Planning for a baby means making many exciting decisions. One of the most important, even though it's down the line a bit, is where, how, and who will help deliver your baby. Our Family Birth Center is the first choice for many Marin moms. We offer resources and care that meets your needs both medically and personally from pregnancy through delivery and beyond. There's truly no reason to go anywhere else!
Our most important concern is the health and safety of mother and child. That means that while we honor labor and delivery as natural processes, we also have to be ready for any possible emergency.
At MarinHealth Medical Center, we have a Prima certified nurse-midwife on-site 24/7 and we are one of the ONLY hospitals in the Bay Area to offer this service.
Listen in as Sheri Matteo, CNM discusses many misconceptions surrounding midwives and why you might want to consider having one assist you during childbirth.
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The Misconception of Midwives
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Learn more about Sheri Matteo, CNM
Sheri Matteo, CNM
Sheri Matteo, CNM, is a Certified Nurse Midwife at MarinHealth Medical Center. She worked at Brooklyn Hospital and North Central Bronx Hospital in NYC before moving to California in 2003. She has worked at San Francisco General Hospital, Sutter Solano and Kaiser. In 2005, Sheri relocated to beautiful Marin. At the end of 2012, she left her long-standing job (and commute!) at Kaiser Redwood City to work locally. She is very honored to work with Prima’s Midwives of Marin and is currently the Prima Director of Midwifery Services.Learn more about Sheri Matteo, CNM
Transcription:
The Misconception of Midwives
Bill Klaproth (Host): Giving birth is one of the most personal, intimate experiences a woman can have. Naturally, many women have very specific ideas about their birth preferences plan, and for some, that means choosing a midwife delivery, but there’s a lot of misconceptions of midwives. Here to clear the confusion is Sheri Matteo, a Certified Nurse Midwife at Marin General Hospital. Sheri, thanks for your time today. First off, what is a Certified Nurse Midwife?
Sheri Matteo (Guest): A Certified Nurse Midwife is a medical professional who has achieved their nursing – their Registered Nursing license – attended nursing school, and then also attended an accredited program to become a Certified Nurse Midwife. What that means is usually attending graduate school at a nursing school. Most Certified Nurse Midwives today have a Bachelor’s Degree of some sort, have a Registered Nursing license in the state that they’re practicing in, and then, also have a Master’s of Science in Nursing or perhaps, another type of Master’s Degree in Nursing that achieves them their Nurse Midwife status. And then, on top of that, we have to be certified by the American College of Nurse Midwives, by their Certification Board, which is the American Midwives Certification Board. That’s a national certification that is recognized in all 50 states and has to be renewed every five years.
Bill: Specific education and certification for delivery.
Sheri: Absolutely, and then every state licenses Nurse Midwives in a different way. Different states have different statutes for licensing Nurse Midwives.
Bill: Sheri, what do most people think a Midwife does? You just named off all of the education, and credentials, and qualifications. I would think most people don’t know that. Am I right about that?
Sheri: I think so. I think there are a lot of misconceptions about Midwives out there. Part of that is because there are different types of Midwives nationally. There are Certified Nurse Midwives, which is what I am, but then there are also Licensed Midwives, or Certified Practice Midwives, who are not nurses, but who achieve their Midwifery education in a different manner, sometimes through an apprentice program or sometimes through other schools that are not nursing schools, but teach Midwifery.
In addition, just to make things a little bit more confusing, there are Certified Midwives, who achieve the exact same education as the Certified Nurse Midwives, but they don’t have an RN license, so they’re not Registered Nurses. They have the same national certification and education standards that we have, but they’re not recognized in all 50 states.
Bill: At Marin, what are the specific job duties of a Midwife?
Sheri: The Certified Nurse Midwives at Marin General are very busy. We attend most of the vaginal deliveries, the spontaneous deliveries that happen at Marin General. Some women defaulted to our care because of their insurance, and other women get to choose whether they want to have Midwives with them. What we have been finding is that more and more women, even though most women don’t have a chose, are choosing Midwifery care. Part of this is because there’s a lot more understanding nowadays that allowing birth to happen in the most natural way, is best for mom, and for baby, and for subsequent health.
There’s been a lot of concern internationally about the rising rate of the Cesarean Section, which is a really important life-saving intervention for both moms and babies in some circumstances but should not be the norm for most low-risk women. Cesarean Sections are a major operation that can have long-term sequelae for the mom, and may not be the best for the baby as well. It should be used judiciously. We’ve had such a rise in C-Section rates that the American College of Obstetricians and Gynecologists have actually had to come out with a statement saying we need to back off on this. We need to let nature take its course and do as much as we can to let labor proceed without intervention. Only in emergencies.
