Yale Medicine's approach to childbirth combines centuries-old traditions and advanced medical practices to provide families with the very best care possible.
For millennia, childbirth took place in the home, supervised by traditional birth attendants and community midwives. But after World War II, here in the United States, childbirth increasingly became the province of doctors. With that shift, medical interventions such as the cesarean section and anesthesia increased dramatically. While infant mortality has plummeted since the shift, many worry that this approach over-medicalizes the natural process of birth.
At Yale Medicine, our certified nurse-midwives (CNMs) occupy a middle ground between these two extremes. They are medical professionals who can provide a full range of health services for women (from adolescence to menopause), yet they focus on a holistic, natural approach.
What is a certified nurse-midwife?
A certified nurse-midwife provides services that are complementary to a physician. They handle most issues that arise during normal pregnancies and births and are trained to recognize when conditions require collaboration with an obstetrician.
Midwives do not perform surgery and they do not manage high-risk pregnancies. Certified nurse-midwives attend over 70 labors and births each month at the Vidone Birthing Center at Yale New Haven Hospital's Saint Raphael Campus.
What is the difference between a doula and a certified nurse-midwife?
Doulas help women through the emotional and physical aspects of pregnancy, childbirth and the postpartum period. Certified nurse-midwives also perform these roles, in addition to medical care and performing the actual birth.
Certified nurse-midwives must have a master's degree in nursing with a certificate of specialization in midwifery. Doulas are trained through independent programs in the community.
What are some of the services Yale Medicine's certified nurse-midwives offer?
Our certified nurse-midwives care for women throughout pregnancy and childbirth. Beyond pregnancy, they offer primary women's healthcare, family planning, preconception care and care during pregnancy and the postpartum period.
They can prescribe medications, interpret laboratory and diagnostic tests and order medical devices. Certified nurse-midwives can also repair vaginal tears, insert contraceptive devices and perform screening for gynecologic cancers.
Certified nurse-midwives try to help mothers have as natural a childbirth as possible, but they also carefully watch laboring mothers and help women decide on pain relief measures. If a woman needs medical pain relief, certified nurse midwives can and will act on that desire. Midwives are experts in helping women cope with labor pain.
Additionally, they may also treat male partners for sexually transmitted diseases and care for healthy newborns during the first 28 days of life. Certified nurse-midwives practice in many different settings: community health centers, traveling clinics, free-standing birth centers, homes and hospitals.
Do doctors and certified nurse-midwives work together at Yale Medicine?
At Yale Medicine, certified nurse-midwives and physicians work as a team, ensuring the best care for all patients, from textbook pregnancies to high-risk deliveries.
What are the advantages of using a certified nurse-midwife?
Normal births overseen by certified nurse-midwives usually require fewer interventions (continuous electronic fetal monitoring, episiotomy, epidural pain relief, cesarean section). Often, this means better outcomes for both expectant women and babies.
Why is Yale Medicine's approach to midwifery unique?
Yale Medicine's nurse-midwifery practice has pioneered efforts to make the birth process more mother and child-centered: reducing the separation of mother and baby after birth, making sure that the laboring mother is attended to throughout the birth process and helping women to have the greatest chance of a natural childbirth.
The Nurse-Midwifery/Women’s Health Nurse Practitioner program is also one of the oldest in the United States, founded in 1956. The Yale School of Nursing has been the home of countless midwives, who through their professional services and scholarships have changed women’s health care in the U.S. and around the world.
At Yale Medicine, there is a special relationship between obstetricians, maternal-fetal medicine specialists and certified nurse-midwives. Because of the long history of midwifery in the Yale Medicine community, certified nurse-midwifery is embraced and the relationship is strong and very positive.