Transcription:

Amanda Wilde (Host): As an expectant parent, you want to set the stage for the best birth experience possible. Today we'll talk about the option of midwifery care with Linda Balles, certified Nurse Midwife at Prisma Health. This is Flourish, a podcast brought to you by Prisma Health. I'm Amanda Wilde. Thank you, Linda, so much for being here. I'm so glad to have you.

Linda Balles: Well thank you for having me here. I'm excited to be here.

Amanda Wilde (Host): Now, I know it's been around since forever, but how would you define midwifery modern midwifery?

Linda Balles: Modern midwifery is a health profession and it focuses on women's health. So it includes anything from, prenatal care, childbirth, the postpartum period, which is after childbirth. We also do gynecologic care, family planning, and preconception counseling. So we care for women from adolescents to postmenopause. They will say from the womb to the tomb.

Amanda Wilde (Host): So is there a difference between midwifery care and OB GYN care?

Linda Balles: There is a difference. Midwives, we tend to, spend more time with our women at office visits. We like to educate. We have a philosophy of care that is different than the doctors where we see pregnancy as a normal process until proven otherwise. We support and encourage, the physiological process for normal labor and birth. One of the biggest things though, even though, we perform the same prenatal visits and we perform, standards of care, OBGYN is a medical doctor, so they are trained to manage women who are considered more high risk. They're able to perform surgeries and they're also skilled in emergent situations. So, that is one of the major differences.

Amanda Wilde (Host): So most midwives are not doctors. What kind of education or certification are midwives required to have?

Linda Balles: Well, certified nurse midwives are nurses who have, gone on to get our, master's degree or doctorate degree in midwifery. And then after that we must pass the national certified Nurse Midwife examination. And that's through our American Midwifery Certification board. so our training, we have probably by the time we're all, said and done, we have probably close to, six to eight years of training

Amanda Wilde (Host): Wow, that's quite a bit. And so you've seen a lot before you're actually certified?

Linda Balles: Right. We have to do a certain amount of hours in order to get your degree and then you go on and take the board to be licensed.

Amanda Wilde (Host): So can anyone receive care from a midwife like who's a good candidate for midwifery care?

Linda Balles: Well, that's a good question. it would be great if everybody could see a nurse midwife and in fact, there's was a study, it's called the Cochrane Study. It's a pretty, well known study. And, they looked at midwives and found that majority of women who had a midwife a lot of times, most likely, they had less intervention, better outcomes, and they were more, satisfied with their experience. And so they're at the final part of this. They did recommend that most women should be offered midwifery care, but not everybody can see a midwife.

Some women are just, not good candidates. For example, they may have a high risk medical condition, type one diabetes or uncontrolled hypertension. If a woman had multiples, if they were carrying twins or triplets, they would best be served seeing an obstetrician.

Amanda Wilde (Host): Midwifery often conjures up a range of images, but often people think of pioneers roughing it out on the prairie or waterbirds at home. Can you tell us more about what really is the midwifery birth experience?

Linda Balles: So the midwifery birth, This is gonna be so confusing, but I'm gonna talk about the certified nurse midwife because there are other different midwives they're different state to state, but a certified nurse midwife, we can either deliver at a hospital setting, or we could be present at a, birthing center. And some states also they can do home birth. So, we here at Prisma we attend birth in the hospital so with a midwife you can get an epidural, you can, choose to have a water birth. We support a woman's decision in what she would like to do.

So we provide that emotional support during labor and we like to empower women to have like a positive birth experience. and I've probably said this back before, one of the things we do, especially at our office visits, is just to educate, so that a woman knows, what to expect to the most part, during labor. We go over, prenatal care, eating right, taking good care of yourself. So we're there during the labor, so we actually help women as they are going through, recommend different techniques to help manage their labor.

One of the myths for midwives is that, you can't have medication and we can prescribe medication. And if somebody wants an epidural, that's perfectly fine. They can have an epidural as well.

Amanda Wilde (Host): Are there any other myths you'd like to dispel about midwifery?

Linda Balles: one of the misses that we only do Home births. Like you were saying before, when you picture a midwife, you pictured, like that old time granny midwife who's probably never even had a high school education going house to house to do these deliveries and now in modern times it's not like that. So a majority of attend birth in the hospital, very few actually go to homes.

Amanda Wilde (Host): Do you work exclusively in the hospital, in your practice?

Linda Balles: Yep, exclusively in the hospital. We have an office where we see, women either prenatal or for gynecological care or somewhat, counseling and family planning that'll be done at our office. And then if we are on call, we are at the hospital.

Amanda Wilde (Host): So much support. Do midwives only provide maternity care or can they provide primary care as well?

Linda Balles: We do primary care. And we see women through their annual visits. If somebody wants preconception counseling, we do a little bit of, infertility workups. So we will start basic, care. And if somebody refers out, for example, they need maybe, to see a fertility specialist will refer that to them, or if they tend to have something wrong, and they need to see an endocrinologist will refer out. Or if they need surgery will refer to a gynecologist.

Amanda Wilde (Host): Can my wives prescribe medication?

Linda Balles: Yes, certified nurse midwives can prescribe me.

Amanda Wilde (Host): So to sum this up, going with midwifery as an option is getting a lot of support in education, including being right there for the birth and afterwards as well. And it includes women's gynecological care from adolescents on.

Linda Balles: You summed it up very well.

Amanda Wilde (Host): Well, Linda, thank you for sharing this detailed information. This is a good, solid foundation for exploring the wide world of MI midwifery. Thank you so much.

Linda Balles: And one thing I just wanna say for midwifery candidate that I neglected. So if someone is looking for that natural birth with little intervention and they wanna be supportive, midwifery is the way to go.

Amanda Wilde (Host): How many births have you attended, and are they all completely unique?

Linda Balles: I've been a midwife for almost, for 25 years. and in 2006, I'm gonna sound so old. In 2006, I hit a thousand, and then after that I stopped counting. So I wanna say I've done a few thousand births, and I'm gonna tell you, everyone is unique. No two births are the same.

Amanda Wilde (Host): So you really have to be on it present using all your pool of knowledge for each individual client.

Linda Balles: Yep. That support patience and the knowledge is so important.

Amanda Wilde (Host): Linda, thank you so much for sharing this detailed information. This is a good, solid foundation for exploring the wonderful wide world of midwifery. Thank you so much.

Linda Balles: Oh, you are so welcome. You have a wonderful day.

Amanda Wilde (Host): For more information and other health podcasts, go to prismahealth.org/flourish. This has been Flourish, a podcast brought to you by Prisma Health. I'm Amanda Wilde. Be well.