If you've been pregnant at any time in your life, then I don't have to tell you just how many decisions go into preparing for baby and life as a parent. You'll probably have more questions to ask than decisions to make, though, and that includes if you're planning on using a midwife. So, when it comes to choosing someone to care for you during your pregnancy and beyond, exactly when should you hire a midwife? Turns out, timing matters, and preparation is the name of the pregnancy, labor, delivery, postpartum, and overall parenting game.
As with everything related to pregnancy and parenthood, there's really no one-size-fits all answer to this question. So let's start with the basics. All the experts, including the American Congress of Obstetricians and Gynecologists (ACOG) and the American College of Nurse-Midwifes (ACNM), agree that qualified and consistent prenatal care is essential to every pregnancy. The Office on Women's Health, part of the U.S. Department of Health and Human Services, says, "Get early and regular prenatal care. Whether this is your first pregnancy or third, health care is extremely important."
The importance of early care is obvious, to be sure, but just what does "early" mean? More importantly, how do you know when you're in that "early" timeframe and it's time for you to make some calls and attend some appointments?
Baby Center urges you to call your provider, whether an OB-GYN or your primary care physician, immediately after the first positive home pregnancy test. Your provider may want to set up a pregnancy confirmation appointment which, according to Baby Center, will help determine when your first prenatal appointment should be. Healthy Women states that, barring any high-risk factors, the first prenatal appointment will likely be somewhere between 8 and 10 weeks, no matter your practitioner type.
If you don't already have a midwife, Baby Center recommends starting prenatal care with your primary care physician and switching to your preferred provider once you find them. Hiring a midwife is not as simple as a Google search, though. This person is going to be helping you bring your child into the world and that's a pretty important role, don't you think? What to Expect says, "be sure to pick a midwife who is both certified and licensed." They highlight the differences between a Certified Nurse Midwife (CNM) and other types of practitioners who do not have the same education nor qualifications as CNMs, saying:
"An CNM is a medical professional who has completed graduate-level programs in midwifery and is licensed and certified by the American College of Nurse-Midwives to practice in all 50 states. CNMs are thoroughly trained to care for women with low-risk pregnancies with the goal of reducing birth injury, trauma, and cesarean section by providing individualized care and minimizing technological intervention during birth."
It's important to note that a CNM is different from a direct-entry midwife or doula. A direct-entry midwife is, according to What To Expect, "trained in midwifery without first becoming a nurse." Essentially, direct-entry midwives are "independent practitioners who perfect their practice through self-study, apprenticeship, and midwifery school, college, or a university program distinct from the discipline of nursing." A doula doesn't have any medical training at all. They're simply present to provide emotional support throughout the entire process, and are not qualified to care for you during your pregnancy on their own.
If you're not sure whether a midwife is right for you or not, Baby Center also encourages soon-to-be parents to schedule a first appointment with their midwife interview sheet on hand. Contemplating certain questions beforehand, like whether or not you want a hospital birth, will help guide the conversation with the midwife. After all, you are hiring her for a job, so it's best you get on the same page about what that job entails. The midwife will likely have some questions for you, too. Though CNMs are highly qualified to care for pregnant people, there are certain high-risk factors, reviewed by Baby Center, that require the pregnant person be under the care of an OB-GYN.
Since most CNMs either provide, or are part of a practice who provides, holistic prenatal health care, it's best to find someone to care for you as soon as possible.