True or False?
Midwives can prescribe medications
and order tests.
TRUE. CNMs and CMs are licensed to prescribe a full range of substances, medications, and treatments, including pain control medications and birth control. They can also order needed medical tests within their scope of practice and consistent with state laws and practice guidelines.
I’m not sure what many people think it is that midwives do during prenatal appointments that is so different from a similar appointment with a doctor, but I can assure you that all of the same measurements, tests, and symptoms are checked and noted. During my (30-60 minute) appointments I always had my urine checked for protein, my blood pressure taken, my fundal height was measured (how big my belly was getting) and the baby’s heartbeat was observed. I, personally, chose not to have it done with a doppler fetoscope (which is an auditory ultrasound) until after the 5th month and they used a traditional fetoscope before that. We didn’t want to find out the gender of our baby before the birth and therefore didn’t feel it was necessary to do a visual ultrasound, although we could have if we wanted.
At one point there was concern over my possibly high blood pressure. This meant a host of blood draws and collecting my own urine for a weekend in a giant container, so that it could be analyzed at the lab. Luckily everything was perfectly fine, and it was decided that the very excitement of going to my prenatal appointments, and driving through maddening rush hour traffic for 30 minutes, made my heart go aflutter. The problem was solved very simply, by taking my blood pressure at the end of each appointment. From the time the tests were run and we made that simple change, my blood pressure was perfectly normal. I also want to say that I chose NOT to have my blood sugar levels tested (for many reasons). My midwives encouraged me to have it done, and I opted out against their advice, but with their education and blessing.
During my labor, they listened to the baby’s heart beat every hour with a doppler fetoscope. Before and after every single push, and sometimes during, they listened to his heart beat to ensure it was strong and healthy. Which it was. They also kept cervical checks to a minimum, but did perform 3-4, because I tested positive for Group B Strep (GBS) and they didn’t want to push any bacteria into the birth canal. The traditional treatment for GBS is IV antibiotics 6 hours before the baby’s birth, which my midwives (out of hospital) could have done. Thanks to their education and my desire for an alternative I opted for a Chlorhexidine rinse of my lady parts every 6 hours, which I administered myself. It was a whole heck of a lot cheaper too. Overall, there was quite a bit of testing and monitoring that went into my prenatal care and birth, all done by my midwives.
The part that made this experience so different from one with a doctor was the amount of education and discussion that went into each test. This resulted in mine and Luke’s informed choices about the health care Porter and I received. In the end, had anything strayed from our original plan, I knew that the responsibility belonged to ME. That’s the only possible way I could feel comfortable delivering Porter from my body in the way I did. My decisions were always respected because that is the nature of informed health care and midwifery. In return, I respected my midwives education and opinions when they really felt a test was necessary or an observation had to be made. The mutual respect that we had with our midwives was the very best foundation for Porter’s birth and for the future of the health care I will choose for us to receive.
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| Porter is practicing his counting for future games of Hide and Seek with Lucy and Aunt Bug. |
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| He cracks himself up. |
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