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Homebirth Gone Awry



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No. 20
from Tolle_lege
Old Nov 01, 2009, 11:49 PM

Default Re: Homebirth Gone Awry
I feel like I had the best "between both worlds" experience with my labor/birth experiences. I have had four children in a small community hospital owned by a large corporation CHW. I had a midwife who delivered the last three. These three were water births. I was allowed to eat and drink freely during labor, though eating was discouraged later on in labor by my nurses. They checked me with a 20 minute strip upon admission and after 4 cm when I got into the tub I was checked with an underwater "dopplar"? the hear the baby's HR. The water took about 80% of my pain away as soon as I got in. It helped my pain management a great deal.
Interestingly enough, the larger CHW hospital closer to where I live does IV on admission, almost continuous monitoring, no eating, and a high rate of C-sections. Many of my nurses during my labor/deliveries stated that they moved to the smaller hospital because they did not like the large busy hospital feel of larger OB unit. Just interesting.
I had thought about having a home birth for the natural choices, but I was glad that I had the opportunity to have a safer birth with modern technology readily available without all my choices being taken away.

I will be going into the second year of the RN program as an LVN, it will be interesting for me to see how OB is run at this larger hospital from a clinical perspective.
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No. 21
from CEG
Old Nov 02, 2009, 05:55 AM

Agreement Re: Homebirth Gone Awry
Originally Posted by Not_A_Hat_Person View Post
I think midwifery should be limited to advance practice RNs. CPM education varies widely. People often cite the Netherlands for good midwifery outcomes. Dutch midwives are required to have 3 years of university education.

The difference between a CPM and a Nurse Midwife is like the difference between a Registered Dietician and Nutritionist; Dieticians have degrees and pass a licensing exam, while anyone can call themselves a Nutritionist.
CPMs actually take the exact same licensing exam as CNMs. So no, not anyone can call themself a CPM unless they do the education, apprenticeship, and pass the exam. In fact in my CNM program and in midwifery programs of other types that I am familiar with, the midwifery students actually get far MORE births and experience in OB than a family practice resident does in their residency.

People get all worked up about the "apprenticeship." What if we called it a "residency." Or let's call what doctors do an "apprenticeship." They're the same thing!

Everything from prescribing meds to ordering tests is totally different when dealing with a pregnant patient population. I do provide some primary care services and that is where my nursing comes in handy- albeit rusty because I was an OB nurse so I didn't even do a lot of primary care, I am having to reach back to nursing school for that. Perhaps and expanded primary care educational component for midwifery schools and the elimination of the nursing requirement would be more effective.
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No. 22
from Apgar10
Old Nov 02, 2009, 10:13 AM

Default Re: Homebirth Gone Awry
Originally Posted by CEG View Post
CPMs actually take the exact same licensing exam as CNMs.
No we don't. Similar in core educational points, but not the same test. If it were the same, we could petition the ACNM (ACMB) to certify us as Certified Midwives, their designation of non-nurse midwife.

People get all worked up about the "apprenticeship." What if we called it a "residency." Or let's call what doctors do an "apprenticeship." They're the same thing!
This is the analogy I use too.

Everything from prescribing meds to ordering tests is totally different when dealing with a pregnant patient population. I do provide some primary care services and that is where my nursing comes in handy- albeit rusty because I was an OB nurse so I didn't even do a lot of primary care, I am having to reach back to nursing school for that. Perhaps and expanded primary care educational component for midwifery schools and the elimination of the nursing requirement would be more effective.
That would be nice, but good luck convincing ACNM their Certified Midwife credential might actually be more effective
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No. 23
from CEG
Old Nov 02, 2009, 02:00 PM

Default Re: Homebirth Gone Awry
Originally Posted by Apgar10 View Post
No we don't. Similar in core educational points, but not the same test. If it were the same, we could petition the ACNM (ACMB) to certify us as Certified Midwives, their designation of non-nurse midwife.






That would be nice, but good luck convincing ACNM their Certified Midwife credential might actually be more effective
Sorry- I got it confused. It's the "Certified Midwife" exam that is exactly the same. I should really, really know the difference. I have heard the NARM is far more rigorous than the CNM exam but I don't want to put that to the test anytime soon
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No. 24
from Apgar10
Old Nov 02, 2009, 02:10 PM

Default Re: Homebirth Gone Awry
Originally Posted by CEG View Post
Sorry- I got it confused. It's the "Certified Midwife" exam that is exactly the same. I should really, really know the difference. I have heard the NARM is far more rigorous than the CNM exam but I don't want to put that to the test anytime soon
Hey, no worries-- it IS confusing!! The ACNM Certified Midwife (CM) credential was made in direct response to NARM's creation of the Certified Professional Midwife (CPM) credential. Anthropologist Robbie Davis-Floyd tells the story about the competition for a direct-entry midwife credentialing process between the two organizations during that period. ACNM really wanted the CPM but NARM claimed it first. ACNM thought by creating the CM, they could give NARM a run for their money and attract more prospective midwives. It seems that ACNM doesn't really pay a lot of attention to the CMs and frankly, if you're going to do the education required to earn the CM, why wouldn't you just be a nurse-midwife?

I'll keep your comment in mind when I eventually get to my CNM exam... I thought the NARM test wasn't too hard or scary.
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