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Melanie Cole (Host): Have you ever wondered what a midwife does, how they’re trained, or if that’s the right choice and option for you? My guest today is Bethany Smith. She’s the Director of Midwifery Services at Greenville Health System. Welcome to the show, Bethany. What is a midwife?

Bethany Smith (Guest): Thank you for having me on. A midwife means “with woman” and contrary to popular belief, not all midwives are women. Midwife means “with woman” and we do everything possible to support women throughout the health spectrum whether they’re trying to have a baby, whether they’re going through menopause, we’re here to support women throughout their health spectrum. Our primary focus is on women during their childbearing years and helping families prepare for their new arrivals but we provide a variety of options; include birth control, health maintenance, menopause care. But like I said, we mostly focus on normalcy and woman care in providing that support during labor and birth.

Melanie: So, many women think that you are just there to deliver a baby but, as you just explained, there’s a lot more. When would somebody come and see a midwife for the first time? If there’s somebody who’s planning on trying to get pregnant, when is the first visit?

Bethany: We have a lot of couples that come to see us for what we consider preconception visits and that is before they’re pregnant. They come to establish care, get to meet us, ask any questions they may have before getting pregnant. We review their medical history and make any recommendations that we feel may help them be successful. But, a lot of people come see us after they’ve already gotten pregnant. They take that pregnancy test and they’re excited and it’s positive. We’re typically the second call after their husband to get an appointment and establish to come in and start their prenatal care. So, we provide the care throughout their entire pregnancy and then we provide the labor and the birth support and care as well.

Melanie: What kind of training do midwives receive?

Bethany: The training for midwives can be wide varied depending on the state and the rules of the state. At Greenville Health System, the nurse midwives here, we’re all certified and so we all have a background in nursing and all have Bachelor’s Degrees in Nursing and went back to school for further training. And, we wall have master’s degrees in Nurse Midwifery.

Melanie: So, then, how do you work with a woman because they typically think of seeing their obstetrician-gynecologist for those checkups while they’re pregnant, getting ultrasounds, whatever it is that they need? What is it you do that is different than an OB/GYN?

Bethany: That is probably the number one question that we get. What makes us a little bit different from a traditional OB-GYN is kind of that hands-on, that more personal TLC touch that we provide. I always tell couples and families you’re not lacking in any sort of care by coming to see nurse midwives. We have the skills and the training and the background to keep things normal when they are normal. But, when things do not go according to plan or when high-risk situations occur, we do have physicians that are a phone call away that can help us. As nurse midwives, we’re able to order lab testing; we’re able to order ultrasounds and referrals; we’re able to order epidurals or pain medicine if that is needed during labor and birth. Being a part of such a larger health care system, we have many different specialties kind of at our fingertips that we can use and call if we need backup and support. So, most women that are healthy and don’t have high-risk pregnancies are candidates and can come and see a midwife for their care.

Melanie: And, Bethany, when it gets closer to the time of delivery, what do you tell women that might be skeptical or a little nervous about delivering with a midwife versus being in the hospital with a doctor?

Bethany: So, our practice of midwifery care, we have dual delivery options. We have some women that choose to deliver at our birth center which is right across the street from the hospital and those options there are for women that want an unmedicated birth or do not want the option of drugs or epidurals or pain medicine. We also deliver in the hospital as well and the majority of the women are still choosing that option just so that they can have every option available at their fingertips, whether they want to have a water birth, whether they want an epidural, women can get all of those options with the midwife through our care. And, so, for couples or women that are skeptical or nervous or unsure if unmedicated birth or natural birth is for them, you know, we always tell everyone to do classes, to do as much research as you can on the front end and, in conjunction with us kind of helping you throughout the process. We can kind of help you figure out what the best options are for you. And, in the moment, if your plan was originally to have unmedicated birth and your plans change, that’s the beauty of being right there. We can call anesthesia and we can order an epidural, if you so desire. But a lot of women when they’re pregnant, if they set their minds to doing something, the majority of the time they’re successful at doing it.

Melanie: And, what if there are complications?

Bethany: That’s a good question. We all know that things don’t always go according to plan and not everything happens low-risk and without any issues. And so we have a great group of physicians in the OB-GYN department that we collaborate and work with. And, the beauty is that they are already at the hospital 24/7 in the event of an emergency. We have a great collaborative relationship with them. So, in the event someone needs a C-section or there’s an emergency or something that the midwife feels she needs more hands or she needs a physician to help her with, they’re literally a phone call or a text away.

Melanie: And, then, how do you foster that relationship with women and even their newborns following the delivery?

Bethany: We do a lot of support for women after the delivery while they’re in the hospital and even once they go home. We have breastfeeding support groups here at our office. We have all of our women come in typically one to two weeks after the delivery just to check in and see how they’re doing and make sure that breastfeeding is going well, make sure the family is adjusting well. We’re always available for phone calls at any point. A special part of our care for some of our women who decide to deliver at our birth center, they get additional phone calls on a daily basis and sometimes a weekly basis when they go home just to make sure that adjustment is going well. We really make it a point to get to know the entire family and making sure that the siblings are adjusting well, the pets are adjusting well, the spouses are adjusting well, and that the family as a whole is intact with this new person joining the group.

Melanie: So, how long can you or do you usually typically be involved with the family?

Bethany: From when they first hire us or join our practice, whether that is before they’re pregnant or after they get pregnant, for the rest of their lives. And, like I said, a lot of our women after they deliver and finish their pregnancy care choose to stay on with us and do their well-woman GYN care with us and we switch over and start, instead of talking about baby checkups, we talk about birth control and Pap smears. So, it’s a very seamless transition throughout our practice. So we keep those connections there with the majority of our families.

Melanie: And, Bethany, what would you like the listeners to know about midwives? What do you think is one of the biggest myths that you can bust up for us just now? Why should they look to Greenville Health System for their care?

Bethany: I think one of the biggest myths is that midwives are women who do homebirth or you have to choose a midwife or you can only choose a midwife if you want to be drug-free or you don’t want an epidural or if you, you know, you’re really hippie and you only eat organic, but a midwife can be anything a woman needs her to be. Our goal is to support women in whatever their goals are for themselves during their pregnancy and during their special time, so it’s not really about us, it’s about what we can best do to help women. But, I think that’s the biggest myth that we do homebirths and you cannot have drugs if you come see a midwife.


Melanie: And, tell us about your team at Greenville Health System.

Bethany: So, our team of midwives here, there are six of us full time midwives currently. And so when a family chooses to come to the midwifery practice, they do not just have one midwife that they see. They become part of the family and they get to have visits and get to spend time getting to know each of the midwives because we all share equal responsibility and we want to know the patients, then we want the patients to know the midwife so you know in advance who could be potentially be with you during labor and it will always be one of the midwives that you’ve gotten to know throughout your pregnancy.

Melanie: Thank you so much for being with us. What an interesting topic. Thank you, Bethany, for being with us today. You're listening to Inside Health with Greenville Health System. For more information, you can go to www.ghs.org. That's www.ghs.org. This is Melanie Cole. Thanks so much for listening.