Bill: So many women are choosing a Midwife-assisted birth over the C-Section, and as you say, C-Sections shouldn’t be used for convenience, only in an emergency situation.
Sheri: Correct.
Bill: What women are a good candidate, then, to use a Midwife?
Sheri: Most women are a good candidate for Midwifery care. Midwives work with women throughout their lifetime. A lot of people think that we only do labor and delivery, but we actually take care of women throughout their lifetime. We can see younger women who are just starting out with their sexual health and need counseling about family planning and birth control. We can see women for their well-woman screenings, their pap smears, their annual breast exams. We can treat STDs – sexually transmitted diseases, and help women navigate staying healthy in that way. And then, of course, we definitely help women with pregnancy and labor and delivery.
We’re really lucky at Marin General because we have full scope Midwifery through the Prima Medical Group. This is a medical group that we work with where women can choose Midwifery care at any time in their lives, women in menopause, younger women, and also pregnant women. We can see them throughout their pregnancy, and then one of the members of our group can be there for their delivery, as well.
When we talk about low-risk women, we’re talking about women who don’t have some other special type of medical problem. Let’s say, somebody with very serious heart disease or some other kind of chronic illness, those women are best taken care of by an Obstetrician who’s a specialist in that, but we can take care of women who are basically healthy. We can also take care of some women who have things like thyroid disease that’s managed, gestational diabetes, as long as it’s under control. We can also consult with doctors. That’s part of our protocol is to know when to consult and when to collaborate with an MD. We can take care of women who have some medical issues that are well-regulated, but for the most part, well-women are the ones who come to us.
Bill: And speaking of that consultation with MD's, I would imagine one of the concerns in choosing a Midwife-assisted birth, is what happens if complications arise? Can you talk a little bit about that, Sheri?
Sheri: Absolutely. At Marin General, we have very specific protocols that tell us when we consult, when we actually collaborate or comanage, and when we have to transfer care to the MD. For instance, somebody who goes into labor very prematurely is not a good candidate for a Midwife. That can be managed really well by an MD. For the most part, multiple gestations – twins, triplets – those are not necessarily Midwife candidates. I think Midwives can sometimes participate in the care of those women, to normalize the experience for them and to just help them be in touch with the pregnancy on a normal level because sometimes those pregnancies can be very medicalized. But, for the most part, they are best to be taken care of by an Obstetrician and somebody with advanced knowledge. Women with really severe high blood pressure in labor, if that develops that would be a woman who would get transferred to MD care, and we wouldn’t really participate in that anymore.
Different hospitals have different protocols, too, about how they staff. In some circumstances, Midwives would practice independently in the hospital, and then the doctor would only come in if necessary. At our hospital, at Marin General, we have the best of both worlds. Our Midwives practice very independently, however, we’re partnering all the time with the doctor who’s on call with us, so if there is an emergency that develops – like a cord prolapse, which cannot be foreseen, and definitely an obstetric emergency – the doctor is there for immediate assistance. We can actually get a baby out very, very quickly if we need to.
Bill: Well, that’s really good to know. And what other misconceptions of Midwives need to be cleared up?
Sheri: I think the biggest misconception – and this was actually proven in a study that was done – a survey that was done recently by an advocacy group that is working on health care issues and health care costs and things. They discovered that access to Midwives is very difficult to find. Even though we can send you to these websites, most insurances don’t list Midwives on their insurance plans, or as their plan as providers. They insist on listing them underneath the physician practice that they work with, and so midwives can be very difficult to find. Access to Midwifery is a very difficult thing for most clients to find.
The other misconception is that we are not medical professionals, that we don’t have the kind of training that we have, that we don’t have the kinds of experience working in the medical system that we do have. Some people think that Midwifery is a very, very alternative model of care that is unsafe. Now, Midwifery can be alternative. Certified Nurse Midwives can practice outside of the hospital in independent birth centers and also in the home, but the vast majority of Certified Nurse Midwives work in a hospital, unlike the vast majority of Licensed Midwives, or Certified Practice Midwives, who do work outside of the hospital.
Most people say that we’re all the same, that we don’t let women have pain medicine, that we don’t believe in any medical interventions, and that’s not true. Particularly for Certified Nurse Midwives, working in a hospital environment, our clients can have pain medicines, they can have an epidural. We want to work with them to make their birth experience the most safe and also the most wonderfully memorable for them because all Midwives believe that birth is a very important part of our life cycle and that it should be a wonderful, and memorable, empowering experience for the family – for the mom.
