well hello and welcome to HealthLine.

I'm Jennifer Blomquist.

I'm so glad you joined us this evening.

I have the privilege of hosting the program and if you're one of our regulars you know how it goes.

We're live here in the studio and we love when people call us or now you can text us with any questions for our guests.

We're doing a topic tonight that I've been doing this show for 18 years and I don't think we've ever done this topic that I can remember.

But it's midwifery midwives.

We have two certified nurse midwives with us today and I think it'd be pretty fascinated by some of the information I want to share with you.

Maybe you have a relative who's having a baby or granddaughter or a daughter just might be something you want to let them know about if they're not watching tonight.

So let me just quickly before I introduce you to our wonderful guests, I want to tell you how you can ask a question so we have the phone number up at the bottom of the screen.

We'll keep that there throughout the program it's (969) 27 two zero.

You can call toll free if you're outside of Fort Wayne.

Just put an 866- in front of there and you call and you talk to a very nice call screener.

They do not just throw you on the air.

You have the option of asking your question live.

I got to tell you that's my preference because our guests can interact with you on the phone line.

So maybe they need more information from you to give give you a better idea or a better answer.

So that's one option or if you prefer to just let the call screener know what your question is, that's fine too.

And then we'll ask for you.

The other method is new.

We just started that this past winter and that's texting.

So that's a little different.

No though it's close but little different (969) 27 three zero.

Go ahead and give us if you want to give us your first name and if you feel comfortable telling us where you're calling from, that's great.

Your phone number remains private so that is not going to show up on the screen and then just text us what your question is.

So that's a nice easy way to get your question answered as well.

So let's go ahead and introduce you to our guests so sitting right next to me on my right is Allison Thorpe and next to her is Kate Confer and you are both certified nurse midwives.

Yes, yes, yes.

Lovingness I told them our first question is I wanted them to explain what is a midwife because I think a lot of us have heard of it.

We probably think of you know, like I grew up watching The Waltons and Little House on the Prairie and I think about all those little babies you some lady just showed up and had like a little basket and they just kind of did their thing.

>> But that's not it really is a profession and you have to be licensed and it's overseen by a physician.

So if you guys want to address that off the bat, your thought is so, so common.

I think even women who see us or come to a midwife don't know what a midwife is.

Right.

So in the state of Indiana there's actually four types of licensed midwives.

There's a certified nurse midwives certified midwives certified professional midwives and direct entry midwives.

OK, so those are licensed midwives who have different educational backgrounds, different scopes of practice and then different pathways to licensure as well and then unlicensed midwives would just be like a midwife and that's the midwife you're thinking of ?

Yeah.

Yeah.

From a long time.

>> Yeah exactly.

But now everyone in Indiana does in Indiana you said they do require you to be licensed to practice like in conjunction with with oversight from a physician you are licensed and like I said those four different types of midwives they do have different educational backgrounds and different types of licensure with different scopes of practice.

So and that also kind of dictates where they can practice.

OK, so for instance a certified nurse midwife could practice in a home birth setting and also you said some of them can even do the prenatal care in the home like your patient wouldn't necessarily go to an office.

>> OK, they can practice in a birth center setting and then also in the hospital and in the state of Indiana they're the only midwife who can practice in a hospital and you know, what would you say to somebody like do they do you feel like maybe it provides more personal experiences or you know, because having a baby is so personal sometimes you know, when you're in a hospital setting it can it can feel impersonal.

Is that kind of is that a patients tell you like when they come to you like why did why do people go to midwives instead of just traditional ob gyn.

>> Yeah absolutely.

Midwives emphasize personalized care that focuses on shared decision making model so definitely involving the patient in all of their care is essential to providing good continuity of care with our patient.

You know, we provide all aspects of their care as well.

A lot of people think when they think of midwives as just pregnancy care, labor and delivery delivering babies, we actually provide care throughout a woman's journey.

So from adolescence all the way through menopause.

So we take care gynecology almost like gynecological we do all of that so we provide care, you know, from contraceptive care throughout pregnancy through menopause.

Well, woman care we do all of that is all encompassing.

