Back to the basics: Midwife care growing in metro-east

More metro-east women are going back to the basics and selecting a certified nurse midwife as opposed to a traditional obstetrics and gynecology doctor.

Sylvia Obernuefemann a certified nurse midwife who has more than 30 years of nursing experience, recently joined Memorial Medical Group, which was looking to expand its practice and include midwifery care. She most recently worked as a nurse midwife at Heartland Women’s Healthcare.

The television show “Call the Midwife” on PBS, which is in its fourth season, also is raising awareness about midwifery. “They don’t realize that they are still out there,” Obernuefemann said of midwives.

Obernuefemann is one of about a dozen certified nurse midwifes in St. Clair, Madison, Clinton and Monroe counties. According to the most recent data available — 2013 — through the U.S. Department of Health and Human Services, there were four certified nurse midwifes in St. Clair, six in Madison, one in Monroe and none in Clinton and 456 total certified nurse midwives providing service in Illinois.

A certified nurse midwife does more than deliver babies. Midwifes must be licensed through the state of Illinois. They care for women throughout their lives. A midwife can prescribe birth control, deliver babies and help women cope with menopause. Obernuefemann says midwives care for women overall including physical, mental and emotional health. They also serve as advocates for mothers during childbirth. They cannot perform C-sections, but can assist a doctor during one.

Cheri Moran, a certified nurse midwife who is treasurer of the Illinois Affiliate of the American College of Nurse Midwives, said the number of certified nurse midwives in the United States is on the rise and more women are seeking out midwives for their healthcare.

The American College of Nurse Midwives has a hefty goal — 20,000 certified nurse midwives by 2020, according to Moran. Currently, there are about 15,000, she said.

“We know that we need far more than that,” Moran said.

Nurse midwives are able to provide care to women throughout their entire lifespan — from puberty through menopause.

“I love the midwifery model of care,” Obernuefemann said. “The midwife cares for you throughout your pregnancy and is there with you when you have your baby. A lot of times that includes labor support for moms who don’t want an epidural. We try to be there for them and help them through this. We also care for women who aren’t pregnant.”

Midwifery is different than other women’s health care as it’s “more family-centric care,” Obernuefemann said. She tries to include older children, fathers or other family members in the visit if they are present.

“Dads help me find the baby’s heartbeat or if there’s an older brother or sister there, they help me measure mom’s belly or find the heartbeat,” she said. “It’s really more family centered rather than just about the woman.”

The biggest question Obernuefemann gets about midwifery — do you deliver babies at home?

“Most midwives in the United States deliver in the hospital,” she said. “I’m a nurse midwife, which means I’m a nurse first.”

Nurse midwifes are legal in every state in the United States, according to Obernuefemann.

“There’s other kinds of midwives that not every state acknowledges,” she said. “Illinois only recognizes nurse midwives.”

Near Chicago, there are nurse midwives who attend home births, but there is no one in this area, Obernuefemann said.

Another question Obernuefemann gets from pregnant women considering a midwife — can I have pain medicine during labor?

Her response: “yes, you can. My job is to help you get your baby here safely, and I want you to feel good about your birth,” she said. “If you know you want an epidural I’m going to make sure you get that at a time that’s right.”

In midwifery, Obernuefemann said it’s important to give women choices in how they want their baby’s birth to happen.

“It’s family oriented. It’s safe. It’s personalized,” she said.

St. Elizabeth’s Hospital in Belleville currently has no certified nurse midwives who deliver babies at the Belleville hospital. However, hospital spokeswoman Kelly Barbeau said they anticipate three certified nurse midwives coming on board over the next several months. She said the midwives will work for Heartland Women’s Healthcare and will be able to deliver babies at St. Elizabeth’s Hospital.

Family-centered care

Elias Smith, 22 months, was eager to help Obernuefemann measure his mother’s belly during a recent appointment at Memorial Medical Group in Belleville.

Obernuefemann has a special tape measure for the children who accompany their mother to use — a rubber ducky. Elias’ mother Bethany Smith of Fayetteville is expecting her fifth child. He or she — the family chose not to find out the gender — is due Dec. 25.

This will be her third baby delivered with the help of Obernuefemann, who makes sure to never say she delivered the baby, because she said the mom does all the work.

“Mommies deliver the babies. We catch them,” she said.

Obernuefemann also elicited Elias’ help when finding the baby’s heartbeat. Then she helped Elias find his heartbeat.

Next Obernuefemann pulled out her container of baby dolls, which show children how big the fetus is at various stages of development. She even helped Elias put the smaller dolls under his shirt to simulate the baby being in his belly.

Bethany Smith followed Obernuefemann from her previous doctor’s office over to Memorial Medical Group.

“Sylvia has been very supportive,” Bethany said.

