At Swedish, midwives’ expansive role in care is helping build community
[5 min read]
In this article:
- Providence Swedish is home to a robust midwifery practice that includes 17 Certified Nurse Midwives.
- Certified Nurse Midwives provide pregnancy and childbirth care, as well as postpartum and well-woman GYN care.
- Mary Mittell, Swedish's medical director of midwifery, shares more about the unique role of these clinicians and how they support respectful, patient-centered care for birthing parents at Swedish.
Midwives are a critical, and sometimes misunderstood, member of obstetrics and gynecology care teams. In popular culture, midwives are stereotypically cast as the folksy and wise aunties who roll up their sleeves to help bring babies into the world, but midwives are, in realty, highly trained clinicians who play much larger roles in primary and specialty care.
At Swedish, Certified Nurse Midwives (CNMs) at First Hill, Ballard and Issaquah not only attend births and help prepare patients and their families for parenthood; they also provide expert, comprehensive women’s health care, including ante and postpartum care, primary care, annual exams, birth control counseling, menopausal care, breastfeeding support and more.
During October, we celebrate National Midwives Week. To learn more about this profession and how Swedish is leaning into this year’s theme of “Strengthening Communities” we spoke with Mary Mittell, CNM, Swedish’s medical director of midwifery. Mittell helps lead a team of 17 Swedish CNMs. She has been a midwife for 20 years and has worked with underserved communities in Seattle and El Paso, Texas. Mittell joined the leadership team of Swedish’s midwifery practice last summer.
Mary Mittell, CNM, Swedish’s medical director of midwifery, helps lead a team of 17 Certified Nurse Midwives at Swedish.
How did you come to midwifery?
I picked up a copy of “Our Bodies, Ourselves” in college and the chapter about pregnancy and childbirth discussed the different scopes of practice and philosophy in obstetrics and midwifery. I hadn’t known anything about it before, but what I read about midwives struck me as the truest, most important thing I had ever read. And I thought, “this is what I need to do.” It just seemed to me that everybody needs healthcare when they’re in their moment of need, and that birth was this important time where it was a medical, physical need and a family life event with a very high level of emotional need. I just knew that this is what I wanted to do. After college, I spent time in El Paso working with the immigrant community. I got a real sense of how race, class and immigration status affect our experience with the health care system, so I went back to nursing school and then to midwifery school. I have been attending births at Swedish for 15 years and have always had great respect for Swedish and their midwife practice.
Midwives are committed to foundational values like shared decision making, individual autonomy, informed consent. We also know that optimal care takes into account the specific needs of individuals. These guiding values remind us to be very humble about our knowledge and curious about our patients' experiences. Providing respectful, patient-centered care is an essential strategy for decreasing health disparities is something that midwives do really well.
What is midwives’ role in health care?
All the midwives at Swedish are nurses with a master’s degree in midwifery. We are nurse practitioners who provide pregnancy, childbirth and GYN care. We also provide postpartum care and well-woman GYN care. We also see non-OB patients for regular, non-pregnancy care. For pregnant people who are low to moderate risk, they can get all their pregnancy care — their prenatal visits, births, postpartum care, follow up, and birth control management, as well as care for common GYN problems. We work very closely with the OB/GYN practice at Swedish —we even share the same office space — and they are always available for consultation or to provide direct care to midwifery patients if complications develop.
What are some common misconceptions about midwifery?
When people hear midwife, they often think home birth or “natural” birth. It’s always a midwife who is attending these births, but most midwives’ work is hospital-based. At Swedish, all our midwives attend births at First Hill or Issaquah. We don’t do home birth at all. I’m also often asked if we are doulas. Doulas are amazing and have a complementary role on in the care team, but they have a different role on the care team. Doulas provide vitally important emotional and physical support during labor and postpartum; midwives do that as well, while being responsible for medical decision-making. Research shows that both midwifery and doula care bring all sorts of benefits to families in terms of lower cesarean rates, shorter labors, fewer interventions, higher breastfeeding rates, etc.
What are your goals for the midwifery practice at Swedish?
Research shows us that the more midwives are integrated into a healthcare system, the better the collective outcomes. My main goals are around really helping the midwifery practice grow so that we can reach more families. We also want to continue partnering with our obstetricians. Midwives and obstetricians are both experts in their respective fields and have complementary skills in caring for families. I want to keep improving our patients’ experience and ensure that families are connected with the best match in terms of their medical risk and personal preference. I would like to help families know more about midwifery, so that they know the breadth of services that we can provide. We're not just for pregnancy or families who want kind of minimal intervention. The majority of patients can benefit from midwifery care.
What role does midwifery play in support of our health equity work?
Midwives are committed to foundational values like shared decision making, individual autonomy, informed consent. We also know that optimal care takes into account the specific needs of individuals. These guiding values remind us to be very humble about our knowledge and curious about our patients' experiences. Providing respectful, patient-centered care is an essential strategy for decreasing health disparities is something that midwives do really well.
Learn more and find a provider
Every year, more babies are born at Swedish than at any other health system in western Washington. Visit our website to learn more about midwives at Swedish and how they can partner with you to create the most personalized birthing experience possible. Swedish has three birth centers — First Hill, Issaquah and Edmonds — making it convenient for people who live or work in the Seattle, Eastside and North End areas. Swedish patients can take classes, meet other families, get help with lactation and go for new parents and well-baby checkups at The Lytle Center for Pregnancy & Newborns at our First Hill birth center. You can also get expert advice there and help with wellness.
If you need a gynecologist, women's health specialist or primary care doctor, Swedish is here for you. Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.
Join our Patient and Family Advisory Council.
Additional resources
TeamBirth maternity program launches at Providence Swedish
Do You Know How a Midwife Can Help You?
Newsweek ranks Swedish among best U.S. maternity hospitals
U.S. News & World Report names Swedish Issaquah among best U.S. maternity hospitals
Not just the baby blues. Swedish experts on postpartum anxiety and depression
This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.