So midwife means with woman and we are with women throughout all of those life changing events.

So we do all of that and you know, a big part of what we do is labor and delivery and pregnancy care but that's not everything.

Well, and I just after doing some research I thought gosh, people should do their homework though because you do have a lot of different choices but also you want to make sure you're getting somebody who is doing it properly, you know, and there had been I don't I don't remember this from when I was a reporter but I guess years to go there had been a couple of women arrested in a different county was outside of our county and because they weren't properly licensed and there were some complications with with a delivery.

And so, you know, the article that I was reading said do your homework, you know, because you want to make sure you're getting somebody who's properly licensed and you know, can provide the good care that you need.

>> Yeah, absolutely.

I think if you're seeking prenatal care or health care from a provider, it's always important to ask their credentials and their educational background.

>> Sure.

All right.

I just want to remind everybody we're going to keep talking about midwifery here with Alison and Kate, but we would love to have your calls.

So again, that's why the phone number is up at the bottom of the screen.

It's (969) 27 two zero and I don't want to forget to tell you about texting because that's really nice and easy and so sure you're shy and you don't want to talk on the phone or anything.

I understand.

So that number is a little different though (969) 27 three zero and the time goes quickly before you know it the hold up a card and tell me we have two minutes left so we'd hate to miss your your question.

Feel free to interrupt us at any time.

We'd love to hear from you.

I think now today the big thing is the ultrasound and some of the high tech equipment.

Can people still have access to that if they go the midwife route feel like everybody wants to know their babies sex?

>> I don't like that personally I never found out with any of my children people started getting angry at us because they wanted to know.

But but that's a big thing like I feel like if people are really into some of the technology that surprise babies, some of us it's just kind of cool that the only one who knows is, you know, God and the ultrasound and so yeah.

>> Makes the delivery room super fun.

I think so yeah.

With routine prenatal care with a certified nurse midwife patients are going to get all of the same prenatal care they would with an OBGYN provider.

They're going to get the same prenatal bloodwork, ultrasounds, all of that will be the same so they will get all the same screenings, anatomy, ultrasounds and the same availability to any prenatal genetic screening which can give them the gender of the baby as well as ultrasound can as well.

So a lot of patients are interested in the early genetic screening that can give them the gender that is available with midwifery care just as it is with OBGYN care speaking of that one thing we were talking about with genetic counseling is like preconception counseling as well and encompassing some of the genetic testing that's available for that as well.

>> Even before you have a baby you can yeah prepare for that right?

>> Yeah, I think people like it like you said, I think we and I was just as guilty of this as anyone else.

I just had the preconceived notion that it was just very simplistic and didn't realize how how well licensed and overseen the profession is of midwifery.

>> So yeah I think you'll find that a lot of midwives are still going to provide evidence based care but are going to come alongside a woman in a way that you know, they're going to provide a lot of education, provide more holistic care and take the family as a whole and help the the woman in the family meet their goals for their pregnancy, their labor and delivery while helping keep them and their baby safe.

>> Yeah, yeah.

And do you guys do have you ever done a home delivery?

>> I was just wondering if in your experience if you've ever done that?

>> Not in my personal experience.

I know I just was yeah.

Was not I have not either that yeah.

And some people are I mean I personally never wanted to go that route and I kind of look forward to being in the hospital a couple of days and eating in bed.

It was the only time I've ever eaten in bed in my life .

>> So not usually after you've had some children it's kind of like you want a little bit of a break so I understand that yeah.

>> I practice in a hospital setting Kate practices in a hospital setting there are some certified nurse midwives in our area that do practice in Barcenas and in do home births as well.

But the majority of certified nurse midwives around the country do practice in the hospital setting even though we practice in the hospital setting a central part of what we do is providing low intervention options for labor and pain management including things like nitrous oxide, hydrotherapy, water, birth, things like that which is a lot of what women want for labor and delivery options.

So those are all things that a lot of what midwifery care encompasses as well.

All right.

I want to remind everybody the only time is going by quickly so go ahead and call us.

Text us.

We'd love to hear from you.

We're going to keep talking about their profession and different options that they can provide but feel free to interrupt us at any time.

