OB/GYN or a CNM?? HELP!!

[OBluv19]

Hello! I'm hoping to get some advice on a current decision I am trying to make. I have been a High risk/L&D/OB-triage RN (BSN) for almost 5 years. I'm 25 years old. I want to further my education and originally was applying to CNM school with maybe a post masters certificate in FNP. However, then I started thinking about just going all the way to become a MD. It has always lingered in my mind to do it, however I believe rigorous acceptance attempts and timing have always scared me. Not to mention, I would have to takes 1-2 yrs of prereq courses before i even applied. Im not married and do not have kids, although i would like to and dont want to be 40 when i do!! LOL. Can anyone give me some feedback or things to consider that maybe could make my decision a little easier? I would appreciate it.

[CEG]

Well, first of all I wouldn't be too concerned about applications. Most med students I have worked with a young people straight out of college with little life experience and no bedside manner or practical medical knowledge (I am not saying this to be rude, it's just true!). So I think having a medical background and experience as well as bedside manner and skill in working with people will be a big help to an application.

Being a CNM is great if you are in a good practice setting. I would look at the laws if you know where you would plan to live and talk to some local CNMs about their practice. It is entirely possible for an OB to practice the midwifery model of care and for a midwife to practice the medical model of care. The issue is will the midwife be in a location where her ability to practice the way she wants is restricted too much by the laws and the local medical community? On the flip side though, OBs face a lot of pressure from the hospital and their peers to practice a certain way, speen up deliveries, do so many sections, etc, so being an OB doesn't guarantee you the ability to practice the way you want either. An OB who starts a birth center or does homebirth is going to get a lot of grief from the community. Obviously CNMs do not provide surgery and there are some cases where patients with whom they have built a relationship must transfer out of their care, which is definitely a drawback.

I have considered going to med school myself so that I would have more freedom to practice (I am in a very backwards state as far as licensing CNMs) but I also think that med school kills the passion that brings someone into the health care field in the first place and I am scared of that. I have yet to meet a resident in OB who had a passion or real desire to provide quality health care. It was always more of a practical decision and the nuts and bolts of patient care.

Good luck with whatever you decide.

[shaynalmt]

I think there are really different philosphical positions of midwives and OB's.

Not that all midwives are wonderful and all OB's stink, but like the last poster said, it's almost

impossible to come out of that with a genuine faith in birth and real care for the person as a human being.

a midwife is not just a baby-catcher who wasn't smart enough for med school.

What and who do you want to be?

"Start with the End in Mind"- have a vision

then do whatever it takes to get there... whatever that is.

Good Luck!

[JeanettePNP, MSN, RN, NP]

Personally if I were going the MD route it wouldn't be for OB/GYN... it's one of the worst specialties to be in, due to the high malpractice. I woudln't want some lawyer to be able to come after me for millions of dollars based on a birth outcome that could not have been prevented. When a patient sees a CNM or opts for a homebirth she is already assuming a certain degree of liability for herself... the homebirth mother realizes that she is responsible for her body and her medical choices. She doesn't expect to go to the hospital and have them guarantee a perfect outcome. OB's have to do too many things that are of no benefit to moms or babies just to avoid getting sued. If you really want to be an MD, then choose a different specialty, and if you really want to work with births, then go with CNM.