Bill: Those are really good points, and just to be clear, all Midwife-assisted births happen at Marin, right? They happen at the hospital?
Sheri: Our practice only does its births at Marin General Hospital in the Marin General Hospital Birth Center.
Bill: Okay, thanks, Sheri. I just wanted to make sure that we were clear about that. Thank you, so much, for your time today. For more information, visit MarinGeneral.org, that’s MarinGeneral.org. This is the Healing Podcast brought to you by Marin General Hospital. I’m Bill Klaproth, thanks for listening.
The Misconception of Midwives
Bill Klaproth (Host): Giving birth is one of the most personal, intimate experiences a woman can have. Naturally, many women have very specific ideas about their birth preferences plan, and for some, that means choosing a midwife delivery, but there’s a lot of misconceptions of midwives. Here to clear the confusion is Sheri Matteo, a Certified Nurse Midwife at Marin General Hospital. Sheri, thanks for your time today. First off, what is a Certified Nurse Midwife?
Sheri Matteo (Guest): A Certified Nurse Midwife is a medical professional who has achieved their nursing – their Registered Nursing license – attended nursing school, and then also attended an accredited program to become a Certified Nurse Midwife. What that means is usually attending graduate school at a nursing school. Most Certified Nurse Midwives today have a Bachelor’s Degree of some sort, have a Registered Nursing license in the state that they’re practicing in, and then, also have a Master’s of Science in Nursing or perhaps, another type of Master’s Degree in Nursing that achieves them their Nurse Midwife status. And then, on top of that, we have to be certified by the American College of Nurse Midwives, by their Certification Board, which is the American Midwives Certification Board. That’s a national certification that is recognized in all 50 states and has to be renewed every five years.
Bill: Specific education and certification for delivery.
Sheri: Absolutely, and then every state licenses Nurse Midwives in a different way. Different states have different statutes for licensing Nurse Midwives.
Bill: Sheri, what do most people think a Midwife does? You just named off all of the education, and credentials, and qualifications. I would think most people don’t know that. Am I right about that?
Sheri: I think so. I think there are a lot of misconceptions about Midwives out there. Part of that is because there are different types of Midwives nationally. There are Certified Nurse Midwives, which is what I am, but then there are also Licensed Midwives, or Certified Practice Midwives, who are not nurses, but who achieve their Midwifery education in a different manner, sometimes through an apprentice program or sometimes through other schools that are not nursing schools, but teach Midwifery.
In addition, just to make things a little bit more confusing, there are Certified Midwives, who achieve the exact same education as the Certified Nurse Midwives, but they don’t have an RN license, so they’re not Registered Nurses. They have the same national certification and education standards that we have, but they’re not recognized in all 50 states.
Bill: At Marin, what are the specific job duties of a Midwife?
Sheri: The Certified Nurse Midwives at Marin General are very busy. We attend most of the vaginal deliveries, the spontaneous deliveries that happen at Marin General. Some women defaulted to our care because of their insurance, and other women get to choose whether they want to have Midwives with them. What we have been finding is that more and more women, even though most women don’t have a chose, are choosing Midwifery care. Part of this is because there’s a lot more understanding nowadays that allowing birth to happen in the most natural way, is best for mom, and for baby, and for subsequent health.
There’s been a lot of concern internationally about the rising rate of the Cesarean Section, which is a really important life-saving intervention for both moms and babies in some circumstances but should not be the norm for most low-risk women. Cesarean Sections are a major operation that can have long-term sequelae for the mom, and may not be the best for the baby as well. It should be used judiciously. We’ve had such a rise in C-Section rates that the American College of Obstetricians and Gynecologists have actually had to come out with a statement saying we need to back off on this. We need to let nature take its course and do as much as we can to let labor proceed without intervention. Only in emergencies.
Bill: So many women are choosing a Midwife-assisted birth over the C-Section, and as you say, C-Sections shouldn’t be used for convenience, only in an emergency situation.
Sheri: Correct.
Bill: What women are a good candidate, then, to use a Midwife?
Sheri: Most women are a good candidate for Midwifery care. Midwives work with women throughout their lifetime. A lot of people think that we only do labor and delivery, but we actually take care of women throughout their lifetime. We can see younger women who are just starting out with their sexual health and need counseling about family planning and birth control. We can see women for their well-woman screenings, their pap smears, their annual breast exams. We can treat STDs – sexually transmitted diseases, and help women navigate staying healthy in that way. And then, of course, we definitely help women with pregnancy and labor and delivery.
