Nurse Specialty Spotlight: Certified Nurse Midwife

Midwives have been helping women deliver babies for hundreds of years. In fact, the word midwife means ‘with woman.’ As highlighted in this Cleveland Clinic article, Cleveland Clinic’s Certified Nurse Midwives oversee approximately 15% of all deliveries.

Tamara Noy, CNM, has been a Certified Nurse Midwife for 2.5 years at Cleveland Clinic, working in labor and delivery at Fairview Hospital, with a practitioner’s office at Lakewood Family Health Center. Prior to becoming a CNM, Noy spent several years in the labor and delivery unit at Hillcrest Hospital, fulfilling roles as a charge nurse, triage nurse, nurse circulator and scrub nurse. She also earned certifications in high-risk obstetrics (RNC-OB) and electronic fetal monitoring (C-EFM).

Noy says her specialty is labor and birth, although she cares for patients of all ages for everything from annual gynecological exams to sexually transmitted infections (STI) testing and more. She says a typical office day is 80 percent obstetrics visits, 20 percent women’s health visits.

When asked why she chose the midwife career path, Noy says, “for the birthday parties!”

She adds: “I’m a birth junkie and I love empowering and helping women. My favorite moment is watching a baby turn in a pelvis and seeing that woman dig deeper to bring her baby Earth side. It’s magical.”

A career that empowers women

Noy says she became a CNM because she wanted to empower women and truly help patients be more prepared for all that encompasses labor and delivery.

“With the birth of my own son, I remember how empowered I felt by my nurse midwife,” Noy recounts. “My CNM saw me as a person and that’s something I always try to bring to my patients. I aim to cultivate a relationship with them that shows I am here to provide care with them, not to them. So much of what our profession does is communication and education and I really try to make my patients feel heard and treat them with compassion and kindness.”

Noy says these care qualities are engrained in her, attributing her care philosophy to her experience first as a bedside nurse.

“Because CNMs are nurses we are trained to see patients holistically,” Noy says. “We focus on caring for the whole patient. My clinical training and education were extremely comprehensive as was my mentorship under Frances (Fran) Jackson and Kelly Gaines-El, two other Cleveland Clinic CNMs, who continue to be wonderful role models for me today.

Noy adds that much of what nurse midwives do is innate and learned from basic nursing skills and experience. For those considering a career as a CNM, Noy says, “women need you!” and recommends completing as much education as possible, mentoring/shadowing, and obtaining a few years of experience in labor and delivery nursing first to be ahead of the curve.

A diverse team for diverse patient populations

Cleveland Clinic’s near 25-member nurse midwifery team is one of the most diverse subspecialties within the Ob/Gyn & Women’s Health Institute. Cleveland Clinic employs Certified Nurse Midwives of all ages who are multicultural and multilingual, including providers who are Asian American, African American, LGBTQ and Jewish, for example.

“Our midwifery team is one of most diverse teams at Cleveland Clinic and we pride ourselves on that,” Noy says. “When you look at all the women who are patients – they are so diverse – and you need to reflect that diversity in your staff. For me, part of being the provider I need to be is also being the voice I need to be for impoverished women and women of color.”

Noy notes that she was very strategic in how she completed her clinical training. Keeping in mind that women of color often don’t have access to providers who look like them, she made sure to precept with those who would offer her insight on cultivating the African American experience.

“So much of midwifery is taught through action, not words,” Noy comments. “These are things that you can’t teach, but watching my African American preceptors, I saw it differently because of the heritage connection.”

Midwifery care in a virtual world

With the recent coronavirus pandemic, Noy says she, like many other providers, is conducting a lot of virtual visits. She says the virtual visits are creating even stronger relationships with her patients as she is seeing patients in their most raw, real form.

Cleveland Clinic’s midwifery team also offers a unique national program from the Centering Healthcare Institute called CenteringPregnancy, which enables midwives to provide women with pregnancy and birth-related information in a group setting. Previously held in-person, Cleveland Clinic’s program is now primarily virtual and continues to be extremely successful.

CenteringPregnancy places pregnant women together per their corresponding gestational age to create support groups for those who are experiencing the same thing at the same time during pregnancy. Noy says the program builds a sense of community, brings accountability to patient care, allows women to advocate for other women, and presents the opportunity to ask questions and hold important discussions that help women and their families.

“This supportive program is helping decrease infant mortality rates and build patient accountability as patients are getting another form of prenatal care through a unique sense of belonging,” Noy says.

Happy Year of the Nurse and Midwife to all Certified Nurse Midwives!