All About Certified Nurse Midwife

There are two types of midwives in the US: certified nurse midwife (CNM) and direct entry midwife . In this article, I want to give you information about what certified nurse midwives are, what their midwifery education and training are, and what they can do for you.

What Are Certified Nurse Midwives ?

Certified nurse midwives (CNM) are nurse midwives who are certified by American College of Nurse-Midwives (ACNM) and hence can practice as a nurse midwife.

Now, what are nurse midwives ?

And what training they must possess in order to be nurse midwivs and become certified ?

To become a nurse midwife, somebody has to complete an accredited nursing program and get a licensure as a registered nurse. After that, she has to complete a program in nurse-midwifery from an accredited institute. So, a nurse midwife is a registered nurse who has a further midwifery education and training.

Once she finishes the nurse-midwifery program, she has to be certified by ACNM in order to practice in 50 states. However, if she wants to practice in states where there is an additional requirement for licensure, then she has to apply and pass the test to get the license to practise in that particular state.

What Can A Certified Nurse Midwife Do ?

A certified nurse midwife can of course deliver services like what a midwife does. Therefore, she can provide:

• prenatal, labor and birth care.
• post partum and newborn care.

In addition, because she is a nurse, she can provide more variety of care and can also write prescription:

• Family planning counseling.
• Well-woman care, health counseling and gynecological exams.
• Menopausal care
• Fertility consultation.

So, as you can see, a nurse midwife provides quite a wide range of health care service to women, much like what an obstetrician does. However, the care from a certified nurse midwife is more personalized. A nurse midwife encourages active participation from the client and promotes client education. In addition, a nurse midwife is more accomodating in her patient's needs.

This philosophy translates particularly well in the commitment of a nurse midwife in assisting low-risk pregnancy. Like their non-nurse midwives peers, nurse midwives encourage women to be involved in their pregnancy and birth. They promote natural childbirth, individualized attention and family involvement during the birth. However, when a problem arises, they can refer women to the appropriate physician.

In addition, as a part of health care system, insurance companies and Medicaid are required to reimburse the services provided by CNMs.

Certified Nurse Midwife And Homebirth

If certified nurse midwives sound that great, why would somebody choose non-nurse direct-entry midwives for a birth ? There are two reason why you would want to choose a non-nurse midwife when it comes to homebirth:

• First, is the legality issue.
  Although certified nurse midwives are legal in all states, their legality when it comes to attending homebirth differs from state to state.
  
  In many states, it is illegal for them to assist homebirths which mean that they can only serve clients at birthing centers and hospitals. State boards of nursing regulate their licensees closely, so in a state where it is not legal for a nurse to assist with a home birth, a certified nurse midwife isn't likely to agree to, for fear of losing her license.
  
  It is also worth to note that even in states where certified nurse midwives are permitted to assist a homebirth, they are still required to practice under the supervision of an OB. Remember, they are nurses first. Therefore it is up to their obstetrician to say whether they can attend homebirths or birth center births.
  
  
• Second, their out-of-hospital training experiences.
  Since nurse midwives are nurses, their background training are very medical and most or all of their clinical training take place at a hospital. This means, they may not have or have only little experience in handling out-of-hospital birth. Therefore, their approaches may not be as hands-off as the direct entry midwives are.
  
  There are exceptions of course. In fact, some of the nurse midwives set out to practise in out-of-hospital setting by joining or starting free-standing birthing centers so they can offer a more natural approach on birth.

For more information on which birth setting a midwife can practice, read our birth setting page.

*NOTE: Do you want to get more tips and techniques for having natural birth? Then subscribe to our FREE monthly newsletter, "Born Naturally" and receive a FREE "Pregnancy Diet Secret" ebook.

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Midwifery articles:

• What is a midwife ?
• Midwife services: how a midwife care for you during pregnancy, labor/birth and after birth
• Midwife fee and how to pay for it
• How to choose and find a midwife

Other articles which may interest you:

• Why choose to have a natural birth ?
• Why homebirth ?
• Giving birth at hospital
• Giving birth at a birth center

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