My first two birthing experiences were with Nurse Midwives that work in a hospital. My experiences were not at all what you expect when the term Midwife is used. Both times and with two different Nurse Midwives at two different hospitals they used Pitocin to start my labors because my water had spontaneously ruptured at home and my labor did not progress. Nurse Midwives still follow a 24 hour guideline even if they are slightly more loose about it than Obstetricians.