When Bethany had her first child, she said she didn’t feel like her OBGYN doctor was hearing what she wanted and ended up having a scheduled birth.

“I felt very unlistened to,” Bethany said.

She opted for a midwife during her other pregnancies because she wanted to have her babies when they were ready.

Caring for the whole woman

Midwives not only care for a woman’s physical needs but her emotional needs as well.

“We know that she has children at home. She’s not just a pregnant lady; she’s more than just that,” Obernuefemann said. “It’s not just physical care but also emotional care.”

She loves the midwife model of care, which is based on wellness.

“We are partners with women. We don’t tell them how to have their baby. We just help them figure out what’s right for them,” Obernuefemann said. “It’s more of a partnership. We are partners in their healthcare. I like that model versus a model ‘let’s fix things when they’re broken.’”

Midwives talk to women about diet and exercise and other things that can protect their health, she said, and don’t just prescribe medication.

During labor, nurse midwives are trained to notice when there may be a potential problem. “We work very closely with a physician, and they are there if we need them,” Obernuefemann said. “We are constantly paying attention.”

Most health insurance plans cover nurse midwives, Obernuefemann said.

Adriena Beatty, an obstetrics and gynecology doctor, said midwifery wasn’t a service available at Memorial Medical Group in the past. “I think it’s good thing to have it available for patients who want a midwife to deliver their babies,” she said.

In St. Louis, there are birthing centers that are just run by midwives, according to Beatty. “It’s good to have that available in Southern Illinois so people do not have to go to St. Louis if they want that service,” she said.

Having a midwife is a patient preference, Beatty said. “They are low-risks patients who want a more natural delivery with little intervention,” she said.

Over the years, Beatty said she has seen more patients wanting midwifery services.

Tammy Young, 35, of Greenville was the first certified nurse midwife to deliver a baby at Anderson Hospital in Maryville, she said. Young works out of Maryville Women’s Center. She’s been a midwife for 11 years, prior to that she was a labor and delivery nurse for 12 years.

“I love caring for women and their babies,” Young said. “I really wanted to make a difference and help women get the birth experience they wanted to have.”

Young said different TV shows have increased awareness about midwifery. “Patients now know that midwives are an option. There’s been a big turn toward natural; women wanting to have the choice for a natural birth — less intervention.”

Young believes in low intervention during child birth. However, she’s more concerned about what the patient wants. “I truly believe in giving them the experience that they want, for some women that’s a natural birth and for others, it’s medicated,” Young said.

Midwives provide women additional support and spend more time with them during the labor experience, she said. They can take care of health needs of all women including baby delivery. However, they can’t do Cesarean sections but can assist a doctor during a C-section.

“We don’t do surgeries, and if a patient is high risk we work in collaboration with our doctors,” Young said.

Becoming a midwife

Most midwives start out as a nurse just as Young and Obernuefemann did.

Obernuefemann, 56, a graduate of O’Fallon Township High School, became a nurse in 1985 and has been a certified nurse midwife since 2006. “I’ve been around a longtime,” she said. “I have lots of experience at the bedside.”

Obernuefemann came to the metro-east when her father was stationed at Scott Air Force Base. She met her husband, and they have been married for 36 years. They have three grown children.

Sarah Pringle, a nurse practitioner with Memorial Medical Group in Belleville, is working toward becoming a certified nurse midwife like Obernuefemann. Pringle, 34, of Edwardsville is expected to take her board certification test soon through the American Midwifery Certification Board.

“It’s really exciting,” Obernuefemann said. “We should be able to provide a midwife for anyone who wants them at their birth.”

Pringle, who has been a nurse in women’s healthcare for a decade, said she thought “this area needed some midwifery care.”

She took online classes at Philadelphia University and did her clinicals at Anderson Hospital in Maryville and The Birth and Wellness Center in O’Fallon, Mo.

If a nurse wants to become a midwife, Obernuefemann said she goes back to school and gets her master’s degree in nursing before going onto midwifery school. It usually takes a total of eight years — six years to get a master’s degree in nursing and two years for the midwifery program.

Obernuefemann went to midwifery school at Frontier University in Kentucky, which she described as the “birthplace for midwifery.”

She is certified through the midwifery board and has a midwife advanced nursing practice license through the state of Illinois. She also has nurse license through the state.

“We have continuing education to maintain that license, because things change in medicine all the time we have to do that to keep our license current,” Obernuefemann said.

University of Illinois Chicago has the only certified nurse midwife program in Illinois, according to Moran, a fellow with the American College of Nurse Midwives. There are about 40 programs across the country.

Pringle said midwifery is more common in other countries throughout the world.

“Midwives all around the world deliver most of the world’s babies except in the United States,” she said. “We need doctors, but we can work together to provide all types of care for women.”

This story was originally published December 7, 2015 at 10:10 AM.