Best CNM programs for home birth midwives?

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Specializes in Nurse-midwifery.

Hello!

Which CNM programs do you think are best for becoming a home birth midwife?

I am working toward becoming a nurse midwife, and have been accepted into some graduate entry programs (accelerated BSN to MSN in midwifery). I'm still waiting to hear back from a few schools, including 2 BSN programs in my area. I ultimately want to practice in an out-of-hospital setting, either in a birthing center or home birth practice. I'm still trying to determine which program would most help me become an excellent out-of-hospital midwife.

I've been accepted to OHSU, Columbia, and Vanderbilt. I'm waiting to hear back from UIC. So far, it's my understanding that OHSU and Vanderbilt offer some clinical experience out of the hospital, and that UIC and Columbia do not. To those who have attended or are attending any of these schools, what has your experience been? What strengths or weaknesses do you see in your programs?

I've also considered doing a traditional BSN (rather than the accelerated BSN to MSN), and then applying to Frontier. Everything I've heard about Frontier sounds great, especially the opportunity to do clinicals in so many settings. The major reason I hesitate to go there, though, is that it's a distance program. I am in a position to move to a new city for school, and would rather be in the "traditional" school environment at this point.

I would really appreciate any feedback. Thanks so much!

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For what it's worth. I have a goal of becoming a CNM also, and while I am not primarily focused on HB-I am as intervention-less as possible and had all of my babies in free standing birth centers. (no HB CNM in my area-or I would have done that!)

I have made my choice and am going the BSN, work for a while, then go to Frontier route. (Obviously, this my goal-I have to make it happen now) I started nursing school in January. I ultimately chose this path because while I too "prefer" the structure and what seems like security of a traditional program, I feel the philosophy and my fellow students philosophy will be super critical. I long for a visionary class mate in school currently, and have yet to find one with similar passions. Also, when the time comes to be doing Midwifery training, with Frontier I can find my preceptor(s) and make sure we mesh and I am learning about the areas that I want to focus on for my future goals. My perception is that I will have a lot more say in where I do clinical rotation.

I do not want to play down that it may be vitally important to get good hospital, crisis, C section experience. I have a friend who is a birth center/ Homebirth CNM and really is grateful for the time she spent as a L&D nurse in a very busy, inner city hospital b/c of the skills she learned and things she witnessed. She said recently, she stepped in to perform an episiotomy in the heat of a difficult labor with another CNM who did NOT have epxeriance. The CNM whose pt needed the episiotomy was unprepared to do this because in her training she did not have experiance with them. The baby came quickly and maybe was saved an emergency transport to the hospital and inevitable C section to follow.

I'm blathering. So sorry! Best wishes in your decisions! Go Midwives, the world needs more!:yeah:

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Specializes in OB.

Hi! I'm a Frontier student and noticed that you both mentioned getting your BSN, then going to Frontier (possibly). Frontier has a great bridge program that allows you to finish your MSN in just 3 years, when you start with an ASN degree. It's a great thing, IMO, shaving off one year of school (and tuition!).

-Just FYI!

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I do not want to play down that it may be vitally important to get good hospital, crisis, C section experience. I have a friend who is a birth center/ Homebirth CNM and really is grateful for the time she spent as a L&D nurse in a very busy, inner city hospital b/c of the skills she learned and things she witnessed. She said recently, she stepped in to perform an episiotomy in the heat of a difficult labor with another CNM who did NOT have epxeriance. The CNM whose pt needed the episiotomy was unprepared to do this because in her training she did not have experiance with them. The baby came quickly and maybe was saved an emergency transport to the hospital and inevitable C section to follow.

:yeah:!

I just want comment that I believe it is rare that a newly graduated CNM is not prepared to perform episiotomy, or have not done one in clinical training. As a previous L&D nurse, I find it hard to envision being able to perform an episiotomy just from watching. There's a lot more going on that just "cutting". For instance, you have understand the difference between a midline and a mediolateral cut and how far to cut. You have to know how to give local anesthesia. Furthermore, it's hard to judge whether or not an episiotomy would have been needed, as women will tear naturally if the baby needs more room. The indication for one is usually a non-reassuring baby, NOT to prevent a C-section, as the head is already crowned.

I'm not trying to start a debate. I love that you support midwifery. But many people come to this thread to get information about CNM education, and I want to do my part to clear up what might cause a misconception.

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Hello!

Which CNM programs do you think are best for becoming a home birth midwife?

I am working toward becoming a nurse midwife, and have been accepted into some graduate entry programs (accelerated BSN to MSN in midwifery). I'm still waiting to hear back from a few schools, including 2 BSN programs in my area. I ultimately want to practice in an out-of-hospital setting, either in a birthing center or home birth practice. I'm still trying to determine which program would most help me become an excellent out-of-hospital midwife.

