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Midwives, hospitals offer birth options

Perhaps never before have expectant parents had as many options for birth as they do now. In years past, the personal touch of a midwife and the medical options of a hospital were on opposite sides of the spectrum. But that is changing.

Bethany Smith, a midwife and the director of midwifery services at Greenville Health System, said the practice of midwifery is very old but its popularity has come in cycles.

“Midwifery has been around for a long time — even in the Bible there was talk of midwives,” she said.

The practice experienced a resurgence in the 1960s when women sought more natural childbirth options.

“The pendulum swung again in the ’90s to a more medical model with epidurals,” Smith said.

Now, women have all options on the table and are able to choose what works best for them. Smith credits the new resurgence in midwifery to millennials and their use of social media, as well as the use of midwives by celebrities, including Kate Middleton.

“People are doing more research,” she said. “There has been a lot more publicity.”

At GHS, midwives deliver at Greenville Memorial Hospital’s main campus and at Greenville Midwifery Care & Birth Center, a free-standing birth center across the street from the hospital that opened in 2015.

“We started in 2011 with the hospital-based practice,” Smith said. “We were a happy medium for a lot of folks. They wanted to be in the hospital.”

That setting offers a safety net, according to Smith, with a neonatal intensive care unit and other systems in place in the event of an emergency. It also allows women to have a midwife attend their child’s birth even if they would not qualify to deliver at the birth center.

The center has strict criteria for admittance. Women who are having a vaginal birth after Caesarean, who want an epidural, who have certain medical issues themselves such as high blood pressure or diabetes, or who have medical issues with the baby including a breech position, would instead give birth at the hospital.

Among the differences between a midwife-attended birth at the hospital and at the birth center are the length of stay after delivery. At the center, the typical stay is four – eight hours. Some women choose to deliver at the hospital for the extra time or help, according to Smith, where they will usually stay for 24 – 48 hours.

Smith said the center has a spa-like atmosphere, with aromatherapy, candles and essential oils. A kitchen is available and moms in labor are often eating and drinking. A garden is available for walks outside.

But hospitals and midwives can go together just fine, Smith said.

“Sometimes there is a misconception that by using a midwife, you have to want natural childbirth or be super hippie,” Smith said. “What sets midwives apart is the amount of time we spend with women. We are with them in labor, explaining the process. Prenatal visits are longer. We do a lot of education to prepare them. We focus on being very personalized. I don’t think there is anything magic in what we do per se. We listen to women and don’t put so many rules and restrictions.”

No matter what birth option a woman chooses — at home, in a birthing center or in a hospital — a midwife can attend in many cases.

“Midwife means ‘with woman,’” Smith said. “That is our ultimate goal: to be with women and be their cheerleader and advocate, whether that’s advocating for an epidural or a water birth.”

What is a certified nurse midwife?

According to Smith, midwives have different levels of training.

“There are different terms for midwives in the community and different ways to become a midwife,” she said.

The seven midwives at Greenville Midwifery Care & Birth Center are certified nurse midwives. They were registered nurses first, with bachelor’s degrees, who then earned master’s degrees in nurse midwifery. They then pass a certification exam. Because of that certification, they are then allowed to write prescriptions, admit patients, order laboratory work and more.

For details, visit

Midwives and birthing centers are located throughout the Upstate, including nurse midwife availability through Spartanburg Regional Healthcare System. For details, visit


Doulas provide yet another option. According to Bon Secours St. Francis Health System, which has several on staff, doulas provide non-medical physical, emotional and informational support to women and their partners during labor and birth. They are women who are experienced in childbirth and who then use that experience to serve as nurturers to women giving birth. For more information, visit and