Episode Transcript
Amanda Sauer:
I did speak a lot about how we do low intervention, low risk. If you want all the things, we do all the things too. So, if you go into pregnancy care and you want to be induced as soon as possible, you want all the medications, you want the epidural, you want all the things – as midwife, we’re there for you to support what you want.
Courtney Collen (Host):
Hello and welcome to “Her Kind of Healthy,” a podcast series brought to you by Sanford Health. I’m your host, Courtney Collen, with Sanford Health News. We are starting new conversations about age-old topics from pregnancy to postpartum, managing stress, healthy living and more. “Her Kind of Healthy” is here to bring you the honest conversations about self-care, happiness, and your overall wellbeing with our Sanford Health experts.
In this episode, we are learning about midwifery and the practice of caring for women in pregnancy, newborns, and also families. If you are a patient exploring provider options and maybe you’re wondering if a midwife would be a good fit, you have come to the right place. Here at Sanford Health, we are so fortunate to have so many wonderful midwives across the region, and Amanda Sauer is one of them in North Dakota. She is a certified nurse-midwife at the Southpointe Clinic in Fargo, and she is here for this conversation. I’m so happy to have her.
Amanda, welcome.
Amanda Sauer:
Thank you.
Courtney Collen (Host):
To start, I’d love to hear about your journey to becoming a midwife, specifically your education and your training, but also what inspired you to pursue this field of health care?
Amanda Sauer:
Initially, I was first a nurse. When I was working as a nurse, I was working at a small hospital, a critical access hospital, that included labor and delivery. Labor and delivery was the area that I loved the most. And we had a certified nurse-midwife that was working there. And I loved being a part of her deliveries. I loved everything about them. As I watched her deliveries, I kind of grew in my desire to want to be able to do more for women. That kind of led me to my path of becoming a nurse-midwife. I took my education further. I went to graduate school, got my master’s and specialized in nurse-midwifery.
Courtney Collen (Host):
What is the difference between an OB/GYN and a midwife?
Amanda Sauer:
So an OB/GYN is a doctor. They went through medical school. They went through that residency. They specialized in OB/GYN. They specialize more in like the high-risk OBs, high-risk pregnancies. They also do surgery, so they can do C-sections, they can do operative deliveries.
As a midwife, we focus more on the fact that pregnancy and labor is a normal thing. We focus more on the low risk, the low intervention pregnancies and labors. Like I said, we view labor and pregnancy as a normal thing. And we’re trained to recognize when things deviate from that normal. And when those deviations happen, that’s when we intervene.
Courtney Collen (Host):
Correct me if I’m wrong, but there are different types of midwives, is that right? And you are a certified nurse-midwife. Can we just talk through briefly the different types of midwives and what makes them all unique?
Amanda Sauer:
Yeah, so there’s three main types of midwives. There’s the certified nurse-midwives (CNM), the certified midwives (CM), and certified practical midwives (CPM). CNMs and CMs are kind of similar in our training. The CNMs are unique as we were nurses first. But both CNMs and CMs go to graduate school. We either have our masters or our doctorates and then we go on and complete a national certifying exam. And we are nationally certified.
CPMs are a little different. They don’t have that formal education. They’re more trained through apprenticeship. So they go with another midwife that’s been a midwife for about three years. They do more out-of-hospital births and home births. They don’t have that formal training and they don’t take that formal certifying exam that the CNMs did and CMs did. But they are certified in their own way. CPMs can only do home births where nurse-midwives and certified midwives can do home births if we want to, but we also do hospital births and birth centers if we want to.
Courtney Collen (Host):
Let’s talk through the prenatal, labor, delivery and postnatal care that you provide as a midwife at Sanford Health.
Amanda Sauer:
So I do all of it. We can do preconception care. We can do the normal routine prenatal care. We manage our own patients in labor and delivery, and then we also do the postpartum care, as well.
Our visits tend to last longer than an OB’s visits would. We like to spend more time with our patients. We like to spend more time doing education, getting to know our patients, doing like anticipatory guidance, letting them know what to expect with what’s coming up in their pregnancy. Kind of preparing them for when they’re in labor and then helping support them through labor and birth as well. At least for the certified nurse-midwives, we were nurses first, so we like to have that patient interaction. We like to do that bedside care. So we like to provide that labor support while they’re in labor and then be there for the end, too.
Courtney Collen (Host):
So you’re really there for the whole process almost, which is really, really cool. What do you, Amanda, love most about providing this type of care at Sanford?
Amanda Sauer:
The part of it that I love the most is the labor support. Here in Fargo we manage the triage and we do the postpartum care, but if I’m not busy in other areas of the hospital, then I really try to be at the bedside with my patients. I like to support them through that labor process and be as present as I can. Studies have shown that having the midwife be there and be present throughout the labor process can decrease the chance of needing interventions.
Courtney Collen (Host):
Yeah, I’m sure they appreciate that too, having you there bedside. If I’m shopping around for a provider and maybe looking to grow my family, how would I know that a midwife is the right care provider for me?
