What is a Nurse-Midwife?

Triangle Physicians for Women is proud to be serving women and families in the Cary, Raleigh, Durham area since 1992.  As a collaborative practice combining the expertise of board certified OBGYNs and Certified Nurse Midwives, we have found the best of both worlds in caring for our patients. The practice hired its first midwife more than a dozen years ago and the response was so positive that we now have seven Certified Nurse Midwives on staff.  Dr. Vulgaropulos said, “The simple truth about our midwives is that our patients fall in love with them.  They render wonderful, nurturing services and provide invaluable assistance to our physicians.”  Learn more at Triangle Midwives.

Nurse Midwifery Services at Triangle Physicians for Women – The Best of Both Worlds

Jessy pregnant  Jessy baby

Though midwives have been around for centuries, there is still much confusion today about their roles and capabilities.  Probably the most frequently asked question we hear from those new to our practice is, “What exactly is a midwife?”  Hopefully, this article will not only answer that question but also will help people understand why we believe we offer the best of both worlds to our expecting couples.

The word midwife means “with woman.”  The term conjures up many different images, in part to the fact that they have been helping women through childbirth for centuries.  The women in the community trained to do this were referred to as midwives.  For decades, the knowledge these women possessed had been passed down to them through the generations.  They were the experts long before childbirth moved into hospitals with physicians in the early 20th century.

Formal midwifery education began in England in the 1800’s and then in the United States shortly after.  Many different types of programs and training have existed over the years that have contributed to the various types of midwives practicing in this country, adding to the confusion surrounding them.  However, the American College of Nurse-Midwives is currently trying to standardize the education and training for midwives so that all nurse midwives will eventually hold the title of Certified Nurse Midwife.

Certified Nurse Midwives (CNM) have, at minimum, a bachelor’s degree in nursing, with seventy percent actually having a master’s degree.  In addition, they must complete a certificate program in midwifery from an accredited institution, which includes a residency where they work with physicians and other CNM’s to receive their training.  The midwives at Triangle OB/GYN are masters prepared CNMs practicing full-scope midwifery.  Full scope midwifery involves providing care to the woman throughout her life cycle from puberty to post-menopause, including pregnancy and childbirth.  Our midwives see teens coming in for their first visit as well as manage women during their menopausal years.  If needed, the midwives consult with the physicians to determine a plan of care for patients needing surgery or more intense care.

Our physicians are on call along with a midwife 24 hours a day.  They are both aware of the status of every patient.  During a woman’s labor and childbirth, if all is proceeding normally, the midwife is in attendance and the physician is on call, but readily available.  If high-risk situations arise, such as a C-section or vacuum extraction, the physician will be present and will work with the midwife to complete the birth.

“Our Certified Nurse Midwives approach patients from a nursing perspective and medical doctors, whether male or female, tend to approach patients differently than nurses do with a much more direct medical orientation.  That means, I believe, that the patient gets the best of both worlds,” says Dr. Vulgaropulos.  In addition, “The midwives are more able than doctors to spend added time with our patients, offering counsel and emotional support.  And we’re fortunate that most of our midwives have had their own birthing experiences, which is a significant life experience to bring to the patient-caregiver relationship.”

For more information about our midwives, please go to the staff section of our website or call the office and one of them would love to speak with you and answer any additional questions you may have.

I think Dr. Grana and her assistant (Mandy) are the best. I have been going to TP4W for years – at least 20, and I have never been disappointed with the level of care I have received. I can be a challenge as my level for pain tolerance is low and they put up with me! I can’t help but highly recommend the practice to anyone looking for exemplary women’s healthcare.

Love love love Dr. Grana and her crew. Love going to Holly Springs office. The girls are the best from Lisa at the front desk to all the girls in the back. Your music and atmosphere is great. Thanks for making these appointments fun!! Yes believe it or not, fun!!!

Dr V and the office staff were all very professional, understanding, caring and very efficient. I would be happy to recommend this practice to friends, family and associates. – Barbara M. Lucas

My visit was great! & my past visit have all been great.Kristy helped me even with me being a bit stressed & in a hurry because I had to be seen & my job is super strict. Her urgency to get me seen was phenomenal. I even got to see Heather, she’s awesome & amazing. She helped deliver my baby girl a year ago. My whole family loves her and Dr Sheshadri. We actually can’t wait to get pregnant again hahaha. Everyone treats you with respect and always makes sure your okay & answers whatever questions you have before you leave. Even leaving a message for the nurses,they get back to you so quickly.  This practice really makes you feel taken care of.  We appreciate you all!  – Erika Hooks

My experience with the TP4W staff has been top of the line.  They helped me through three pregnancies and coached me through every step of the way.  Eternally thankful I chose TP4W.  – Britney

TP4W have such amazing doctors, midwives and nurses.  I cannot say enough about Dr. Grana and the rest of the staff for all the help, advice, guidance and medical care they provided me with all of my kids.  She made me feel safe and calm through both c-sections.  My routine care and pregnancy care have always been top notch and I would recommend them to anyone looking for an OBGYN.  – Brooke

We were honored to receive a hand written note..

Dr. Grana, Angie, Jessica, Heather, April, Sarah and the rest of the staff –

Thank you all so much for taking such good care of me through both of my pregnancies and births, especially my latest one on 10/29! most of yall know how nervous I was from having gone through a lot (to say the least) with my first in 2016. You all made me feel so comfortable and at ease before, during and after. And going through a touch year with my dad, you guys always asked how he was doing at every appointment, which was so thoughtful and beyond your job description. I know that you all see many women go through what i did each and every day and deliver many babies and perform many c-sections. But I hope you know how special Ruby’s delivery was to me. You all have amazing jobs! I cannot thank you all enough. Merry Christmas!

Love, Lucy

I have been going to TP4W since 2010/11 and could not be happier.

The staff, nurses, midwives, and doctors are all amazing. I have 2 sons, both delivered via cesarean by Dr. V. Every visit and every provider did everything in their power to give me the birth experience I wanted, and also ensure that myself and my babies were safe and healthy. Dr. V even did everything in his power to help me avoid my first c-section and VBAC with the second, but that turned out to be out of his hands and he was the absolute best surgeon. With my two pregnancies, I experienced a few scares and some unusual circumstances that would be too long and too private to write in a review, but every single hurdle was handled with grace, honesty, and professionalism. I am so thankful for the recommendation from a friend to come to this office. I can’t imagine ever going to another practice.

TP4W is amazing and I am so very thankful I found them 9 years ago!! Amazing partnership between midwives and doctors, sweet nurses and front end staff, and relaxing environment. I literally recommend them to all my friends! I look forward to my appointments and feel like I’m going to catch up with old friends.

I’ve always had wonderful experiences at TP4W. Everyone is friendly, knowledgeable, and thorough in their care. April delivered my son and I can’t say enough wonderful things about her. She is patient and compassionate. I had the best labor and delivery experience thanks to her. I do and will continue to recommend them to my friends and family!