HONOLULU (KHON2) – Midwifery is a longstanding practice where trained professionals help women during labor and assist them with delivering their babies. Many midwives deliver babies through home births, at birth centers or in a hospital. 

In the past few years there has been a growing demand of pregnant people requesting to be seen by a midwife over their OBGYN. This is true in the United States and in Hawaii. 

Some credit COVID policies on pregnant women during the pandemic creating a greater need for midwives while other health officials credit the type of care a pregnant person receives from a midwife compared to their OBGYN. 

Leʻa Minton is the President of Midwives Alliance of Hawaiʻi and said they have also seen an increase in women wanting to work with midwives across the islands of Hawaii.

“Midwives are utilized around the world. There are system issues as to why there are so few midwives utilized in the United States,” said Minton. “More people are learning about them and seeking them out. There has definitely been an increased interest in receiving care from midwives.”

For example, some women feel that midwives spend more time with them, or share more education with them, or even listen to them during prenatal appointments. Minton said this may come from how their systems are set up.

“It’s not to say that OB’s can’t be as caring, understanding and imparting education and knowledge to their clients,” said Minton. “Midwives often use the term clients instead of patients as we look at it as the person is paying for a service and that we as a healthcare provider do not have power imbalance with them.”

She said the client is always in charge of making decisions for themselves; they just provide education so their clients can decide what works best for them. 

Midwives specialize in healthy pregnancies that are not deemed high-risk. However, what classifies a pregnant person to be high-risk varies on state-to-state and on their healthcare provider. 

“Midwives can do many of the same things OB’s do, they just don’t do surgeries like cesarean sections or forceps deliveries. Midwives also are trained from the premise that pregnancy is normal and healthy until proven otherwise,” said Minton. “Midwives also have training in caring for newborns through age 4-6 weeks depending on the type of midwife they are certified as.”

She said not all midwives are the same and have the same type of credentials. In the United States there are three different types of midwives. Certified Nurse-Midwives (CNM), Certified Midwives (CM), and Certified Professional Midwives (CPM) for more information on the differences and training click here. 

Minton said CNM and CM have graduate education which is a minimum of a master’s degree. She said there is no minimum educational training for CPM, but they do have to have a minimum of an apprenticeship route. They are required to have at least a GED or high school diploma to enter an apprenticeship.

On Oahu, Minton said there are only two hospitals who have midwives on staff. Kaiser Permanente and Tripler Army Medical Center. This means if a pregnant woman is wanting to work with a midwife during her pregnancy, she will have to seek outside care if she is not birthing at one of the two hospitals on Oahu.

“The majority of hospitals in Hawaii do not have midwives on staff. There are no hospitals on Kauai with midwives on staff or who have admitting privileges.” said Miton. “On Oahu the two hospitals that have midwives on staff are Tripler and Kaiser, so only for members of these services. There are no public hospitals with midwives on staff or who have admitting privileges.”

She said Molokai has midwives on staff, yet less than 15 births a year take place on Molokai as most of them fly off island to birth. Maui Memorial Hospital has one midwife who has admitting privileges and on the Big Island, Kona Hospital and Hilo hospital do not have midwives on staff. 

“North Hawaii Community Hospital does have midwives on staff,” said Minton. “On the continent many hospitals can have midwives on staff, especially at military hospitals, Kaiser Permanente hospitals, Indian Health Service hospitals, city and county hospitals, university hospitals and state hospitals that offer obstetrical services.”

Essentially, midwifery focuses on seeing and caring for families, parents and children together, by recognizing the importance of the whole family unit, and how their wellness impacts each other.

Minton said midwives are comfortable with sitting in discomfort with clients because pregnancy, birth and postpartum can be uncomfortable. She said that doesn’t make it wrong or bad or abnormal but being present for others in their life experiences is very important. 

Midwives Alliance of Hawaii (MAH) has collaborated with maternal health organizations across the State and continues to do so to help improve midwifery care and access to midwives.

Their purpose is to preserve the art, science and the independent practice of midwifery while promoting good public relations through education with the people of Hawaii.

“Being a midwife is meaningful work that requires being present with clients daily, and sharing what we know about the profession with clients and the community so that each person can choose what works best in their life,” said Minton. “It’s rewarding and challenging and it requires always being accountable to our profession, to clients and to the community.”

For more information about Midwives Alliance of Hawaii head to their website.