When the word “midwife” is mentioned, many people think of an uncertified woman who delivers babies at a prospective mother’s home.

The three medical professionals in the Butler Health System who hold the title could not be further from that description.

Devon Swanson, certified nurse midwife at BHS Women’s Care Associates in the shadow of Butler Memorial Hospital, said she and the two other midwives at the health system were registered nurses before enrolling in classes to attain a master’s or doctoral degree in midwifery.

Swanson explained that there are three types of midwives.

Lay midwives have no medical training and only serve as an apprentice to another untrained midwife.

Lay midwives are the women who help with a delivery at home and are not medical professionals, Swanson said.

Certified midwives have a bachelor’s degree in some field then returned to college or university to earn a master’s or doctoral degree in midwifery.

Certified nurse midwives, such as Swanson and her two peers at BHS, were registered nurses who returned to college or university to earn a master’s or doctoral degree in midwifery.

Swanson was drawn to women’s health issues during her career as an R.N. for a dozen years in Vermont.

“That’s where I found my love for women’s care,” she said.

Swanson then served as a surrogate mother and gave birth to a baby who is being raised by friends.

“That was my first introduction to what a midwife does and who a midwife is,” she said. “So I went back to school.”

Swanson earned her master’s degree in midwifery and has been a certified nurse midwife at Butler Health System for nine years.

One misconception about midwives, Swanson said, is that they only deliver babies.

But in addition to providing prenatal care and delivering babies, BHS midwives provide gynecological care to girls and women throughout their lives.

Swanson explained that she can assess, diagnose and treat women, order testing, perform screenings, refer women to specialists and perform pap tests and other annual exams on top of prenatal care and delivery for prospective mothers.

The only procedures a certified nurse midwife is not permitted to perform are a vacuum delivery, where a vacuum is attached to a baby’s head to help it out of the birth canal, and a Cesarean section, where a baby is surgically removed from the womb, Swanson said.

“But we assist the doctor with Cesarean sections,” Swanson said.

She said the three midwives at BHS Women’s Care Associated on Fifth Street in Butler are constantly running back and forth between their office and the hospital, as women in labor frequently arrive at the emergency room or must be seen in the maternity ward or after a medical procedure that required them to be admitted.

Swanson said some women arrive at the ER in labor with no prenatal care or in distressed labor that was spent at home with a lay midwife.

Swanson and her two peers work in collaboration with the three full-time obstetricians/gynecologists at BHS Women’s Care Associates, whose practice is at the health system’s Crossroads Campus.

She said while the midwives do not require one of the physicians’ confirmation on the care they give, doctors are always available to the midwives, especially if a mother in labor requires a C-section or vacuum delivery.

“We’re very much independent practitioners, and we collaborate with them,” Swanson said. “There is a doctor on call 24/7.”

She said some women prefer to see a doctor, while others use midwives for their care. Some have no preference for one or the other and see both.

Many prospective mothers decide to see a BHS midwife because they offer more intimate care than physicians.

“Our take on pregnancy and delivery is that it’s a normal event,” Swanson said. “We are just trained in a different mindset: that labor and delivery are a natural thing.”

Pregnant women often feel more comfortable asking a midwife questions about their pregnancy or female health care than they do a physician, she said.

“(Doctors) are medically trained,” Swanson said. “We are medically trained and also holistically trained.”

Asked her favorite aspect of being a midwife, Swanson said she enjoys caring for females throughout their lives and seeing their families grow.

Of course, she also enjoys delivering babies, and does not have a count on how many new lives she has brought into the world.

“I guess it’s the relationship with women and being with them at the most intimate time of their lives,” Swanson said.

Tina Krolikowski, who graduated from Butler High School in 2014 as Tina Kramer, has residences with her husband in Columbia and Butler counties.

Krolikowski learned she was pregnant as she took classes toward her doctoral degree at Carlow College and her husband continued to work in Columbia County.

She lived at the couple’s Clearfield Township property while attending classes, which she planned to stop two weeks before her due date so she could return to Columbia County to deliver the baby.

She had been receiving prenatal care from a certified midwife at an obstetrics practice in Columbia County.

But baby Lee apparently did not approve of his mother’s plans.

While visiting her father in Clearfield Township, Krolikowski’s water broke.

“I called my husband and told him to head this way,” she recalled.

Luckily, Krolikowski had made an appointment with a certified nurse midwife at BHS Women’s Care and had copies of her medical records sent there in case the baby came early and she had to deliver at Butler Memorial Hospital.

Her father drove her to the hospital, and a BHS midwife met her there and stayed with her until little Lee appeared on Feb. 21, 2022.

She recalls being upset because her son, who made his debut one month in advance, had to be whisked away to be put on oxygen while she remained in the birthing suite to receive the normal care a women has after giving birth.

That night, Lee was taken to West Penn Hospital in Pittsburgh for neonatal care.

Krolikowski remained at Butler Memorial Hospital for one night after that before being released.

The new mother spent one night at her father’s home before going to West Penn Hospital, where she was permitted to stay in the room with tiny Lee as he received care.

The tyke is now a busy 1-year old who keeps his parents hopping.

Krolikowski said she decided to see a midwife instead of a doctor due to her experience as a mental health counselor.

“I’ve come to know that the professional title doesn’t necessarily guarantee a better or higher-quality of care,” she said. “I think a person should be judged on their merit.”

She said discussions with other young mothers revealed that certified midwives are preferred by many seeking obstetrical care.

She also appreciates the less-formal atmosphere at a prenatal visit with a midwife as opposed to a doctor.

“The feeling in the room is (doctors) are busy and have to move on to the next patient, but with the midwife, I feel like I could ask questions,” Krolikowski said.