UNC Health Talk

Making a Midwife Part of Your Birth Plan

So you’re having a baby—congratulations! Before you think about names or how to decorate the nursery, you need to find someone to manage your pregnancy and help deliver your bundle of joy. For most women, this is an obstetrician, but some women opt for a midwife. UNC Certified Nurse Midwife Meg Berreth answers some commonly asked questions about midwifery.

What does a midwife do, and why should I consider using one for my pregnancy?

Midwife means “with woman,” and midwives are specialists in low-risk, normal pregnancies. We partner with you and your family to help you have the best labor and delivery experience that you can within the bounds of safety.

The midwives at UNC Medical Center see prenatal patients in three locations and even offer a group prenatal care model called CenteringPregnancy. We deliver our patients at UNC Hospitals. You will see a midwife for your prenatal appointments, and the midwives at UNC will deliver your baby in the hospital. We spend time guiding you and helping you understand what to expect and the best ways to care for yourself. In labor, we offer a lot of support. If there’s more than one safe way to do something, we present those options and let you choose.

What if I have a high-risk pregnancy?

Depending on the level of risk we may be able to provide your prenatal care. Otherwise, we would refer you to our physician colleagues.

But what if there is a complication during my pregnancy?

While we are specialists in low-risk care, the decision about who is appropriate for our care is an ongoing process that happens throughout your pregnancy. We use our physician colleagues whenever needed. Obstetricians are always available at UNC if you develop a complication during pregnancy that necessitates a physician, whether that means a one-time consult or transfer of care.

What can a midwife do for me that a doctor can’t and vice versa?

There’s definitely a lot of overlap between obstetricians and midwives. Your frequency of visits and the labs and ultrasounds we order are no different from what an obstetrician would do. Midwives tend to focus more on providing labor support for our patients; we are there with you throughout the entire labor, focusing on your birth wishes and goals. We use technology and medical interventions only when we need to for the safety of you or your baby.

We are not surgeons, so we use our physician colleagues if you need a cesarean. At UNC, there are always three obstetricians on the floor, so if you need a cesarean or have complications, they are there to help.

We have a really wonderful blend of obstetricians, nurses and midwives at UNC, so we’re able to attend to low-risk and high-risk births. We have the ability to leave things alone as long as we can and intervene if complications arise.

Can I have a midwife and still have an epidural?

Yes. At UNC, about half the patients of midwives get epidurals. Some of them come in the door wanting an epidural and that was always their plan, and some decide they want one during labor. We attract a lot of patients who have a goal of not having an epidural, and we work with them to maximize their own coping skills.

We don’t induce labor without medical reasons, and we encourage our patients to move around on their own, wear their own clothing and to eat if it’s appropriate. Our priority is a healthy baby, a healthy mom and an experience that a woman feels good about. So if an epidural is part of that experience, we can consult our anesthesia colleagues just as quickly as physicians can.

Do you do home births?

No. Our service delivers babies only in the hospital. In fact, 85 percent of all deliveries attended by midwives in the United States are in hospitals.

Why do you deliver babies only at a hospital?

When it comes to childbirth and obstetrics, you often can anticipate complications, but sometimes you can’t. A matter of minutes can make a big difference. We have pediatric specialists and obstetric specialists immediately available should mom or baby need them. I love knowing I have those resources available if that is what my patient needs.

What if there is an emergency with my baby?

We have an NICC (Neonatal Intensive Care Center) code, which is a button on the wall that we can press. If we suspect there might be a problem prior to delivery, we have the NICC team there on standby. But in case something unexpected happens, they can be there quickly.

What do midwives do other than help deliver babies?

We provide full-scope wellness care for women, including teenagers. We offer a wide range of services including gynecological exams, obstetrical care, labor and delivery, contraception, perimenopause and women’s preventive health care.

How many babies do midwives deliver each year?

In 2016, UNC Midwives attended 483 births.

Learn more about UNC Midwives.