ter, a patient and her family may have the option of minimal intervention with a very natural birth, yet be steps away from all the technology of a full-service hospital and a special care nursery. This is what we are developing for our hospital. The latest addition to our birth center plan is two certified nurse midwives (CNM), and the plan is to add more midwives. There is much confusion about who
midwives are and what they do. CNMs have a bachelor’s degree and a master’s degree in nursing, having completed the Master’s in Midwifery program, which includes formal instruction as well as on-the-job training. After finish- ing the master’s program, they must pass a certification exam. Of course, midwives have been around for centuries. These were women who learned from experience and observation, and often they had very few tools or medicines to work with. While these women have tradi- tionally been called “lay midwives,” in Tennessee and about 30 other states, there is a newer term for them: Certified Professional Midwives (CPMs). State regulations now recognize a certifica-
can do VBAC deliveries—with the op- tion for water birth, if desired—because all the staff and equipment are there to perform an emergency C-section if needed. Our VBAC patients are con- tinuously monitored during labor for early signs of uterine rupture. Because we follow these precautions, women with a previous C-section who choose a vaginal delivery may accomplish that goal safely while being cared for by a midwife. We are the only facility in Knoxville that offers these options.
tion process for CPMs developed by the North American Registry for Midwives. This exam is offered to women who have on-the-job-training, especially with home births. In Tennessee, a CPM may provide care for low-risk clients who are expected to have a normal pregnancy, labor, birth and recovery. For all clients, the CPM must form a collaborative care plan with a physi- cian; the birth can take place in what- ever setting the mother chooses. The CNMs at our Women’s Pavilion
Leonard A. Brabson, MD, FACOG, is medical director of the Women’s Pavilion at Tennova Physician’s Regional Medical Center (formerly known as St. Mary’s & Mercy) and medical direc- tor of St. Mary’s Birth & Midwifery Center. For more information, visit
StMarysBirth.net or e-mail Midwife@
stmarysbirth.net or
DrBrabson.net. See ad, page 40.
Dr. Leonard A. Brabson
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