Rachel Sieman, CNM
7600 Southern Blvd., Suite 1
Boardman, OH 44512
(330) 629-8466

FAQs from the Journal of Midwifery and Women's Health


CERTIFIED NURSE-MIDWIVES help over 300,000 women give birth each year in the United States. Most of these births are in hospitals. CNMs also care for women who decide to have their baby in freestanding birth centers and/or at home CNMs provide health care to women all through life, including prenatal care,birth,care after birth, care for the new baby, annual exams, birth control planning, menopause and health counseling.

SHOULD I SEE A MIDWIFE IF I AM NOT PREGNANT?
Many women go to their CNM for annual check ups, family planning, and to get care for common infections that happen to women. For example, your midwife can answer questions about all the methods of birth control, help you decide what is best and safest for you, and prescribe it for you.

WHY WOULD I CHOOSE A MIDWIFE FOR CARE DURING MY PREGNANCY?
CNMs believe you need time and special attention so you can be healthy and able to take care of your baby. Midwives specialize in providing support, regular health care, and in helping you get anyadditional care needed. Midwives are experts in knowing the difference between normal changes that occur during pregnancy and symptoms that require extra attention.

WHAT IF I HAVE A "HIGH RISK" PREGNANCY OR COMPLICATION DURING LABOR?
Your CNM will prescribe medicine and order treatment for any common illness that you might get during pregnancy. Midwives work with doctors who specialize in illness during pregnancy. If you havea medical problem during pregnancy or complication during labor, your midwife will work with a doctor to make sure you get the best and safest care for you and your baby. Your midwife will also work with other health care providers: nurses, social workers, nutritionists, doulas, childbirth educators, physical therapists, and other specialists to help you get the
care you need.

WHAT IF I WANT PAIN MEDICATION DURING LABOR?
If you think you want pain medicine during labor, your midwife will give you information about the medicines available so you can decide what is right for you. Midwife means with woman. If you decide you want pain medicine during labor, your midwife can prescribe it for you.

Do you deliver babies at home?

This is by far the most frequently asked question I receive.

I know that when many people hear the word midwife, they think of someone with long hair, long skirts, and Birkenstock clogs, who delivers babies at home!  While that's true of some, it's only partially true of me!

The practice of Nurse-Midwifery has evolved greatly over the past 75 years or so.  To begin with, nurse-midwives are highly educated practitioners. They are educated in both the profession of nursing, and the art of midwifery.  Most states now require that a nurse-midwife have a master's degree in nursing as well.

Nurse-midwives do more than deliver babies, too! We do well woman care, including PAP tests and breast exams; we can diagnose and treat gynecological disorders; we can write prescriptions in all 50 states. 

Only about 4% of midwives deliver babies at home these days. The other 96% of babies are born in hospitals.  While I believe that planned home birth can be as safe as a hospital delivery, I currently attend births in the hospital (St. Elizabeth and Northside Hospitals in Youngstown.

I am no stranger to out-of-hospital birth, however. While I was in graduate school, I worked as an RN at a birth center called Doughty View Midwifery Center, located in Millersburg, Ohio. 

Can I still get an epidural?

Yes!  You can have an epidural!  Because midwifery is about birthing your way.

However, if you want to birth naturally, I will support your choice 100%.  I will encourage you to become educated about childbirth, show you ways to cope with the discomfort, and be with you continuously during your labor.

You may find that you don't need the epidural....but you can still have it if you choose.

I am also working towards opening the area's first freestanding birth center in the spring of 2013.  Please visit the Mahoning Valley Birth Center website for details and to follow our progress.

Physicians and Midwives: What's the Difference?

1.  Midwives have a different philosophy.  We believe that pregnancy and birth are normal, natural processes, which most often don't need intervention.

2.  Studies show that midwives have superior outcomes.  Really!  When compared to physicians with low risk patients, midwives with the same types of patients had better outcomes. Patients who use a midwife are more likely to feel in control during labor, and to have a spontaneous vaginal birth.  Midwives have fewer C-sections, fewer epidurals, fewer episiotomies, fewer medicated births, and even in high risk populations, fewer low-birthweight babies (Obstetrics & Gynecology
1990;75:341-345).

3.  Midwives offer continuous labor support.  This means we are with you throughout your entire labor, and will not just arrive to "catch" your baby.

4.  Midwives will support your choices.  That means if you want an epidural, you can have one, but we will support you in such a way that you may not need it!

5.  You will probably have longer office visits, because we like to explain everything and give you lots of time for questions.

The Many Faces of Midwives

Coming soon:  Are all midwives created equal?  Clearing up the confusion about CNMs (certified nurse-midwives), CMs (certified midwives), CPM's (certified professional midwives), DEMs (direct entry midwives), "lay" midwives and "granny" midwives.  I'll answer all your questions about educational preparation, standards and scope of practice, and legal issues.



The Midwifery Model

The Medical Model

The woman maintains power and authority over herself.

Power and authority are handed over to the physician and institution.

Responsibility is in the hands of the woman herself, shared with her midwife.

Responsibility is assumed by the physician.

The goal is to assist the woman toward self-care as a healthy person in a state of normalcy.

The woman is encouraged to be dependent and is treated as potentially ill and in an abnormal state.

The mother and baby are a unit whose medical and emotional needs are complementary; what meets the needs of one meets the needs of both.

The mother and baby are separate patients whose medical and emotional needs may conflict; the mother's emotional needs may jeopardize the baby's health.

The woman's body is a well-functioning home for herself and her baby. Its needs and workings are best known by the woman herself.

The woman's body is a mechanical organism that needs fixing. Its needs and workings are best known by the physician.

The emphasis is on pregnancy and birth as times of physical/ psychological/ emotional growth for the mother and fetus.

The emphasis is on pregnancy and birth as times of stress and danger.

Childbirth is seen as an activity that the healthy woman engages in.

Childbirth is seen as an occasion for the provision of medical services.

The midwife guides and educates the woman during her experience.

The physician manages the care of the woman.

Childbirth is seen as an event in the lives of the woman and her family. The woman's active birth-giving is enhanced by education, support, and skilled care.

Childbirth is seen as a surgical procedure (obstetrics is a surgical specialty) performed on the pelvic region of a woman, involving the removal of a fetus and placenta.

Adapted from In Labor: Women and Power in the Birthplace by Barbara Katz Rothman