Future CNMs - page 6

Just thought it would be kind of nice to get a little chat going. I know there are a couple of us who are CNM wannabes buthave worries too. My biggest concern is malpractice insurance. Hopefully... Read More

  1. by   abake003
    You know, none of them seem to be concerned about prescriptive authority being taken away ... more about the birthing centers closing and even hospital-based midwifery services closing, based on the malpractice issue. Several midwives in this area have lost their jobs because of the insurance issue and although they are anxious at the moment, seem to think the situation will improve....they're just not sure when! And yes, midwifery care has increased (at least based on a figure I saw from acnm.org).

    Quote from mitchsmom
    midwiftippitoes, it seems like teaching OB as a midwife would be very satisfying... maybe even more so in some ways (avoid some of the frustrations with conflicts on the floor). This way you really get to teach things from your perspective!! I think I would enjoy that a lot.

    Welcome Jennifer! I am also on the 'long-term goal' track... this is my third year back in school part-time. I will have my BSN in spring 2006, go work L&D and then pursue CNM from there.

    abake003, do the midwives you talk with act like presciptive authority is going to be taken away? (do you have it in your state? mine has it) I couldn't imagine it being taken away once it's already been gained, but then again I'm not really in the loop on all that. I was told by a univ. CNM instructor that the malpractice thing always seems to wax and wane through the years (although obviously never really completely wane, always an issue). What do the midwives that you talk to say? Although it always seems like a scary specialty to get into, hasn't midwifery care increased?
  2. by   RN2CNM
    Hello all, I have posted before, but I am a RN on my way to CNM. I am looking into a couple of online programs, but before I apply I want to know if the demand for midwives here in Texas, specifically San Antonio, is big enough for me to pursue this degree. I really don't want to move, so I would like to know if there are any nurse midwives who work in San Antonio or anyone who knows a midwife in SA and what they think about the issue. I really have always wanted to become a CNM and I just don't want to go through all the school and then not have a job when I graduate. Please help. I want to start a CNM program in the Fall 2005, so any advice would be appreciated.

    Thanks
  3. by   JAHJF
    This may have been discussed some where previous in the thread but I'm working my way through and was wondering what everyone thought of the programs at Frontier and East Carolina University (I really am going to need a distance/online program but I'm nervous about taking the leap because I'm so used to a classroom setting)?
    Thanks
  4. by   mitchsmom
    Quote from JAHJF
    This may have been discussed some where previous in the thread but I'm working my way through and was wondering what everyone thought of the programs at Frontier and East Carolina University (I really am going to need a distance/online program but I'm nervous about taking the leap because I'm so used to a classroom setting)?
    Thanks
    Can't tell you much; the people I've had contact with were happy with Frontier (including a cousin of mine & the midwife that I was with a little bit in clinical); don't know about ECU (is it a true distance program like Frontier?); I think Stony Brook is (or was) also a true distance program. A person I was in contact with, who had been up to Stony Brook inquiring about their program seemed to like it.
    I hope you get more responses... I'd like to see the answer too
  5. by   FrumDoula
    For the longest time, I thought I wanted to be a CNM. Years and years. I thought it was the only game in town.

    Then, as a doula, and as a pregnant mother, I got a fuller view of what CNM's are and aren't. And I saw the very real limitations that hospitals and their supervising docs put on them, which can really limit the care they can give to their clientele. I was able to see this both as a client, a doula and as the good friend of a CNM who was on faculty the University of Missouri.

    Be aware that many CNM's are little more than mini-OB's, which is SO sad. Some are fantastic! But even if you're a more naturally oriented midwife, your practices are largely dictated by the OB's on staff. Some OB's absolutely love CNM's. Others wish they would simply shrivel up and die, and it's THOSE cupcakes that make work a real drag.

    I'm not so sure that one needs a nursing degree to be a good midwife, in fact I'm very sure about that fact. And the statistical data comparing CNM's vs. CPM's seems to bear that out. I do wish that both sets of midwives could get along in the sandbox a bit better. The infighting does nothing to improve solidarity for midwives as a whole.

    Something like 98% of CNM's work in the hospital setting. Some work in birth centers, and a few catch babies at home. It's tough finding physician backup. The only reason I've ever considered going to medical school is for the sole purpose of becoming an OB in order to provide midwifery backup.

    Right now, I'm under the care of a direct entry midwife, a CPM. She's amazing. There is absolutely NO comparison between the care I receive from her and what I got from my CNM the first time around with my son. And it's the reason I'm considering becoming a CPM instead of a CNM. For instance:

    1. My midwife comes to my home for prenatal visits. They last over an hour. Compare that to the 15 minute visits I got in a CNM office. We talk about tons of stuff, really form a relationship. We drink tea, have a snack, etc. We watch videos together, discuss birth philosophy, get educated.

