Naturopathic midwifery - Part 1

Posted by Tatiana

Naturopathic midwives make up a small minority among midwives. They are naturopathic doctors who practice midwifery either in conjunction with a larger practice, or as their primary practice. I was introduced to the existence of this subset of midwives recently and personally vacillate between being compelled by the notion and turned off by the notion. I want to know more. I'm investigating it further by interviewing some ND midwives, but I want to first provoke questions I haven't considered from the rest of you.  

Here's a breakdown of my current understanding and opinions of naturopathic midwifery:

Education is expensive and comprehensive. To become an ND is four-five years of graduate level schooling at the clip of about $25K per year. An ND education from a school recognized by the AANMC has substantial overlap with MD training but of course approaches it from some vastly different modalities.  Most naturopathic colleges offer specialization in midwifery.  Naturopathic midwives generally become NDs plus CPMs, LMs, CNMs.

What I regard as the pluses:

ND midwives are able to care for women and their children before pregnancy, during, and ever after. There's an opportunity for continuity of care that most other midwifery paths don't offer. I'll note that it is also possible to create a similar model of practice as a CNM and Nurse Practitioner.

The inherent philosophy of naturopathy is more gentle than allopathic medicine - the trust of the body's innate ability to heal itself, the focus on lifestyle and diet changes in conjunction with other less invasive treatments, etc.

When you're talking about being a midwife, this is one of the more financially lucrative paths to take - there is a much higher earning potential for naturopathic midwives than CNMs (outside of hospitals), CPMs, LMs, DEMs, and others not coming to mind. What appeals to me about the ability to make substantially more money is the ability to subsidize things of value and great need - such as providing midwifery care for women who otherwise would have difficulty accessing it, and supporting the education of midwives from less privileged backgrounds. (Have you noticed that the demographics of midwives and student midwives do not reflect an accurate cross section of the ethnic and economic differences within the US?)

At the naturopathic midwifery conference I attended in May I enjoyed hearing talks by naturopaths on midwifery topics. The combination of the medical research and evidence-based practice with the basic rawness of midwifery is definitely appealing. The willingness to examine and employ mainstream medical approaches when they "work" alongside the naturopath's own toolkit has its own appeal, and I like that the scientific and medical training of a naturopath makes critically examining research more accessible.

What I regard as the minuses:

It's hard to refute that naturopathic medicine practitioners serve a pretty specific and limited demographic of primarily caucasian primarily upper middle class folks. I don't enjoy the narrowing of that lens. That's an issue in midwifery care that I'm already uncomfortable with, and I don't want to compound it further by creating a practice that is even more inaccessible.

The cost of education - holy smokes! You'd better be prepared to willingly serve those folks of means for quite a few years before you pay off that 'spensive schooling.

The downside of having continuity of care is that by offering well woman care for women at all stages of life, and perhaps pediatric care for the children of those women through childhood, you lose a lot of time you would otherwise spend midwifing. 

Homeopathy. I'm just not entirely on board with the "evidence-based-ness" of that one. (I'm not in the "its all bogus" camp, either. I use it for my kids, but I think of it as primarily placebo-based therapy.)

Here are some questions I'd like to pose to Naturopathic Midwives:

What are the demographics of your practice?

Was the cost of the education worth it?

How does being an ND improve your practice of midwifery?

What do you see as the advantages and disadvantages of naturopathic midwifery?

Can you be a naturopath if you're not on board with homeopathy?

Do you think your training medicalized your view of birth?

Are you bound by tighter protocols than a non-ND midwife would be?

I invite you to suggest further questions for me to ask before I dash off to grill these folks. I'm going to post my findings in a "Part 2."