Man of the hour: Would you have a male midwife?

Midwifery is a field long dominated by women — hence the name — with females comprising more than 99% of certified nurse-midwives (CNMs) in the US. Yet, this April, Peter Johnson, Ph.D., CNM, of Boones Mill, Va., took the reins as the first male president of the American College of Nurse-Midwives.

Though many Americans may be unfamiliar with midwives beyond the brilliant British drama series “Call the Midwife” on PBS, having one at your side — male or female — may be very useful.

Midwives are advanced nurses who provide comprehensive reproductive and maternity care. As of 2021, midwives attend around 12% of US births, and that share is rising.

“Midwives are essential today because they deliver high-quality, relationship-centered care at a time when access to maternity and women’s health services is shrinking and outcomes are worsening,” said Johnson. “Decades of research show that midwifery-led care is associated with excellent outcomes, lower intervention rates and high patient satisfaction.”

The new ACNM president’s midwifery path started as a young nurse in the US Air Force when he was assigned to a hospital maternity unit, around the same time he became a father.

“I was struck by how profound the transition through pregnancy and birth is,” recalled Johnson, adding that he was unsettled by highly medicalized maternity care, often at the expense of the human experience. “It was in that setting that I met practicing midwives for the first time — I was immediately impressed,” he said, ultimately applying to the Air Force midwifery residency in 1984 and becoming a CNM in 1985.

Andrew Youmans, CNM, RN, of Ferndale, Mich., is another man who is passionate about midwifery. The registered nurse and Ph.D. candidate at the University of Michigan School of Nursing, fell into the profession by chance.

While searching for clinical jobs in 2012, he started working as a tech in labor and delivery. He also found work as a nurse in another local emergency department in Georgia. At the ER, he noticed how many women used the emergency department for prenatal care due to being underinsured or having no insurance.

He also noticed how uncomfortable the emergency department clinicians were with caring for pregnancy. These experiences inspired him to pursue midwifery, graduating from Frontier Nursing University in 2014. (Nurse-midwives become RNs first, then attend a graduate program at a masters or doctoral level before becoming Advanced Practice Registered Nurses as Certified Nurse Midwives.)

Youmans takes pride in the palpable impact he has on his patients’ lives. As a midwifery student, he said he will never forget the time he did a prenatal ultrasound on a deaf patient.

“I took a few extra minutes and turned the volume all the way up on the Doppler device and placed the woman’s hand on the speaker so that she could feel the thumping of her baby’s heartbeat,” he said. “She got a big smile on her face and began to cry since this was the first time, in any of her pregnancies, that she had ever felt her babies’ heartbeat, and she was so appreciative.”

Still, as a male in the field, Youmans is aware that some patients are hesitant to be in his care. “I learned to focus on ‘reading the room’ and being very aware of a patient’s comfort level and tailoring the care to match that,” he added.

Youmans urges women to consider what you expect from a midwife. He suggests asking yourself questions like: “Is the midwife, or other clinician you are seeing, respectful?” and “Do they listen to your questions and concerns and communicate answers effectively?”

“Midwifery should be a profession open to all who support providing people respectful care and supporting women,” he added.

Echoing that sentiment, Johnson noted that what matters most is that you are working with someone trained to provide respectful, evidence-based, relationship-centered care. As a society, Johnson stressed that we’ve moved beyond defining professions like law, engineering or medicine by gender, and he believes midwifery will follow suit. It “should be seen as a meaningful and viable career for anyone with the passion, skill and commitment to practice it well.”

Kathleen Dowd, CNM, a nurse practitioner from Sausalito, Calif., and founder of Gentle Touch Wellness, a midwifery-owned virtual practice, has over 30 years of experience in the field.

She describes a midwife’s role as meeting people where they are, listening to them and respecting their right to make decisions.

“We don’t use medical intervention unless it is medically necessary; medical intervention can be life saving, but it always comes with risks,” she said. “We treat pregnancy and birth as normal, we respect a woman’s body to know what to do in most situations. We are vigilant about watching for deviations from normal, and acting when appropriate.”

Dowd, who is also the founder and co-chair of the California Nurse Midwives Foundation, noted that “most countries have midwives as the main providers of prenatal and birth care, and all have better outcomes than the US [which] has the worst maternal health outcomes of any industrialized nation,” she said.

Dowd vividly remembers being educated alongside the first male midwife to attend the University of California, San Francisco. “Men get the same training and they are enculturated in the same philosophy of care,” she said. “I don’t think it’s about sex, it’s about the practitioner themselves.”