Lynnetta Allen, of South Euclid, Ohio, was a single mother, pregnant at age 19 and apprehensive about her pregnancy.

But, she said, the staff at University Hospitals in Cleveland offered a nurse midwife to guide her.

Birthing Options | Hospital Secrets | Women's Health

"The service provided by the midwife was personable, and it made me feel more comfortable at my visits, knowing that I would see the same woman at each visit, someone who had become familiar with me and the progression of my pregnancy," Allen said.

In addition to good health care and an abundance of information, Allen said she formed a good relationship with her nurse midwife that included extra phone calls to get questions answered. "The midwife was knowledgeable about many things and was able to answer questions for me," she said. "I felt comfortable with the midwife and was able to form a bond with her."

Nurse midwives help deliver babies in hospitals, birth centers and homes. They also provide health care to expectant mothers and gynecological care to females in general. They do not perform any surgeries or invasive procedures, and they typically operate interdependently with a doctor. Those factors can create a very different experience from the typical hospital atmosphere and process.

A Different Experience

The room is slightly illuminated by candle light, and there is a subtle hint of lavender in the air as soft music plays at a Florida birth center.

One of the birthing rooms is decorated in purple and green, because color therapists say these colors mean good luck and health.

The atmosphere of the Family Birth Center in Ft. Myers, Fla., is not a coincidence.

The dynamics of the environment are meant to bring about a calming and soothing effect for expectant mothers, said Samantha McCormick, a nurse midwife and owner of the center.

McCormick believes the relaxing environment of a birthing center provides the optimal experience for a mother to give birth and a baby to be welcomed into the world.

"We like to provide an environment similar to what got the baby (conceived)," McCormick said. She sees birth centers as an alternative to hospitals.

"For some women, hospitals make them anxious, and a relative may have died there," she said.

Not For Everyone

Birth centers typically only accept low-risk pregnancies. This excludes women who have gestational diabetes or high blood pressure, McCormick said.

Expectant mothers may choose a birth center because of the overall experience.

"In a birth center, the baby never leaves their mother's side," McCormick said. "Birth centers don't have nurseries. Some women feel uncomfortable with having a baby taken to a nursery." Water births, which are also offered at many birth centers, provide an ultimate relaxing experience, she said. Proponents say they reduce blood pressure, provide significant pain relief, promote relaxation and reduce the need for drugs and intervention.

Forming A Bond

Midwives also strive to form a bond that allows them to gain the trust of their patients.

Kelli Gaines, a nurse midwife at Huron Hospital in Cleveland, knows all about gaining the trust of her patients.

Gaines typically works alongside a physician, but she said her approach is more personal, because she does not see as many patients.

During a recent encounter with an obese patient who wanted birth control, Gaines took the opportunity to talk to the woman about her weight and asked if she wanted to become healthy. She subsequently referred the patient to a dietitian.

"A lot of times, I am all that they have," Gaines said. Because her hospital is located in one of the poorest cities in the U.S., many of her patients do not have many resources.

"Nurse midwives are a little more approachable," she said. "People sometimes feel intimidated by a physician."

More Than Pregnancy

Elizabeth Stein, a certified nurse midwife who has her own practice in Manhattan, agrees.

Stein's practice offers services for prenatal care, labor and delivery, postpartum care, breast-feeding, family planning, gynecology, sexually transmitted diseases, infertility and menopausal care. She provides care to a lot of women who are not even pregnant.

"Seventy-five percent of my practice is basic well-women care," Stein said.

As a nurse midwife, however, she believes she is given an opportunity to provide her patients with information that may not be provided during the typical doctor-patient relationship.

"I like working with women," she said. "I like to educate and empower people."

McCormick, who is married to a gynecologist, added that malpractice insurance affects the care that doctors provide.

"I pay 10 percent of what my husband pays in malpractice insurance," she said. "I can afford to take more time with patients."

McCormick added that, often, doctors have more invested with education and overhead costs. It simply comes down to seeing enough patients to meet financial obligations and determining how much it costs to keep an office open.

Different Kinds Of Midwives

On the other hand, nurse midwives have to be more discriminating in who they will care for, because they are not trained for certain problems.

Nevertheless, if a woman's health history makes her a good candidate for a nurse midwife, she should understand the three categories of midwives.

A certified nurse midwife must have a nursing degree and then complete a program accredited by the American College of Nurse Midwives, as well as a national examination.

A certified midwife completes a national program and must pass the same test as a CNM but does not necessarily hold a nursing degree.

A lay midwife does not have any certifications or hospital admission privileges. However, she is more likely to deliver a baby in a home, similar to a doula.

A doula is someone who works to protect the sacred environment of birth and post-partum, according to doula Barbara Herzberger. That can include teaching breast-feeding and even home assistance for the first night.

Stein said it is important to check a prospective midwife's credentials.

"I am a CNM, and I feel that CNMs are the best and safest choice when choosing a midwife," Stein said. "Please choose carefully." Other Links:

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