Midwives in Pittsburgh
Article by Natalie Watson, Community Midwife and Candidate for CPM, Steel City Midwives
My introduction to midwifery was in 2007 with the, now relocated, “Mr. Midwife”, Patrick Thornton. This was two years before my husband and I started our family, but I wanted to get plugged in with someone that could potentially provide pregnancy care for me in the future. Patrick and I talked about all of the usual gynecological things; plus my overall health, my relationship, my work, and my wants regarding family planning. I also received a Pap Smear and breast exam that day. All together, the appointment took about 45 minutes and I left feeling confident, safe, and heard. I was lucky because at that time, most twenty-somethings didn’t even know midwives existed. Not only had I stumbled across what is currently considered by the World Health Organization to be the global gold standard for maternity care, I had discovered that midwives can also offer well-person gynecological care.
Southwestern PA has become a medical hub with many high tech facilities and hospital systems over the last 20+ years. Each area of health has its specialties and Midwifery is a specialization in and of itself. Just like obstetricians are providers that have a surgical expertise as part of their offerings, Midwives are experts in normal physiological birth. They are specifically trained to support birthing bodies and vaginal deliveries. In Pittsburgh there are 3 distinct types of Midwives providing different ranges of services. Each of these offshoots of Midwifery are coming from different training backgrounds, and serving in different locations.
Certified Professional Midwives
Steel City Midwives is an example of a Certified Professional Midwife (CPM) practice in the region. Karen Crow and I each have BA’s in non-nursing fields that we worked in before transitioning over to being birthworkers. We were both Doulas and Childbirth Educators before beginning our formal midwifery training. We spent 3 years studying and training with a North American Registry of Midwives (NARM) preceptor and now provide homebirth services. We are Waterbirth International Certified, maintain current NRP/CPR, and serve families living within a 1 hour radius around Pittsburgh. We provide full perinatal care to low risk pregnancies, and if a client’s pregnancy moves beyond our scope of practice, they may need parallel care with a physician or to transfer to an Ob/gyn or MFM for a hospital birth. We are fully autonomous and able to provide midwifery care per our own private practice policies. Since we are not practicing in a hospital setting, we do not offer IV, epidural, or nitrous pain management. Steel City Midwives also always stays with clients for any home-to-hospital transfers in labor. CPMs function under the PA 1929 midwifery statute. Currently 35 states regulate CPMs, but Pennsylvania does not because of the large Amish/Mennonite population in the state. I plan to be sitting my NARM exam this summer and Karen has full CPM designation.
The second type of midwives practicing in the Pittsburgh area are Community/Traditional Midwives. Like CPMs, their specialization is normal physiological birth in the out-of-hospital/homebirth setting. They function the same as CPMs in their offerings, but are trained by apprenticeship, self-study, etc.
Many Traditional Midwives are bringing cultural practices into their midwifery services and may have a variety of educational backgrounds. Michele James-Parham of Amethyst Midwitchery & Womencraft has been a Traditional Midwife for over 20 years. They’re based out of their Northside home office and offer perinatal primary care, well-person gynecological care, LGBTQ+ specialized care, herbal products, and much more. They are a fixture in the Pittsburgh homebirth community and provide volunteer midwifery services at The Free Clinic for the People. Michele primarily trained in Oklahoma under a Traditional Mexican Abeula Midwife. Michele also maintains their NRP/CPR, participants in continuing education, and does peer review. Community/Traditional Midwives are also fully autonomous in PA and able to provide midwifery care per their own private practice policies. These policies will vary based on the midwife.
Certified Nurse Midwives
The third type of Midwives working in Pittsburgh are the most abundant. Certified Nurse Midwives (CNM) are all Registered Nurses that then received at least their Masters degrees in midwifery. You will find them working at UPMC Magee Hospital, AHN Jefferson Hospital, and UPMC Horizon – Shenango Valley, among others. The CNM’s at these locations are primary maternity providers that will catch/deliver your baby, but do not perform surgical, vacuum, or forceps deliveries. Because they work in the hospitals, they are able to offer medications and epidurals for pain management.
They can also provide basic gynecological/well-person care, write prescriptions, and consult with Ob/gyn’s or Maternal Fetal Medicine (MFM) physicians for moderate risk situations. If your pregnancy or labor/birth becomes high risk, you will need to be transferred out of their care, or in some instances, need to also see MFM in a co-care capacity. Although they are your primary provider, these CNMs are employees if their hospital system and not in private practice. This means they are not autonomous in their ability to make decisions regarding your care. They have to follow hospital policy and they have an Ob/gyn that is collaboratively overseeing the midwifery group per PA state law.
The Midwife Center is only freestanding birth center in Western PA and it, too, is served by CNMs. These midwives have the same training, scope and designation as the aforementioned midwives working at the hospitals. In addition to having rights to practice at UPMC Magee-Womens Hospital and/or transfer with clients there in labor, The Midwife Center is a nonprofit that catches babies at their Birth Center in the Strip District. They offer a wide range of services including a walk-in-clinic on Fridays and waterbirth for those that meet The Midwife Center’s criteria. Since the Birth Center itself is not a hospital, they are unable to offer epidural pain management at that location. However, they do have IV pain medication and Nitrous Oxide (laughing gas) available. Although a private practice group, the midwives at The Midwife Center are not autonomous and have an Ob/gyn group from UPMC Magee-Womens Hospital that collaborates with them per PA state law.
Our city truly is full of great options for midwifery care. Homebirth, Birth Center birth, medicated hospital birth, waterbirth, and basic gynecology are all at our fingertips. Make sure to research whatever practice you feel drawn to and know that there are Midwives in Pittsburgh to support you.
Article by Natalie Watson, Community Midwife and Candidate for CPM, Steel City Midwives. For more information, please email them at firstname.lastname@example.org or call 412-345-3726. You can also connect with them on Instagram or Facebook @steelcitymidwives. Please tell them