So I was telling you before that my first introduction to the field of midwifery was I was a brand new reporter 30 some years ago right out of college and we were doing a weeklong series about women's health , different aspects of women's health and I got assigned a whole thing on midwifery and that was really my first introduction to it.

I had not really heard about it before then so I feel like it's relatively new.

>> But do you do you feel like it's grown over the years and what do you see for its future?

>> Yeah I I just even in my experience in women's health since I graduated from nursing school in twenty twelve I feel like I'm just in this area midwifery care has grown so much which makes me so excited for women's health care I I don't think there can be enough midwives so I hope to see the practice continue to grow and grow and yeah that we can continue to reach more women and I was read an article that actually kind of helped to increase the popularity of midwifery was just a shortage of physicians in the OBGYN field which it it is hard I mean when you you know, I just from my pregnancies it is you know it was hard sometimes getting appointments you have to have them but they're not always at the ideal times or anything for you and you kind of had to take what you could get and then now I think it's set up so differently.

So I would go see my doctor in the office but then he was the one who would deliver the baby in the hospital and now it's a different state.

It's like a hospital staff that takes care of the deliveries and then you see your doctor in the office which I know for a lot of people it's kind of a turnoff.

They feel like they know there delivering a baby with somebody that maybe they're just meeting for the first time impersonal.

>> So a lot of practices are set up quite differently.

I think in some practices you may have kind of tandem care with advanced practice providers like a nurse practitioner or a midwife and then also see a physician throughout your like well for well woman care or even during a pregnancy.

So lots of different practices in the nation or doing a lot of shared care models like that.

Sure.

Yeah.

You know there have been a shortage of ob gyn physicians across the country.

Midwives have provided definitely a gap to providing care to women because of that shortage and it's definitely a great model that have helped a lot of women midwives provide, you know, a great access to women with low risk healthy pregnancies and can provide that care with collaboration with physicians as needed for complications that arise.

So it's a great model that works really well.

I'm glad you mentioned the complication because I think that when I remember when I was putting that special together I thought gosh, you know what if something because things can go awry, you know, by by no one's fault it's you know, it's an amazing is a miracle.

There are so many babies born free of complications when you think about all the things that big and small can go wrong.

>> So there is but you have backup especially when I'm in a hospital setting.

Yeah.

So there are lots of low risk women and low risk pregnancies but we do understand that not every woman is low risk and complications can arise throughout pregnancy, labor and delivery.

>> So midwives are experts in normal, right?

Yeah, but we are also experts in recognizing risk factors and then also complications and knowing when to consult or collaborate with our collaborating physicians that we may have either in an office setting or in a nearby hospital setting if at home or in a birth center or if practicing in the hospital in conjunction just right down the home.

So midwives typically will have a collaborative physician that they have that they can call needed in those situations.

>> Yeah, I don't want to interrupt you but I do want to say we do have a call our first let's have more let's have more staff with just one.

So somebody called him and told us to ask for them.

It was James and he was wondering if midwifery is used more with single single moms.

>> I don't know I I don't think necessarily more with single mothers.

I would say our practice and encompasses all mothers.

We take care of a diverse population definitely we provide care to single mothers as well.

But I definitely feel like I can see how maybe single mothers may want to seek out maybe a little more support from somebody like your wife.

>> Sure.

But also a midwife is going to provide support in other ways to all mothers whether if they have needs for some community resources and things we we are going to provide like medical care, emotional support and things like that.

But we're also just one person.

So we we also know when to use our community resources available and and help help gather those people to help support our moms when needed.

>> And it's interesting too.

There's probably some evidence of a social stigma that we're still probably still trying to overcome with with you know, with midwifery because it's it's different, you know, and it's not been around at least in mainstream adult like I said ,this is 30 some years ago.

>> Was it like the first time I had ever heard of it?

So do you think it's going to continue to become more popular?

I mean do you see like the OBGYN shortage continuing because I mean there's you know, there are only so many physicians and there's so many patients I feel like I think so and I think also in in practices where midwives may be in more of a hospital setting patients may just be placed with a midwife for a first appointment and so sure they don't mean like Allison said may not really have that or maybe you said it may not have that option.

