CNM or direct-entry midwife - page 2

Hello. I am trying to decide between a career as a CNM or a direct-entry midwife. I know there are some differences between the two and I was wondering if anyone can expand on this. I read that CNM... Read More

  1. by   clhRN2b2010
    I just wanted to pipe in that I am also beginning the journey to CNM after planning on DEM for three years and realizing that for all the above reasons and wasn't the best fit. Philosophically, HB and DEM is absolutely where my heart and head are and I am preparing to be challenged in my core. Some of my very hard core friends are treating the decision to go CNM like a betrayal. For me, it has practical reasons: insurance, money, practice partnerships, being where the women are who need you.. and in addition to the reasons listed above, we want to be able to international mission work and in most countries the DEM is not recognized at all. To do such relief work and be eligible for aid and collaborative partnerships, the CNM is the way to go.

    So....18 years after graduating college for the first time, I am heading back for NS this Fall to begin this journey.
  2. by   okchug
    Thanks to all of you.
    This is a very enlightening thread. I have struggled with the same decision for years and felt alone and confused. In my state, there is no regulation on lay midwives. They are perfectly legal and don't have to be licensed or anything. though they are not supported either. We've lost 3 birth centers in the last few years. I had a friend recently start a home-birth and ended up going to the hospital and they wouldn't let the midwife thru the door! so sad..
    I have finally decided to go to nursing school, then on to CNM in order to avoid all the obstacles around here. As a doula I have worked with some great CNMs in the hospital even. The moms had "home-away-from-home" experiences. So I know it's possible to work within the system. It's just a matter of finding the right system.
  3. by   smallwonders07
    Hello. To those of you who have done both CNM and direct-entry midwifery, how similar is the curriculum? Do both sides emphasize herbs/homeopathy? Thanks.
  4. by   nizhoni

    I am an RN who is a California licensed midwife and a direct-entry midwifery educator. I have not done a CNM curriculum but have seen several. I would say there tends to be more variation between the curricula for direct-entry midwifery schools than there is between the various nurse-midwifery programs. And in answer to your specific question, you are unlikely to find much regarding herbs and/or homeopathy in CNM curricula. DEM pharmacology typically includes the study of the usual birth-related allopathic meds (Pitocin, methergine, antibiotics for GBS prophylaxis, cytotec for hemorrhage, etc.) as well as the study of alternative pharmacology, including herbs and homeopathy. However, some of the newer nurse-midwifery texts now make mention of alternative pharmacological methods, and I think that's very useful. Why shouldn't all of us midwives have equivalent knowledge in these and other areas?

  5. by   clhRN2b2010
    As far as I have seen and heard, if as a CNM student I want to expand my knowledge base of alternative, herbal, or homeopathic treatments I will need to do that on my own. Some programs are beginning to make teeny tiny steps in that direction.

    It is something that I would do though because I think that the women we serve would be better served if I had that knowledge and experiance to draw from also.
  6. by   smallwonders07
    Nizhoni, Thanks for the reply. I didn't know direct entry midwives used things like pitocin and other drugs. I thought they weren't allowed to prescribe drugs?
  7. by   sierrak
    I am now a senior and i am kind of "iffy" about what i would like to pursue in college. I also live in Maryland and i would like to know if not becoming a cnm and going directly into it would be a good idea. Should i even count it as an option?
  8. by   springing
    I think if you plan on staying within the U.S. CNM is the most PRACTICAL route. However, it's worth it to note than in many other countries, DEM is the norm, not the outlier. In Australia, for instance, where midwives attend the vast majority of births, getting your bachelor's degree in midwifery as opposed to nursing is considered the best route to take because you spend more years learning the trade. You can also obtain a midwifery certificate after one year of post-BSN study, but getting the bachelor's in midwifery is preferred. In New Zealand, midwives must obtain midwifery degrees. In Britain, only nurses who specialized in adult health care can take a post-bachelor's course to become a midwife. Any other nurse specialization is required to take the whole three-year midwifery degree. in Canada, there are a bunch of four-year midwifery bachelor's programs. It seems like just like the metric system and the side of the road we drive on, America is determined to be contrary to the rest of the world However, with the exception of Canada (where salaries are about as high as the U.S.), midwife salaries are on par with other nurses with bachelor's degrees.