Midwifery

TPMG midwives provide:

• Annual gynecological exams, pap smears, and screenings
• Management of low-risk pregnancies and co-management of high-risk pregnancies
• Education and prevention
• Breastfeeding support
• Sexually transmitted infection diagnosis and treatment
• Contraception counseling and management
• Management of common gynecologic problems

The midwives at TPMG OB/GYN are Certified Nurse-Midwives (CNMs). This means they can prescribe medications, order tests, and provide treatments for their clients.

Many studies compare midwifery-led care with care provided by other birth providers. The results of these studies consistently highlight several benefits of having a midwife at your birth. First and foremost, midwives have a lower cesarean section (CS) rate. Midwives are not surgeons; their goal is a vaginal birth, as long as you and your baby remain healthy. Midwives prefer to use movement, position changes, and stretching to help your baby into the optimal position for birth, even if it takes a bit longer. As a matter of fact, the TPMG midwife CS rate in 2022 was 23%, significantly less than the national average of 32%.

Midwives typically have lower rates of labor induction and augmentation, in the absence of medical need. Women laboring with midwives have a significantly reduced chance of having a third- or fourth-degree perineal laceration.  When babies are healthy, midwives promote the “Golden Hour” with immediate skin-to-skin contact and delayed cord clamping. Honoring the Golden Hour helps improve mother-baby bonding and breastfeeding success. Lastly, women who give birth with midwives have an increased sense of control during their labor and birth experience.

Midwives and doulas often share similar mentalities regarding physical and emotional support during labor, but they have very different roles on your birth team. A doula is a non-medical team member who is trained to provide continuous physical and emotional support to families before, during, and after childbirth. The midwife is the healthcare provider on the team and, although she will also support you physically and emotionally, her role is clinical. She is trained to pay attention to how your body and your baby adapt to labor. Her primary focus is to make sure you both remain safe throughout pregnancy, birth, and the postpartum period. A doula is an invaluable member of the birth team but is not a substitute for a midwife or doctor.

Absolutely. TPMG CNMs provide evidence-based education to help you develop the birth plan that is best for you. Midwives specialize in unmedicated childbirth but, when attending hospital births, can provide you with a full range of pain relief options, including epidurals.

For some women, pregnancy, and labor can transition from low or moderate risk to high risk rapidly. Midwives are trained to identify the difference between normal changes in pregnancy and changes that require additional care.  In pregnancy, we collaborate with other providers, be that our OBGYN colleagues, maternal-fetal medicine specialists, or other specialties such as cardiology, endocrinology, or gastroenterology. If labor is a high risk, we work collaboratively with our amazing team of physicians to ensure we give both you and your baby top-notch care. If a surgical birth (cesarean section) is needed to help your baby arrive safely, a physician will join the birth team.

At TPMG we have a team of providers including CNMs, nurse practitioners, and, when needed, physicians. We want you to feel confident with your birth provider when the time comes. With that in mind, we encourage you to rotate whom you see at your prenatal visits so that you have met each midwife when you arrive in labor.