Dotson is active in speaking to groups and promoting the innovations of midwives and has written articles for journals such as Midwifery Today. They are certified by passing a national board exam and are held to rigorous standards of practice and continuing education. Their credentials also must be approved by local hospitals before they are allowed to manage hospital deliveries. About a dozen hospitals and birthing centers in Northern Virginia currently permit CNMs to attend births. Dotson is enthusiastic about Loudoun' s new openness to midwife-assisted deliveries.
Midwives have a lot to offer in any birth setting.
Virginia nurse-midwives attended 3,036 births in 1996, or 3.4 percent of the state's total 90,155 births. Recent studies have shown that CNMs have better overall birth outcomes than doctors. Midwives, in general, spend more time with women during prenatal visits, and they emphasize emotional support, as well as counseling, education, and health promotion. Many CNMs also spend an entire labor and delivery providing direct coaching and care, in contrast to physicians, whose attention is sometimes more episodic.