgent care. However, different health care providers offer different types of care and approaches to pregnancy and childbirth. These differences can affect your experiences in labor and birth. Midwives view pregnancy and birth as normal life events during which you need special attention and care to prevent problems. For most women pregnancy is not a time of illness. It is a time of change when you and your baby should be supported so you both can be as healthy as possible. Medical care focuses more on treating disease and on handling problems that can happen during labor and birth. In a medical care model, pregnancy is more likely to be viewed as a potential problem. Sometimes procedures may be used that are not needed for most women and that may cause other complications.

Your midwife will be by your side during labor, birth, and after birth. During this time, your midwife will provide health care, education, and guidance and make sure everything is moving forward as it should. A midwife will work with you to prepare a birth plan that includes your goals for the birth of your baby. Your birth plan includes your decision about where to have your baby, who will be there with you, how to reduce discomfort, and what will happen if there is a problem or an emergency.

Midwifery and Childbirth Procedures

Most babies are born without any problem. All that is needed is careful education, support, and monitoring through pregnancy and birth. However, sometimes a problem occurs and procedures during pregnancy or childbirth may be needed. If this occurs, certified nurse-midwives and certified midwives have the education and expertise to prescribe pain medication, induce labor, or bring in another member of the health care team to help if needed.

If you had a cesarean for a previous birth, you may be able to have a vaginal birth during a later pregnancy. Three out of four women meet the guidelines to try for a vaginal birth after cesarean (VBAC). Your midwife will discuss the benefits and risks of VBAC so you can decide if a VBAC is a safe and desirable option for you.

Resources

The Journal of Midwifery & Women’s Health offers free handouts on many topics related to pregnancy and birth at www.sharewithwomen.org.

The American College of Nurse-Midwives has developed a trimester by trimester guide of tests sometimes recommended during pregnancy and a helpful guide to making decisions about tests for birth defects.

In 2010, the National Institutes of Health released an expert statement that offers advice about VBAC. A Woman’s Guide to VBAC has additional information on birth options after cesarean. For additional information about VBAC, visit Childbirth Connection and the American Pregnancy Association.

To learn more about what a normal birth is and how to achieve this, consider reading the Supporting Healthy and Normal Physiologic Childbirth consensus statement.





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