Midwives are qualified health care providers who go through comprehensive training and examinations for certification. Certification is offered by the American College of Nurse Midwives (ACNM) and the North American Registry of Midwives (NARM). The practice and credentials related to midwifery differ throughout the United States. Utah recognizes and supports various types of midwives, allowing families to find just the right midwife for them. Different types of Midwives in Utah include:
Certified Nurse-Midwife (CNM): an individual trained and licensed in both nursing and midwifery, the majority choose to practice in hospital (although Utah has several CNMs with out-of-hospital practices). Nurse-Midwives possess at least a bachelor’s degree from an accredited institution of higher education and are certified by the American Midwifery Certification Board.
Certified Professional Midwife (CPM): an individual trained in out-of-hospital midwifery who meets practice standards of the North American Registry of Midwives; can attend an accredited school or train solely through apprenticeship
Direct-Entry Midwife (DEM): an individual trained exclusively in midwifery through a variety of routes, including: self-study, apprenticeship, midwifery school or college/university program; may be a CPM; may be a nurse, but not a nurse-midwife
Licensed Direct-Entry Midwife (LDEM): Utah's licensing designation for the Direct-Entry Midwife who chooses to license. An LDEM must be a NARM Certified Professional Midwife (CPM) with additional training in the use of specific prescription medications. LDEMs may not manage twin pregnancies, twin and breech births, and some other rare conditions. Licensed Midwives are authorized by UT law to obtain, carry, and administer specific prescription medications including drugs for: hemorrhage, laceration repair, I.V. therapy, Rh incompatibility, newborn prophylaxis, and other drugs they are qualified to use.
Unlicensed Direct-Entry Midwife (UDEM): Other DEMs (including CPMs) may practice legally without a license in Utah, and are unregulated by the state, thus they are not required to follow the rules for licensed direct-entry midwives (i.e., they can manage twin and breech pregnancy and birth legally). However, their practice is still defined by statute under the legal definition of Direct-Entry Midwifery. Unlicensed midwives are legally allowed to carry oxygen in the state of Utah.
A Midwife is a primary health care provider who is trained and educated to provide comprehensive, clinical care for low- to moderate-risk women throughout their childbearing year. Midwives assess the health of mother and her unborn baby prenatally, monitor mother and baby during labor, catch the baby, manage most emergencies, repair lacerations, conduct newborn examinations, provide postpartum care for mother and baby for up to six weeks after birth, continue to assist with breastfeeding support as long as mother and baby nurse, and provide well woman care, within their scope of practice, for those mothers.
A Doula is a trained labor support person. S/he is specially trained to inform parents of birth options, give emotional support, and provide physical and emotional comfort measures and assistance during labor, birth and postpartum. Some doulas help women during the postpartum period with support services such as: meal preparation, light housekeeping, some childcare, breastfeeding support, and newborn care (diapering, bathing). Others concentrate solely on pregnancy and birth. S/he does not perform any clinical duties such as taking blood pressure, doing vaginal exams, monitoring fetal heart tones, or catching babies. These skills are outside the scope of practice of a doula. The advice a doula offers should not interfere with the relationship between the mother and her maternity care and newborn care providers.
The average cost of a natural, drug free, vaginal birth in the hospital can run between $6,000 and $10,000 depending on location. Interventions, medications, laboratory, diagnostic testing, surgical delivery, anesthesia/epidural, nursery, etc... are ADDITIONAL costs. That is just the hospital fee! The doctor's fee is another $3000 or more. Most Midwives in Utah charge between $2200 and $5900, depending on region of the state. That is for ALL your care -- prenatal, birth, newborn and postpartum. What a bargain !!
** See our Prices page for more details about the cost of our care.**
Reimbursement by insurance depends on what, exactly, is written into the midwifery law in your particular state and what your specific Schedule of Benefits defines, designates, outlines and excludes in your policy. Utah does not allow LDEMs to bill medicaid but does not restrict us from billing private insurance. We currently offer out-of-network medical billing for insurance. Medicaid does not currently pay for CPMs in Utah and Tricare does not pay for CPMs in any state. However, Medicaid will cover your labs and ultrasound, if desired. In any state, a home or birth suite birth can be reimbursed out of a medical savings account or HSA.
Yes, we frequently do both VBACs and water births (often both at the same time!)
Mothers who have had a previous cesarean will need to permit us to get copies of their surgical records to assess specific details about her cesarean incision and repair. We also require a prenatal ultrasound to confirm the safe and appropriate positioning of the placenta away from the previous incision site.
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