Word History: The word midwife is the sort of word whose etymology seems perfectly clear until one tries to figure it out. Wife would seem to refer to the woman giving birth, who is usually a wife, but mid ? A knowledge of older senses of words helps us with this puzzle. Wife in its earlier history meant "woman," as it still did when the compound midwife was formed in Middle English (first recorded around 1300). Mid is probably a preposition, meaning "together with." Thus a midwife was literally a "with woman" or "a woman who assists other women in childbirth." Even though obstetrics has been rather resistant to midwifery until fairly recently, the etymology of obstetric is rather similar, going back to the Latin word obstetrīx, "a midwife," from the verb obstāre, "to stand in front of," and the feminine suffix -trīx; the obstetrīx would thus literally stand in front of the baby.
Certified Nurse-Midwives (CNMs) are registered nurses with graduate training in midwifery. Upon completion of a university-based educational program, the midwife takes a national exam and is certified by the American College of Nurse-Midwives Certification Council (ACC). In California, the state Board of Registered Nursing then licenses the CNM to practice midwifery. California CNMs have prescription writing authority and are covered by most insurance plans.
Midwifery education emphasizes personalized, family-centered care. The focus is on patient education, wellness and consumer choice. Midwifery care is attractive to many women and families because of the personalized nature of the relationship and the philosophy that pregnancy, birth and transition through life’s stages are normal events. CNMs emphasize education and preventative care. In labor, CNMs tend to be with the family, often at the bedside, throughout the birthing process. Midwives hope to ensure that the woman’s experience will be as safe and satisfying as it can be.
Midwives care for women from menarche through menopause. For the gynecologic client, this includes education about nutrition, exercise and lifestyle in addition to routine physical exams, pap smears, birth control and the diagnosis and treatment of minor infections and gynecologic problems.
Certified Nurse-Midwives have been practicing in California since 1960. The first CNM practice was established in Madera County in the San Joaquin Valley after a State Department of Health recommendation that nurse-midwives could be valuable additions for prenatal care and could reduce infant mortality. California's CNMs practice in all settings including private hospitals, public health departments, HMOs, family planning clinics, homebirth practices, birthing centers and universities.
Since the Nurse-Midwife Practice Act passed in 1974, California's population of CNMs has grown to one of the largest in the county. Currently, there are more than 1,000 CNMs in the state. There are 371 nurse-midwifery practice sites in California, according to the ACNM Directory of Nurse-Midwifery Practices. In 2001, California's CNMs attended the births of 44,552 babies (8.4%), and provided care to nearly 10% of pregnant women in the state. [California DHHS statistics]
There are currently 44 accredited educations programs offering post-baccalaureate certificate and masters degree programs in nurse-midwifery and midwifery. A number of these programs have distance learning education options. Three graduate programs in nurse-midwifery are in California: Charles R. Drew University of Medicine and Science, San Diego State University, and University of California, San Francisco/San Francisco General Hospital.
California Nurse-Midwife Practice and Reimbursement Issues:
For more information on midwives and nurse-midwifery visit the American College of Nurse Midwives at www.midwife.org
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