Future CNMs

Specialties CNM

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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 . Hopefully something will be done soon. I don't mind the schedule.

For me it is a calling. Everything about OB/gyn is fascinating to me. I am also really supportive of the midwifery model of care and its affect on both mother and baby. Countries who use the mw model of care have lower infant mortality rates. Even in the US, where we ranked around 40 last year-- not good, when adjusted for the fact drs had higher risk pts, mw's had lower infant mortality rates in the first year. I don't like the MD care for low risk pgs.

Does anyone know if cnm's every work for the hospital and do shift work?

So what are your worries, hopes and why do you want to be (or are you) a CNM.

Specializes in NICU.

Hi everyone! I haven't had time to go back and read through the whole thread yet, but wanted to subscribe :) I am at the very beginning of my journey. I am on the waiting list for my school for my ADN and will begin nursing classes Fall 05. Right now I'm taking all my general ed. classes. When I graduate in May 07, I aspire to work in the L&D/aftercare unit of my local hospital. While I'm working, I'm going to slowly work towards CNM - I don't plan to finish for quite a while - my youngest just turned 2, so this is definitely a long term goal. But it is a definite for me! I'll post about my experiences (childbirth-related) next time. Gotta run! Great to see this thread :)

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What are the people at Frontier forcasting in terms of the malpractice issue, prescriptive authority and future of midwifery in the US? Everything I hear from Maryland CNMs is quite negative.

I just started Frontier last month and it is an amazing school. It is one of the most respected in the field and the faculty is incredible! I researched many schools and kept coming back to Frontier. I will never regret my decision to go there. It will be a hard 2 years but definately worth it in the end. The comraderie and sense of community among the staff and students keeps everyone going. I can't say enough about what an amazing school it is.
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Specializes in OB, lactation.

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?

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Alright guys....time for me to say adieu...... I am heading on a different track now I think. Midwifery is still an option, but a very faint one. I now think I might like to teach, but I am going to see where my journey takes me. Whatever I choose to do, I will get my Masters.

Good luck to all of you! I'll probably still jump in once in awhile and check out what's going on!

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Specializes in OB, lactation.

I hope you find something that you are happy doing! Best wishes in whatever you chose :)

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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). :)

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?

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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

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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 :)

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Specializes in OB, lactation.
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 :)

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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

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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

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

rofl Alison! :rotfl: :coollook:

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