Profession delivers

The practice of midwifery has existed as long as human civilization. It comes from an Old English term, simply meaning “with woman.”

Elizabeth Gray Sova has brought this practice back to Luzerne County, having joined the Obstetrics and Gynecology Department at Geisinger Wyoming Valley Medical Center in Plains Township. Geisinger has had midwives before, but Sova is the first to deliver babies.

Sova is a registered nurse and certified nurse midwife with more than 20 years of experience in labor, delivery, prenatal and newborn care. In 1985, Sova was a labor and delivery nurse when she decided to pursue an advanced practice in nursing; midwifery was a perfect fit for her.

The practice of midwifery is increasing in popularity as women seek the personal care that a midwife can provide. That is exactly what happened when Michelle Cook of Wilkes-Barre met Sova during a routine obstetrical visit. Cook was nearing her delivery date with her second child, and during her visit with Sova the two hit it off. Cook was thrilled to have Sova there for her delivery, she said. “Beth made it more personal, like having my mom there,” says Cook. “She’s another female that understands and knows what you are experiencing.”

Midwives typically spend more time with their patients, working to become partners in their health care rather than health providers. The philosophy of nurse-midwifery is to provide health care to women while respecting their needs. They encourage education, communication and individual health care experiences.

Pennsylvania midwives must have a collaborative agreement with a physician, according to the Pennsylvania Code. To practice, they must be registered nurses, be licensed midwives and engage in continuing education programs. Licensing requirements include an examination

Midwifery fell out of favor early in the 20th century in the United States, due to rapid advances in physician practiced medicine. Internet research reveals that midwives did not have access to these new practices, which meant their complication rates were higher compared to physicians’ deliveries. This was a factor that led to the declining calls for midwives. The practice did not totally vanish though — in a few areas of the country, practicing midwives treated mostly immigrants and minorities. Midwifery began a resurgence in the 1970-1980s as studies showed that the practice was safe and women once again became more comfortable with midwife deliveries.

To further ensure the patients’ safety, the collaborative agreement with a physician must include a plan for emergency services and availability of a physician for consultation. With proper certification, and certain guidelines, midwives may also prescribe, dispense, order and administer drugs.

Midwifery is “high touch, low tech,” says Sova. “Midwifery is the art of knowing when to do something and when to let it happen.” Physicians practice in a medical model, she said; with a midwife, the woman delivers the baby, and “it’s a privilege to be there.”

Michelle Cook’s first child, daughter Olivia, was delivered by an obstetrician three and a half years ago. Comparing the delivery experiences, Cook says, “(midwifery delivery) is a more natural thing — with doctors it was more tense, with Beth it was calm.” It is a trust that birth is going to unfold as it is supposed to, explains Sova.

Midwives are trained in emergency management, but Sova works in cooperation with obstetricians in Geisinger’s practice and will refer a patient to an obstetrician if she requires care beyond Sova’s area of expertise.

Midwives not only attend to patients during pregnancy, but also provide gynecologic exams, birth control and other primary health care for women from puberty through menopause and beyond.