Midwifery Services

Midwives are healthcare professionals who specialize in assisting normal, uncomplicated births. Certified nurse-midwives are licensed advanced registered nurse practitioners (ARNP) with graduate degrees in nurse-midwifery who have passed a national certification exam. We also do ongoing continuing education to maintain our certification and license.

Midwives can manage your care throughout pregnancy, birth and beyond. We support you with prenatal care and education, labor and birth, post-partum and newborn care, and breastfeeding. Certified nurse-midwives are authorized to prescribe medications, order lab tests, and admit and discharge people from the hospital.

UW Medical Center – Northwest offers a variety of classes including Lamaze, Hypnobirthing, breastfeeding, infant care and CPR. There are also many offerings in the Puget Sound region, including yoga-based classes. We strongly encourage first-time parents to enroll in a childbirth preparation class.

For expectant or new fathers (and father figures), we offer a Conscious Fathering class to help parents learn how to feel more involved and confident in birth and child rearing.

Our goal is to help you have a safe, satisfying and memorable birth experience. During labor, the midwife and nurse can provide a variety of comfort measures and will help you follow your birth plan as closely as possible. The midwife will be with you throughout your labor and your baby's birth, along with the childbirth center's supportive labor and delivery nurses and staff. We also encourage you to invite anyone you believe can provide support to you in your labor or people you would like to have present at the baby's birth, such as family, friends or a doula.

We will refer women with significant health problems or high-risk pregnancies to obstetrician care if needed. If complex problems arise during the birth, the hospital's obstetricians, neonatologists and obstetric anesthesiologists are available around the clock to partner with us in your care as needed.

If a cesarean birth is needed, your midwife will likely assist the obstetrician during the surgery, as well as continue to provide you with physical and emotional support.

After an uncomplicated birth, most women and their newborns stay in the hospital for about 24 hours. The stay may be extended if complications arise. If your newborn needs specialized care, we have neonatology providers available in-house 24/7.

We have many options for comfort and pain management in labor. Midwives can order pain medications if you need or want them. If you choose an epidural, our anesthesiologists are available 24 hours a day to provide this service, and your midwife can continue to manage your labor and birth.

Medications available for pain relief include:

• Nitrous oxide
• Epidural anesthesia
• Oral and IV narcotic pain medications (which are only used in certain circumstances)

We also utilize a variety of non-pharmacological methods to promote comfort and coping in labor, including:

• Deep relaxation and breathing
• Warm water immersion in labor tubs
• Calm environment with low lights, quiet or soft music
• Massage, therapeutic touch and acupressure
• Positions, movement
• Aromatherapy
• Positive attitude and affirmations

We encourage prospective parents to learn as much as possible about pregnancy, childbirth and parenting. Here is a list of resources to supplement the information provided by your midwife.

We understand that the time following a baby’s birth can be both joyful and challenging for new parents and their families. During your hospital stay, the midwives along with our nurses and lactation specialists will help get you started with breastfeeding and self-care.

UW Medical Center – Montlake and UW Medical Center – Northwest have the Baby-Friendly designation, which is granted to hospitals that promote mother-baby bonding and offer expert lactation support.

We follow mothers and families closely after each birth to help with their adjustment to breastfeeding, postpartum depression and anxiety, contraception and other postpartum issues. We see all new mothers in clinic two weeks following the birth, or sooner if any issues arise.

On your first prenatal visit, the midwife will gather a detailed history, including information about your health and your family’s health. We will offer you an ultrasound to confirm your due date and check for the baby’s heartbeat. We will also recommend some lab tests, including a blood draw, and discuss your options for prenatal genetic testing. We would also like to do a thorough physical exam, typically at your second visit.

Initially, your prenatal visits will occur once a month, then every two weeks from 28 weeks on and weekly starting at 36 weeks. Extra visits may be needed if any complications arise.

It is important to us to get to know you and your family and to listen to your feelings and expectations about your pregnancy and birth. At your prenatal visits, we will talk with you about your baby’s development, the labor and delivery experience, family changes, sexuality, employment, school or any other concern related to your health and your pregnancy. You are welcome to bring your partner, your children, or other family members or support people to visits if you wish.

In addition to caring for women during pregnancy and birth, we manage gynecologic care for women from teen years through menopause. Our focus is on the whole person, not just physical well-being. We strongly believe in empowering women to take charge of their health. We discuss current medical treatments as well as alternative therapies. If additional services are needed, we have access to a large network of highly qualified specialists within UW Medicine. Most importantly, we offer gentle, sensitive care and take time to get to know you. In addition to pregnancy care, our women’s health services include:

• Annual exams and management of basic primary care problems
• Vaccinations
• Pap screening (with colposcopy referrals as needed)
• Vaginal infections (yeast, bacterial vaginosis), screening and treatment
• Contraception counseling and management, including pills, IUDs (intra-uterine devices), vaginal rings, transdermal patches, skin implants, barrier methods (diaphragm, condoms, etc.), and fertility cycle awareness.
• Sexually transmitted infection screening and treatment
• Pre-conception counseling
• Menstrual issues

Here are some answers to common questions about midwifery at UW Medicine.