These might include epidural anesthesia, electronic monitoring, and intravenous medications. In addition, the midwife always has consultation and referral with an obstetrician readily available for complicated labors and possible operative deliveries. They practice legally in most states. Home-birth midwives, as well as midwives who practice in birth centers, should have strict criteria for women who are appropriate to deliver outside the hospital. They should have a plan for obstetric referral and hospital transfer if a problem should arise.
Midwives spend time with woman , both during the prenatal visits and during labor.
They expect questions. They encourage the women in their care to seek information and to come to their births as knowledgeable as possible, since knowledge is power. Nonetheless, they also encourage an attitude of flexibility, since every woman and every birth is unique and cannot be predicted. Midwives, like physicians, measure bellies, listen to baby heart rates, ask for urine samples and order ultrasounds, but they are interested in more than the physical progress of a woman's pregnancy and labor. They are concerned with good nutrition for a healthy baby and with exercise to optimize chances that the baby will come down the birth canal the right way.