What is a midwife?

There are 39 licensed midwives in South Carolina, according to data published in early January by the S.C. Department of Health and Environmental Control.

Historically, midwives were women who helped deliver babies. Today, the licensing process is a little more technical.

According to the health department, midwives “provide collaborative prenatal care, primary assistance in the birth process, initial care of the newborn, postpartum care of the mother, and follow-up on both.”

Some midwives in South Carolina are known as certified nurse midwives — nurses or nurse practitioners who also are licensed midwives. Others learned the trade through an apprenticeship.

All midwives in South Carolina must pass both the North American Registry of Midwives national written exam and an oral exam administered by DHEC.

Source: DHEC

A Charleston midwife will make a case on Capitol Hill today that more midwives and more midwife-assisted birth centers would save the country a lot of money.

Lesley Rathbun, owner of Charleston Birth Place and president-elect of the American Association of Birth Centers, is scheduled to speak during a congressional hearing about a new study showing that women who seek prenatal care with a midwife at a birth center are less likely to require a cesarean section during delivery than women who give birth in hospitals.

The study, published Jan. 31, was commissioned by the American Association of Birth Centers and tracked more than 15,000 pregnancies across the country, including some in the Lowcountry, over a four-year period. It determined that 6 percent of those women who sought advice from a midwife at a birth center required a C-section during labor. About 24 percent of women who deliver babies in hospitals require the surgery.

“It’s a huge expense to the health care system. The cost of having a C-section averages over $30,000,” Rathbun said. “Having a baby (at Charleston Birth Place) is a third that — way less than a third of that. It’s cost savings.”

Most insured women will pay the same amount to deliver a baby at a midwife center as they would at a hospital, Rathbun said. But data indicates that if 10 percent of healthy pregnant women gave birth in a birth center instead of a traditional hospital setting, the country could save $1 billion every year, she said.

“But 10 percent of those women couldn’t have a birth center birth today because there’s not enough midwives and birth centers to do that,” she said. “So we’re going to talk to legislators about improving access to this type of care for all women, removing barriers for midwives to own birth centers and to help birth centers that already are open stay in business so that we can grow — and it is growing. There are more than when I opened five years ago.”

Rathbun opened Charleston Birth Place near Trident Medical Center in North Charleston in 2008. Since then, her staff has helped deliver nearly 900 babies. There are a few other midwife birth centers in Columbia and the Upstate. Rathbun’s facility is the only birth center in the Lowcountry and the only birth center in the state that is run by midwives who also are licensed nurse practitioners.

Leigh Wood, a midwife at Charleston Birth Place, said the midwife model of care is gaining ground because it is time-tested.

“On the whole, midwifery care is wellness care,” Wood said. “Taking care of well people, keeping them well, teaching them how to stay well and it works. We’re safe because we know who doesn’t need to be here and they’re out of here.”

To qualify to deliver an infant at the birth center, the expectant mother must have no health problems, including diabetes or high blood pressure. The Charleston Birth Place does not deliver twins at the facility and the baby must be positioned head-down in the mother’s uterus just before birth.

Dr. Jim Martin, a local obstetrician who partners with Charleston Birth Place to assist with higher-risk pregnancies at Trident Medical Center, said the facility is a great option for healthy women who want as little medical intervention as possible during a pregnancy.

“I’ve been working with midwives for 25 years in different capacities. They serve an excellent niche in the medical community and they are certainly quite competent at what they do,” he said. “It’s not for everyone, but it’s certainly nice to have that alternative.”

Reach Lauren Sausser at 937-5598.