Frequently Asked Questions (FAQ)

What is a Certified Nurse-Midwife (CNM)?

A certified nurse-midwife (CNM) is a registered nurse (RN) with advanced education in midwifery. CNMs are highly-skilled medical professionals who are qualified to provide excellent care for women and babies. Today, more than 40 major colleges and universities offer either certificate or master's degree programs in nurse-midwifery. All CNMs become certified by passing a national examination with rigorous standards and must meet individual state licensure requirements, including continuing education. In order to ensure safe and effective patient care, CNMs strive to obtain the highest level of expertise. In the state of Maryland, CNMs have prescription-writing privileges, expanding their ability to provide comprehensive care to women.

For more information about CNMs, please visit the American College of Nurse-Midwives website:

If I choose a certified nurse-midwife rather than an obstetrician, how will my care be different?

At Midwifery Care Associates (MCA), we believe that there is more than one way for a woman to receive safe and fulfilling healthcare during the childbearing period. Women who are interested in highly personalized attention with a focus on shared decision-making may find midwifery care to be a great fit. As certified nurse-midwives, we strive to educate patients about the benefits of viewing pregnancy, labor, and birth as normal processes.

We believe that minimizing routine interventions, when appropriate, can often lead to a safer and more fulfilling patient experience. However, we also value our training in the quick recognition of what is abnormal, and that which may need further attention. Our physician colleagues at Simmonds, Martin & Helmbrecht are committed to respectfully collaborating with us when complications arise, so that the benefit of having a midwife never comes at the cost of quick access to advanced care.

As midwives, we have a great respect for the intuition of women and right of every woman to make the decisions that are right for her and her family. We also have a great appreciation for modern technology when used appropriately and judiciously.

The midwifery model of care has been shown to produce excellent health outcomes for women and babies, with a high rate of patient satisfaction. For the vast majority of MCA patients, the care of certified nurse-midwives is more than adequate for the entire course of one's pregnancy, labor, and delivery. Except in very complicated scenarios, patients will not need to have visits with our doctors.

Why would I need a midwife when I'm not having a baby?

Contrary to common belief, a woman does not need to be pregnant or planning pregnancy to benefit from midwifery care. Certified nurse-midwives are trained and licensed to provide a full range of women's health care from adolescence through the post-menopausal years. We offer preventative well-woman visits annually to patients of all ages. Sexual health counseling (including review of contraceptive options and testing for sexually transmitted infections), cancer screening (including the Pap smear), and visits to discuss gynecologic problems are among the services offered by our midwives.

Where do the midwives of MCA deliver?

We attend births at Shady Grove Adventist Hospital in Rockville, Maryland and Frederick Memorial Hospital in Frederick, Maryland.

Both facilities provide exceptional patient care for mothers, babies, and their families with state-of-the-art services.

Do you attend VBACs (vaginal birth after cesarean)?

The certified nurse-midwives at Midwifery Care Associates offer the option of a trial of labor after cesarean section (TOLAC) to patients who are appropriate candidates for vaginal birth after cesarean (VBAC). With the support of our collaborative physicians, interdisciplinary colleagues, and the practice guidelines of our professional organizations, we strive to offer women who have undergone one or two cesarean deliveries choices in how they want to deliver during the current pregnancy. If you are interested in TOLAC/VBAC with our practice, we request that you obtain records from your previous provider for your first visit. We will review them thoroughly to determine whether TOLAC/VBAC would be a safe option.

What are your cesarean rates?

We are asked this question regularly and are proud to publish our most recent rates:

  • Primary cesarean rate (women having their first cesarean birth): 6%
  • Total cesarean rate: 12%

Percentages of live births with specified method of delivery per 100 live births:

Cesarean Rates


Source of U.S. Cesarean Rates: Birth Data Files, 2015 User's Guide,

Do you attend breech births, twins, or water births?

We are not currently attending breech births or the births of twins. If these are identified during the course of your pregnancy, we work with our consulting physicians to develop a plan of care.

Although we offer hydrotherapy (use of the tub and/or shower) during labor, we do not currently attend waterbirths.

If my baby is delivered by a midwife, can I still get an epidural?

Epidural pain relief is the most common method used in hospitals during labor. As midwives, we believe that every woman has the right to determine what pain relief is best and safest for her. Many women may choose comfort measures for labor pain that do not involve medication, including position changes, heat therapy, hydrotherapy, and relaxation techniques, to name a few. However, others decide before or during labor that the assistance of pain medications will make labor and delivery more enjoyable. The CNMs at MCA will provide guidance and counseling to patients to equip them with the information needed to make these very important decisions. We will support your choices.

What happens if there is an emergency during my delivery?

Certified nurse-midwives have extensive training in the labor and delivery process. The midwives at MCA are equipped to quickly recognize abnormal signs and symptoms and initiate the appropriate measures. Identifying risk factors that may increase complications during childbearing is an important component to preventing such emergencies. The assessment of each woman's risk status may begin even before her pregnancy and continues into the postpartum period. If an emergency occurs while under the care of the MCA midwives, our physician colleagues at Simmonds, Martin & Helmbrecht are immediately at our disposal to provide high-risk care and surgical interventions such as cesarean section.

Can I select a specific midwife to work with?

The CNMs at Midwifery Care Associates work as a seamless team. In order to serve as many patients as possible, we function on a rotating schedule for your prenatal care. During the course of your pregnancy, you will have the opportunity to meet all of our midwives. We want you to be comfortable with the care of our entire team. Depending on the length of labor and time of day, you may see more than one midwife. We invite you to make your annual well-woman visits with the midwife of your choice.

I'm several weeks pregnant and have been going to another practice. Can I switch to your practice?

Yes. We accept pregnancy patients into our practice regardless of how far along you are in your pregnancy. To get the process started, please call our office. You will then need to send us your complete medical records from your current provider, including labwork and ultrasounds.