As many hospitals shutter or shrink their midwifery services, University of Chicago Medicine is expanding its own, offering more personalized childbirth experiences for parents-to-be.
This year, UChicago Medicine went from having one certified midwife to five, and the department plans to add another to the staff soon. The goal is to provide 24/7 midwife availability by early summer 2025.
“We’re growing, and we’re growing quickly, and that’s unique in Chicago. It speaks to UChicago Medicine’s commitment to midwifery access,” said Elizabeth “Libby” Oppert, MSN, CNM, head of UChicago Medicine’s midwifery program and a midwife for the past 15 years.
How midwives help pregnant patients
Midwives are advanced practice nurses with specialized training in prenatal care, labor and delivery, postpartum care, and gynecologic and reproductive wellness.
When people choose midwifery care, most often the midwife manages the pregnancy and the birth independent of the obstetrician-gynecologist (OB-GYN). They also can serve as the patient's advocate in the delivery room.
Even for high-risk pregnancies, UChicago Medicine's midwives can work in conjunction with an OB-GYN and provide added support, information and attention to pregnant patients.
Their goal is to ensure safety and individualized care to support a patient's birth goals.
“The benefit to patients comes down to the way we approach care,” said UChicago Medicine midwife Megan Kilmer, DNP, CNM.
Midwives can spend more time with patients – appointments are 20 to 40 minutes long – and they’re in-person or virtual. Since pregnancy is an introduction to healthcare and hospitals for some people, midwives can walk them through the processes.
Trends midwives are seeing
UChicago Medicine’s midwives say they’re seeing a surge in demand for their skills. One reason is that expectant parents like and need the added attention and knowledge to help them make decisions about their birthing plan.
Pregnant people are becoming more aware that this is an opportunity in life to be empowered in what their body can do and are seeking support for it. It could be as simple as knowing they can do what feels good in their body and will not be told to push in a certain position. Or it can be about choosing a provider comfortable with labor and birth, should they choose to have an epidural or remain unmedicated, Oppert said.
Since the COVID-19 pandemic, midwives have noticed that more pregnant patients are aware of signs of depression and anxiety. That’s a good thing, Oppert said, as untreated mental health and substance use disorders can lead to higher maternal mortality, according to the 2023 Illinois Maternal Morbidity and Mortality Report.
Navigating the emotional rollercoaster that comes with giving birth, or having pregnancy complications, can be difficult. When useful, midwives prescribe medications or provide mental health referrals.
Midwifery can reduce health disparities
Research has consistently shown that midwives decrease costs by reducing cesarean sections, preterm birthrates, episiotomy rates and more. They also assist with perinatal health disparities. Increasing access to midwifery care is especially important to expectant Black mothers, who are three times more likely to die from a pregnancy-related cause than someone who’s white.
“As we see more growth in midwifery, we see how that could change,” Kilmer said, adding that UChicago Medicine’s investment in its midwifery program will have a positive impact.
UChicago Medicine is focused on increasing access to midwifery in the hospital setting.
“The hospital leaders see the benefit of midwifery and want to invest in it, because they see the long-term change that we can bring to the hospital and what we’re able to offer patients,” Kilmer said. “We want to support whatever the patient wants, and we want to do it safely, whether that’s in a birth center, in the home, or in a hospital.”
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