We’re really lucky at Marin General because we have full scope Midwifery through the Prima Medical Group. This is a medical group that we work with where women can choose Midwifery care at any time in their lives, women in menopause, younger women, and also pregnant women. We can see them throughout their pregnancy, and then one of the members of our group can be there for their delivery, as well.
When we talk about low-risk women, we’re talking about women who don’t have some other special type of medical problem. Let’s say, somebody with very serious heart disease or some other kind of chronic illness, those women are best taken care of by an Obstetrician who’s a specialist in that, but we can take care of women who are basically healthy. We can also take care of some women who have things like thyroid disease that’s managed, gestational diabetes, as long as it’s under control. We can also consult with doctors. That’s part of our protocol is to know when to consult and when to collaborate with an MD. We can take care of women who have some medical issues that are well-regulated, but for the most part, well-women are the ones who come to us.
Bill: And speaking of that consultation with MD's, I would imagine one of the concerns in choosing a Midwife-assisted birth, is what happens if complications arise? Can you talk a little bit about that, Sheri?
Sheri: Absolutely. At Marin General, we have very specific protocols that tell us when we consult, when we actually collaborate or comanage, and when we have to transfer care to the MD. For instance, somebody who goes into labor very prematurely is not a good candidate for a Midwife. That can be managed really well by an MD. For the most part, multiple gestations – twins, triplets – those are not necessarily Midwife candidates. I think Midwives can sometimes participate in the care of those women, to normalize the experience for them and to just help them be in touch with the pregnancy on a normal level because sometimes those pregnancies can be very medicalized. But, for the most part, they are best to be taken care of by an Obstetrician and somebody with advanced knowledge. Women with really severe high blood pressure in labor, if that develops that would be a woman who would get transferred to MD care, and we wouldn’t really participate in that anymore.
Different hospitals have different protocols, too, about how they staff. In some circumstances, Midwives would practice independently in the hospital, and then the doctor would only come in if necessary. At our hospital, at Marin General, we have the best of both worlds. Our Midwives practice very independently, however, we’re partnering all the time with the doctor who’s on call with us, so if there is an emergency that develops – like a cord prolapse, which cannot be foreseen, and definitely an obstetric emergency – the doctor is there for immediate assistance. We can actually get a baby out very, very quickly if we need to.
Bill: Well, that’s really good to know. And what other misconceptions of Midwives need to be cleared up?
Sheri: I think the biggest misconception – and this was actually proven in a study that was done – a survey that was done recently by an advocacy group that is working on health care issues and health care costs and things. They discovered that access to Midwives is very difficult to find. Even though we can send you to these websites, most insurances don’t list Midwives on their insurance plans, or as their plan as providers. They insist on listing them underneath the physician practice that they work with, and so midwives can be very difficult to find. Access to Midwifery is a very difficult thing for most clients to find.
The other misconception is that we are not medical professionals, that we don’t have the kind of training that we have, that we don’t have the kinds of experience working in the medical system that we do have. Some people think that Midwifery is a very, very alternative model of care that is unsafe. Now, Midwifery can be alternative. Certified Nurse Midwives can practice outside of the hospital in independent birth centers and also in the home, but the vast majority of Certified Nurse Midwives work in a hospital, unlike the vast majority of Licensed Midwives, or Certified Practice Midwives, who do work outside of the hospital.
Most people say that we’re all the same, that we don’t let women have pain medicine, that we don’t believe in any medical interventions, and that’s not true. Particularly for Certified Nurse Midwives, working in a hospital environment, our clients can have pain medicines, they can have an epidural. We want to work with them to make their birth experience the most safe and also the most wonderfully memorable for them because all Midwives believe that birth is a very important part of our life cycle and that it should be a wonderful, and memorable, empowering experience for the family – for the mom.
Bill: Those are really good points, and just to be clear, all Midwife-assisted births happen at Marin, right? They happen at the hospital?
Sheri: Our practice only does its births at Marin General Hospital in the Marin General Hospital Birth Center.
Bill: Okay, thanks, Sheri. I just wanted to make sure that we were clear about that. Thank you, so much, for your time today. For more information, visit MarinGeneral.org, that’s MarinGeneral.org. This is the Healing Podcast brought to you by Marin General Hospital. I’m Bill Klaproth, thanks for listening.