Amanda Sauer:
I think the best way to know if a midwife would be the right care provider for you would be to make an appointment with a midwife. We do a lot of pregnancy care, prenatal care, but we do care outside of pregnancy as well. We do wellness visits, we do preconception visits, we do contraception counseling and things like that, too. So if you’re ever wondering if a midwife would be a good fit for you just make an appointment with us. It could be a preconception counseling, it could be anything, a wellness visit, whatever you need.
Courtney Collen (Host):
Sure, thank you. How do midwives collaborate with physicians who specialize in obstetrics or OBs? Is there a collaboration for care at Sanford?
Amanda Sauer:
There is. Here we collaborate a lot with the maternal-fetal medicine doctors. But we collaborate with the OBs as well. So like I said before, midwives focus on the low-risk pregnancies. But things happen in pregnancy there. Things can change. Your pregnancy can turn into a high-risk pregnancy. And there are certain conditions that we can’t manage on our own and we would have to collaborate with an OB or maternal-fetal medicine.
And an example would be gestational diabetes. If the pregnancy outside of the gestational diabetes is a healthy pregnancy and the baby’s growing appropriately, it’s completely appropriate for the midwife to continue to do the routine prenatal care. And then having either maternal-fetal medicine or the OBs manage the part that makes the pregnancy a little more high-risk, like the gestational diabetes portion. So they would monitor that aspect of the pregnancy while the midwife manages the rest of it.
Courtney Collen (Host):
One of my first podcasts at Sanford was with Megan Bergers, who is a certified nurse-midwife down here in Sioux Falls. And we talked all about low-intervention birth options at Sanford. And I didn’t know anything about low intervention birth. And that’s one thing that really makes the birthing process unique is being able to kind of choose your own, I don’t know, lack of better words, settings, you know. Can you kind of speak to that and elaborate more on that low-intervention option that I know midwives are really proud to offer at Sanford Health?
Amanda Sauer:
As a midwife, we’re trained to view pregnancy and labor as a normal and natural thing. Going into your own natural labor, it’s a normal process. And we are trained to support that natural physiologic process. If you go into your own spontaneous labor and things are progressing normally there’s no reason for us to intervene. Not everyone needs their water broken. Not everyone needs Pitocin.
Sometimes once you get to the hospital, everyone kind of gets all anxious and thinks that things need to be put on the clock and things need to progress in a timely manner. As long as that labor’s occurring spontaneously and things are progressing, there’s no reason for us to intervene as long as both mom and baby are healthy.
Courtney Collen (Host):
I love the perspective that, you know, birth is a normal and natural thing. I just went through it nine months ago. So I love seeing what our bodies are capable of doing. And then having the care support kind of around you, whether it be midwives or obstetrics or nurses in the room for that support. Amanda, just like shopping around for any health care provider, for example, in pregnancy – what are some questions that we should be asking before we choose a midwife?
Amanda Sauer:
I think before going into your first prenatal appointment, I think it’s important to think about what’s important for you out of your pregnancy care. If you have strong desires or things that are very important to you, I think it’s important to bring up to whoever you’re wanting to see just to make sure that your desires would match up with that specific provider. If you’re going down the midwife route, I think it’s important to have a conversation about “What would happen if my pregnancy does turn high risk? If I have to transfer over to one of the OBs, what would that look like? Would I still get that support from the midwife or would I have to cut ties completely? What would my prenatal care look like?”
Courtney Collen (Host):
Yeah, there’s so much to think about, but I do love that there are so many options at Sanford. Do you feel that way too as a provider, assisting your patients or supporting your patients in that way?
Amanda Sauer:
Yeah, there’s someone here for everybody. I know here in Fargo we have a lot of different OB/GYNs. We’ve got a lot of different midwives. The midwives here, we all kind of share patients. So usually they see each of us at least once throughout their pregnancy. But then on the OB/GYN side, there’s a bunch of them. So even if you start your prenatal care with one provider, and if you feel like you’re not meshing well, you can always switch and meet with another provider too and see if you mesh a little bit better with that other provider.
Courtney Collen (Host):
Sure, thank you.
Amanda Sauer:
If you’re questioning midwifery care or you are unsure about anything, make that appointment with us. I did speak a lot about how we do low intervention, low risk. If you want all the things, we do all the things too. So, if you go into pregnancy care and like you want to be induced as soon as possible, you want all the medications, you want the epidural, you want all the things. As midwife, we’re there for you to support what you want.
So, if you want all the things, as long as it’s safe and reasonable and evidence-based, we’ll allow that as well. So just because we’re midwives and we’re low intervention doesn’t mean that we can’t do all the things if that’s what you want of your pregnancy care.
Courtney Collen (Host):
Amanda, thank you so much.
Amanda Sauer:
Thank you.
Courtney Collen (Host):
To learn more about certified nurse-midwives providing care near you or to book an appointment, visit sanfordhealth.org. This was the “Her Kind of Healthy” podcast by Sanford Health. I’m Courtney Collen. Thanks for being here.
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Posted In Fargo, Nursing and Nursing Support, Pregnancy, Women's
