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    Choosing a Pregnancy Practitioner

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    Midwives: The 'Girlfriend' Approach

    A full year before she even got pregnant, Holly Sanders, 38, knew she wanted to deliver at The Maternity Center, a freestanding birthing center staffed by midwives in Bethesda, Md., after hearing about friends' experiences there. "Initially it was sort of a gut-level reaction," says Sanders. "I knew I wanted to have natural childbirth, and I've always found hospitals off-putting. I felt like birth was not a sickness but a beginning, and my own comfort level was being in a birthing center with midwives and the hominess that environment offered."

    Once she began her prenatal visits, she liked the control and responsibility the midwives left to her. "I really liked the sense of women doing for themselves, of taking into our own hands this wonderful miracle that is natural to our bodies. It was the little things, like going to get your own chart and weighing yourself ... and the care was personal, like a good girlfriend sharing information with you," Sanders says.

    "I felt much more relaxed asking questions because it wasn't as formal or clinical a setting as a normal doctor's office." After her daughter was born, Sanders and her husband dozed together with their daughter and woke up a few hours later to a pancake breakfast prepared by her best friend, brother, and sister-in-law. "It was a really wonderful way to have our first day with our baby."

    Certified nurse-midwives are registered nurses who typically receive 18 months to two years of midwifery training and are then given credentials by the American College of Nurse-Midwives. They are licensed in the state where they practice and may provide care either in a hospital or birth center. Some nurse-midwives practice in partnerships with doctors, but they all have consulting relationships with an obstetrician in case a patient needs more specialized treatment. Lay midwives, on the other hand, may have the same training, coursework, and clinical experience as certified nurse-midwives, but they usually aren't nurses and deliver in the home or a birth center. Their experience, licensure, and legal standing varies significantly, both individually and from state to state.

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