    2. My midwife concerns herself heavily with nutrition from the get-go. My CNM basically said, "Just eat healthy." with no real effort at ascertaining what I was eating or how to improve my eating habits. Since this is an early intervention known to have real effects on a pregnancy, I find that shameful. With my midwife, I was told to fill out a nutrition journal, take herbs, etc.

    3. My midwife is able to draw all the labs she needs in my home. It's a heck of a lot nicer to get your blood drawn at your kitchen table than at a lab, let me tell ya! And instead of hopping into stirrups to do a vag swab to test for Strep B, I did it myself. Also a nice difference.

    4. My husband and son have been able to become MUCH more involved in my care, and not simply token players who get to watch the midwife do her thing. My son now knows how to check for heart tones with both a doppler and a fetoscope. His questions get taken very seriously, too. It's great. He sits and holds my hand when I get my fingerstick to check my blood. He gets to help dipstick my urine. While not everyone would want their kids this involved, for us it's been a wonderful learning and growing experience. He loves when the midwife comes over. And it's cute, quite frankly, to hear him very seriously try to assess the baby's sex via heart tones!

    My husband, in addition to becoming very good at locating heart tones, has also learned how to assess the baby's position. And he's learning how to check me for dilation and effacement as well. When it comes time for the baby to be born, he'll catch the baby with the midwife's guidance. I have rarely seen this in hospital births as a doula, even with the CNM's (though I know it does happen). And with my CNM, she was much more into the standard medical model, both in terms of how she viewed pregnancy and birth to how she saw fit to run her prenatal visits. I know she was not reflective of all midwives.

    All in all, I feel that my CPM has approached the gold standard of prenatal care far more than the CNM did. Here in California, midwives are licensed. Which is a good and a bad thing. But they 're more accepted here than in Missouri, for example, where it's a felony to be a lay midwife. It's total BS. It depends where you live, really.

    It's been a real education for me regarding the differences between hospital/clinic based midwifery care and home-based midwifery care. I feel as if my midwife is FAR more able to spot potential complications, given the thorough care I've received as well as the amount of time she's spent with me. So I actually feel SAFER in her care than I would if I was going to a doc's office to wait for an hour for a 10 minute appointment.

    We'll see which way I go. I still intend to become an RN. I just may not go the CNM route, unless I can work at some kick butt birth center or with a homebirth practice. I'm not sure I could stomach hospital shift work, although I certainly think it's better than nothing!

    To be a midwife is to be inherently political! You stick yourself into a long standing battle between those who SHOULD direct women's health care and those who THINK they should direct women's health care.

    Alison
  6. by   FrumDoula
    Just wanted to share one more story. When my son was still 5, he said to me one day, "Mommy, someday I'm going to become a doctor so I can back you and the other midwives up!"

    Can you STAND it??!!

    Alison
  7. by   SmilingBluEyes
    rofl Alison!
  8. by   FrumDoula
    Quote from SmilingBluEyes
    rofl Alison!
    Knew you'd appreciate that one, SBE! I'm telling you, the kid is more informed about birth than many of my former clients!!!!
  9. by   JAHJF
    Just for info:

    ECU told me that classes are 100% online?, you go to Greenville 1-2 days at the beginning of each semester for orientation, and they have clinical sites all over NC (of course) but also in New Mexico, Texas, Tennessee and are trying to set up a site in SC. So if you live near a clinical site its a program to think about.
  10. by   casi
    Hello! I thought I would drop in and say hi. I'm very interested in the prospect of becoming a midwife, but that is in the very far future for me.

    I think I'm a bit unlike the other posters here because I really haven't had any experience in the area. I'm still in pre-nursing, so no clinical experiences in L&D and I don't have children. It's just something I have felt drawn to for a long time. At first years ago when I brought up the prospect to my mother (I was probably about 16) she just laughed. Now she introduces me to just about anyone who will listen as "This is my daughter Casi, she's going to be a midwife."

    I'm curious. I haven't heard of the distence learning option before. How does that work? Where does your hands on experience come from?

    Also I wantted to recomend an amazing book Baby Catcher: Chronicles of a Modern Midwife by Peggy Vincent, it's the story of a midwife and the heck she went through to become a midwife
  11. by   JAHJF
    Quote from casi
    I'm curious. I haven't heard of the distence learning option before. How does that work? Where does your hands on experience come from?
    Online course work w/a preceptor you or the school sets up to work with for clinical experience and hopefully it is as local as possible to where you live.
  12. by   midwife2b
    I'll be glad to talk to any of you about the program at ECU. I just graduated from it and I am taking my boards in exactly one week.

    ...still tired, still studying, still learning new things every single day...
  13. by   JAHJF
    Quote from midwife2b
    I'll be glad to talk to any of you about the program at ECU. I just graduated from it and I am taking my boards in exactly one week.

    ...still tired, still studying, still learning new things every single day...
    Thank you so much for offering info.

    I sent you a private message w/some questions.
    Thanks for you help in advance.

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