Yeah, they're they're just placed with an advanced practice provider instead of a physician because of no availability.

But then they meet that provider and kind of stick with them.

And I think a lot of our patients have told us, you know, throughout the years that you know, they didn't know about midwives but once they came and learned more about us and that the experiences that they've had with the care that they have received, they were overjoyed and they really like the model that we had with midwives in general and how midwifery care is set up and the philosophies behind midwifery care in the you know, options for pain management and things like that and they just like the whole philosophy behind it so that they would seek out midwifery care again.

And so we've even had patients that have moved to other states and asked how do I find a midwife where I'm moving?

And so you know you know, patients that had never heard of midwives want to know how to keep finding them and other places.

So I do feel like midwives will continue to grow in popularity not just based on need but based on, you know, patients the desire for also low intervention options, you know, to support healthy physiological birth.

All right.

Well, we did get a text from somebody so I want to read that question to you guys.

Jasmine in Fort Wayne , thank you so much for taking advantage of our new texting option.

She was wondering what the difference is.

It's funny because we were talking about this before the show the difference between a midwife and a doula.

>> OK, I love this question because Alison and I were discussing it.

>> Yeah.

So there is a difference between a midwife in a doula and I think Jasmine also said can I have one or the other or do I need both?

Yeah, there are huge differences between a midwife and a doula so a midwife I talked about a midwife has know licensure education and a doula is there for mostly just emotional, physical and labor support.

>> They they typically do not require an education.

They can get a certification but don't need like a license or anything.

They're not going to deliver a baby.

They don't prescribed medications.

They don't provide prenatal care.

>> They may help provide some education but they they're just more support for the mom and the family.

>> Whereas your midwife is your obstetrics provider.

Yeah.

Yeah.

Medical care doodlers are really good with helping moms cope with the discomforts of labor helping with positioning of babies.

They're really good at knowing like how to move mammas to help babies descend in the pelvis so they learned good techniques through their training with that kind of thing.

So they're really good with position change changes, massage breathing techniques, comfort measures, those kind of things.

Midwives are great with those things too.

Can we always be there one hundred percent of the time with moms as a labor we try as much as we can can always be there one hundred percent of the time.

That's where a doula can really be of great value.

So I always tell my patients definitely a doula is a great support person to have when you're in labor especially because your midwife might not be able to be there one hundred percent of the time and that's something to discuss with your midwife are they going to be able to be there with you as much as you would like them to be?

And if not, should you consider getting Dula Abdullah is a great resource especially if you want a low intervention unmedicated birth.

>> That is a great resource and I think you can consider the setting where you're delivering so they could be in the hospital or in yeah OK.

Yeah consider the setting where you're delivering if you're delivering at home you may not necessarily need to do as much because your midwife may be more consistently present.

OK yeah I think about that so yeah I've heard I've heard of that and I saw a comedy about a really mean doula and it was just she was mean to the husband like she was ordering him around and telling them she was slacking off and everything and he was afraid of her so but I'm sure there are lots of nice doodlers out there though so sadly we only have about a minute left.

So I don't know if there's anything else you would want to say because also I think there may be an issue like somebody may say oh you know, my daughter wants a midwife.

I'm not sure I'm a little nervous about it.

It sounds like you guys are open to talking to the family members who are trying to reassure them because it's a newer concept maybe for them I would say first and foremost know that we are highly educated certified nurse midwives are highly educated.

We're licensed, we're backed by physicians.

We know our boundaries and we use our resources effectively.

If you have any questions, definitely you seek out midwife schedule a meet and greet appointment or a discussion to talk it out, talk about a preconception visit to discuss any, you know, problems underlying health conditions.

Those are great things to seek out and talk about ahead of time and see if a midwife might be right up your alley.

I definitely things to take into consideration.

So thank you so much Katherine Ellison Kate excuse me Kate and Kate and Allison, thank you so much for your time tonight and thank you to all of you for tuning in tonight and for the questions.

Loved it.

Have a great night.

We'll see you back here next Tuesday.

Take here bye bye