Midwifery Care

While doctors budget their time to deal with pregnancy complications, midwives have the luxury of spending time on a broad spectrum of concerns that pregnant women have. At each prenatal visit, their goal is to discuss whatever is on a woman's mind — from birth plans to choosing a car seat.

More and more women are choosing to place their prenatal care, labor and delivery in the hands of a midwife, usually in a hospital rather than at home. Nationwide, there are more than 7,000 midwives who participate in 10 percent of the births.

UCSF Medical Center was in the forefront of midwifery care and has a 30-year tradition of including midwives as part of the obstetrical team, where they provide care for pregnant women, attend births and teach as part of the UCSF faculty.

At UCSF, midwives and doctors work together. If your pregnancy becomes high-risk or complications arise, you don't have to abandon your midwife. You can continue to see your midwife and see an obstetrician or perinatologist for management of complications.

A common misconception is that women choose midwifes only if they want a "natural" or unmedicated childbirth. Although assisting in natural childbirth is one of their strengths, their primary goal is to help you make your choices.

Midwives are trained to see childbirth as a normal, healthy event. They favor avoiding procedures and medical interventions whenever possible, which has resulted in positive effects on the culture of labor and delivery at UCSF. For instance, episiotomies, a surgical cut between the vagina and the rectum, made during the final stages of labor and delivery, used to be standard. Now, it occurs in only 5 percent of births at UCSF. This shift was due in part to the influence of midwives and the open minds of doctors who work with them.

At UCSF, midwives serve patients at all four obstetrics clinics.