I've been accepted to OHSU, Columbia, and Vanderbilt. I'm waiting to hear back from UIC. So far, it's my understanding that OHSU and Vanderbilt offer some clinical experience out of the hospital, and that UIC and Columbia do not. To those who have attended or are attending any of these schools, what has your experience been? What strengths or weaknesses do you see in your programs?

I've also considered doing a traditional BSN (rather than the accelerated BSN to MSN), and then applying to Frontier. Everything I've heard about Frontier sounds great, especially the opportunity to do clinicals in so many settings. The major reason I hesitate to go there, though, is that it's a distance program. I am in a position to move to a new city for school, and would rather be in the "traditional" school environment at this point.

I would really appreciate any feedback. Thanks so much!

Based on my experience with attending ACNM conferences and listening to the speakers, I have always been fascinated with OHSU as one of the innovative places for midwifery. They let women labor for longer that "the guidelines". They are one of the 2 hospitals in the US using Nitrous Oxide in pain management.

As far as getting home practice experience, some of my classmates had only home birth experiences in the intrapartum component. You could try to see if that would be possible for you, wherever you decide to go. That's usually how you would get the "home practice" experience as a student. Hospitals may not be a desirable place for you to end up, but it would be where you would get your clinical skills such as IV and catheter placements. What you decide to do after you graduate is up to you, which of course is what's wonderful and versatile about being a CNM. Good luck.

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I live in IL and as far as i know - it is illegal for homebirths to take place in the state with ANY kind of provider (CNM, CPM, etc.) - so the likelihood of you actually could find ANYONE willing to be public at all about attending home births is really non-existent.

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Specializes in Ante-Intra-Postpartum, Post Gyne.
I live in IL and as far as i know - it is illegal for homebirths to take place in the state with ANY kind of provider (CNM, CPM, etc.) - so the likelihood of you actually could find ANYONE willing to be public at all about attending home births is really non-existent.

IL laws against home birth fortunately to not extend to the rest of the country. I am in California and they even allow LM (Licensed Midwives) who have never even gone to nursing school attend home births. Cara Muhlhahn is a CNM that does home births in NYC and is very public about doing so, she even wrote a book about it. It is legal in other states as well.

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IL laws against home birth fortunately to not extend to the rest of the country. I am in California and they even allow LM (Licensed Midwives) who have never even gone to nursing school attend home births. Cara Muhlhahn is a CNM that does home births in NYC and is very public about doing so, she even wrote a book about it. It is legal in other states as well.

*I agree. It is sad. I had my daughter in a planned homebirth with a CNM and a CPM in VA, and now that I live in IL, I'm torn about going to school to be a CNM because my only options in this state would be hospitals.

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Specializes in Nurse-midwifery.

Thanks to all who have commented. I'd love any continued insight!

My top choice at this point is OHSU. If that doesn't work out, I may do the traditional BSN route, and then go to Frontier. Where I end up will also depend on my husband's job options and where we're able to move.

Also, for others interested in the programs I mentioned, I did find out that Columbia does offer a little experience out of the hospital, with a few clinical options in birthing centers or home birth.

As for home birth in IL - I live in Illinois and have been involved a bit in legislative efforts here on behalf of CPMs. It is my understanding that home birth is legal for CNMs and MDs, but not for CPMs (in Illinois). However, the laws for physician collaboration for CNMs are not great in Illinois, so while it's legal to do home birth, it's difficult to find back up physicians, as far as I understand.

Thanks again to everyone!

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*I agree. It is sad. I had my daughter in a planned homebirth with a CNM and a CPM in VA, and now that I live in IL, I'm torn about going to school to be a CNM because my only options in this state would be hospitals.

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IL is tough. I live in IL, and have 4 births myself- 2 in the hospital (first and last babies) with CNMs, and 2 at home with lay midwives (second and third babies). The midwives who attended my homebirths absolutely operate outside of the law. Their group is a mix, but they are mainly what you would call apprentice-trained. My experience (having chosen homebirth as a consumer in this state) is that there is such a contrast between hospital and home births, that I see them as totally different kinds of midwives....I know thats a generic assessment that probably isn't the same as the other states, but that' s been my experience. I'm going to school to be a CNM, and so in my state, that means I will work with women who deliver in hospitals. If I wanted to be a homebirth midwife, I would do an apprenticeship with a homebirth practice.

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Specializes in Emergency Department.
I live in IL and as far as i know - it is illegal for homebirths to take place in the state with ANY kind of provider (CNM, CPM, etc.) - so the likelihood of you actually could find ANYONE willing to be public at all about attending home births is really non-existent.

Stickler here... It's not illegal to give birth at home anywhere in the US. The practitioner is the one who finds herself shackled by the law depending on the state. Further, CNMs do attend home births legally in Illinois-- but with collaborative agreements with physicians. A whole 'nother shackle.

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Frontier School Of Midwifery and Family Nursing is a great school from what I hear. And it would have to be, it was the first school to start the midwife role! Go to http://www.midwives.org

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