Midwifery, practiced around the world for thousands of years, is the act of assisting at childbirth and during pregnancy. Worldwide, midwives deliver morethan two-thirds of all babies. In the United States, midwifes were replacedby physicians when advances in medical care shifted childbearing fromthe home to hospitals in the early 1900s. Since the 1960s, women interested in natural childbirth began turning to midwifes again.

Midwives focus on the physical, emotional, and social needs of women and their babies. They view childbirth as a normal event and encourage patients and their families to actively participate in decision making. They use medical technology only when necessary.

There are three types of midwifes in the United States today: certified nurse-midwives, certified midwives, and lay-midwives. Certified nurse-midwifes, also called nurse-midwives, are educated in nursing and midwifery, and certified by the American College of Nurse-Midwives Certification Council. In some states, they also have to meet other requirements to practice. Certified nurse-midwifes provide routine women's health care as well as assistance with pregnancy and childbirth. Their services include: prenatal care, labor and delivery management, care after birth, newborn care, family planning, preconceptioncare, managing menopause, birth-control advice, counseling on staying healthyand managing diseases. They are affiliated with physicians, who they can turn to when problems come up. Most work at hospitals, family planning clinics,or birthing centers affiliated with hospitals. Educating patients is an important role of certified nurse-midwifes. They counsel women about how to have ahealthy pregnancy, labor and delivery techniques, breast feeding, parenting,sexually transmitted diseases, spousal and child abuse, and social support networks.

Certified midwives have formal midwifery education, including an apprenticeship, but they are not nurses. They usually help women deliver babies at home or in birthing centers. Certified midwives are legally recognized in 29 states. They perform most of the same services that certified nurse-midwives do andusually are affiliated with doctors, hospitals, and laboratories.

Lay-midwives are generally trained informally through apprenticeships with midwives; some do have formal education. They are not certified or licensed andtypically assist only in home births. Many practice as part of a religious community or an ethnic group. In some states it is illegal for a lay midwife to charge for services.

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