RN as a Midwife Assistant

Specialties CNM

Published

I am an RN who has had the goal of working towards becoming a CNM. However, a year out of nursing school in a very tight labor market (central California) has led me no where near a job in L&D, postpartum, or even a job at a big hospital where I could work my way into those departments. (I am working in a snf full time and floating to med/surg or outpatient infusions, in a small rural hospital...)

Long story short, I was referred by my former CNM (who has just retired) to a LM who is looking for a assistant. We meet today and we went over my duties, pay and she mentioned that assistants fall into this grey area of liability, but she thought we would be okay since I was an RN and not a lay person. This is something I really am excited about, but in my nursing school they drilled into us about "protecting your license", so I'm a tad paranoid...

I can not find out what standards their are for assistants online. Anyone know where I would find this info? What about my ? Any thoughts?

Hi there! I'm not completely sure, but am responding with what I think I know because no one has given you an answer yet. :)

I was living in California as well when I decided that I wanted to be a midwife. As I was going back and forth between the CPM vs. CNM option, I decided on becoming a CNM because at that time (about 5 years ago) I was under the impression that to be practicing completely legally as a midwife in California, one had to have physician backup.

If that is still the case, I would think that your RN license would absolutely be on the line if you were part of a birth with a bad outcome without physician backup. I do know of a midwife in California who was also an RN and lost her RN license after a bad home birth outcome.

I am now an RN living in Oregon and attending home births with a CNM, but physician backup is not required here, so her practice is completely legal.

If you can't find information about liability on the website, I would call the California Board of Nursing to get all of the information you need about protecting your license.

Good luck!!

Specializes in Reproductive & Public Health.

I am in Mass, and we don't really have CNMs attending homebirth, although they theoretically could thanks to our new legislation. We have a handful of CPMs, but not too many and AFAIK they don't use RNs. Anyway, I have looked into this as I am a former CPM, on my way to CNM. As long as the LM is not practicing illegally, you are perfectly within your scope to practice as a birth assistant, as long as you are very clear on your limits- i.e NO PRACTICING AS A MIDWIFERY STUDENT! No amniotomies, no catching babies, no suturing etc. When I worked as a CPM in Florida, we had an RN as a birth assistant and it was very tricky, as she realllllly wanted to be a CPM but was not officially enrolled as a student in our program. You cannot blur these lines, or your license will be at risk.

Look up your state's laws regarding non-nurse midwifery. If the LM is practicing within state guidelines (which vary widely), you are fine. Obviously don' take my word for it- contact your BON if you are unsure.

Specializes in Nephrology, Cardiology, ER, ICU.

I would contact your malpractice carrier - they could advise you as to the legality. I would also check with your state board of nursing.

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