CPM VS. BSN

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cayenne06, MSN, CNM

Specializes in Reproductive & Public Health. Has 10 years experience. 1,394 Posts

I didn't go into midwifery to help affluent women have beautiful home births. I went into midwifery to serve ALL women, in all areas of reproductive health, regardless of their socioeconomic status.

This. Right on. Amen, sister.

I work at Planned Parenthood and don't even catch babies anymore. And I've never felt more fulfilled in my work. Being a midwife is so much more than catching cute slippery newborns (although that's an awesome perk!).

AspiringNurseMW

AspiringNurseMW

1 Article; 942 Posts

Dollars in do not equal salary, benefits, time off, retirement..... for the most part it's a solo business. With no potential for career development. The CPM is a terminal credential. That's it.

This! This right here is why I am choosing CNM over CPM. I have a family with 2 young daughters and need to consider our future. What if something happens that leaves me physically unable to attend births, having a background in nursing means that I can still take my knowledge and schooling to a different type of job, administrative, teaching, etc. I can pursue other post masters or a doctorate. I can work as a nurse if I need to. Even as a midwife, I won't be limited to home or birth centers. I could get a job potentially only doing gyn care.

At first I looked into CNM because my state does not license CPMs, but the more I learn about nursing in general, the better I feel about this choice.

minerwife927

minerwife927

26 Posts

Follow your heart. I am an LPN and started my journey to become a CPM. I toyed with the idea of CNM but my heart lies in home birth and evidenced based births so hospital was out for me. Licensing for CPM varies from state to state but MD just became a licensed state recently and PA is working on it. If you want to work in a hospital environment I guess CNM is best route. Why not take a class at The Farm and see what you think after that. Definitely pick up some books from Ina May and read what she has learned being a CPM. I know some in my unlicensed state in PA that make much more yearly than a CNM

klone, MSN, RN

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership. Has 16 years experience. 14,256 Posts

Follow your heart. I am an LPN and started my journey to become a CPM. I toyed with the idea of CNM but my heart lies in home birth and evidenced based births so hospital was out for me.

Okay, I have to say I bristled at this. I know the hospital birth system is far from perfect, and in many places, it's downright dysfunctionally broken. But in many places it works WELL, there are robust midwifery practices, and residents/attendings who have working collaborative relationships with them, and practice evidence-based medicine. There are also many wonderful FSBCs, and more are being created every year, all over the country. Please don't paint all "not at home" births with the same broad brush.

I can tell you some horror stories about non-CNM midwives in practice here in Denver, and how very NON evidence-based their practice is.

There are also many CNMs who do homebirths.

FutureNurseKali

FutureNurseKali

48 Posts

@minerwife927 Thats all I've been hearing is how CNM is the best route to take. But then I've read so much information on how CPM's have been so fulfilled and happy on the decision they made to get that credential. I've researched several successful birthing centers that now have staffed midwifery students and no one seems to be regretful about becoming a CPM vs a CNM. I got into the idea of nursing initially because it was thet only way I could fulfill my passion on being involved in the labor and delivery process. There is no other specialty I'm even remotely interested in at all. Dealing with women's health, labor, delivery, postpartum all of these things are what I'm interested in. Which is why the CPM credential was far more appealing to me. I also don't want to make the wrong choice either, which has me on the fence. Especially with everyone saying that I'll be on call 24/7 and I won't ever make any money. I do work full-time and I have 3 children to support, so financials are important as well. I also don't want to have to quit my job to attend school either, I enjoy my household being a two income household. I just hope I'm able to follow the right path and make a sound decision.

LibraSunCNM, MSN

Specializes in OB. Has 10 years experience. 1,607 Posts

Follow your heart. I am an LPN and started my journey to become a CPM. I toyed with the idea of CNM but my heart lies in home birth and evidenced based births so hospital was out for me. Licensing for CPM varies from state to state but MD just became a licensed state recently and PA is working on it. If you want to work in a hospital environment I guess CNM is best route. Why not take a class at The Farm and see what you think after that. Definitely pick up some books from Ina May and read what she has learned being a CPM. I know some in my unlicensed state in PA that make much more yearly than a CNM

Yes, this is pretty unfair. Hospital birth does not equal a lack of evidence-based practice. Many times it does, but there are great institutions out there keeping birth safe for women who need or choose a hospital birth. And as we've heard from prior posters who actually were CPMs, there can be a huge dearth of evidence-based practice amongst CPMs. I think part of this probably stems from the very broad educational requirements for CPMs (until recently I don't think you even needed to have a high school diploma to be a CPM).

"Taking a class at the Farm" will not open my eyes to anything I don't already know. I have read all of Ina May's books and have the utmost respect for her, but that doesn't mean that CPMs are inherently safer than CNMs because they only do homebirths, or that CNMs only work in hospitals...I could go on.

That's great that you know CPMs who make more than CNMs, but I think that's probably extremely rare (again, going on the excellent insights that cayenne and queenanneslace have given us).

Edited by LibraSunCNM
forgot a word

cayenne06, MSN, CNM

Specializes in Reproductive & Public Health. Has 10 years experience. 1,394 Posts

I'd encourage anyone considering CPM school to search my posts and posts from other CPMs on this site. I too became a CPM because I had no desire to work in "mainstream" health care. Well, circumstances change, career goals can shift as you grow and learn, and what you want or need in 10 years might be very different than what you want now. Your options as a CPM are limited. And I do want to stress that there is a big problem with non-evidence based care being taught as gospel in the CPM pathway. I am shocked sometimes, when I think back to certain things I was taught in CPM school.

CNMidwife2Be

CNMidwife2Be

47 Posts

FutureNurseKali if midwifery is your goal than you should definitely speak to some CNMs in your area. I realized my calling to midwifery before starting nursing school and didn't know if should pursue the CPM or the CNM. My heart lies in out of hospital birth and I never had any interest in nursing. Ultimately though (after a lot of research), I concluded the following about the CPM credential:

1.) training is incredibly inconsistent. I've met talented, skilled CPMs who are licensed in their states. I've also met CPMs who were lacking basic safety info and yet who passed the cert exam. The 3 year MEAC approved programs seem to provide a more solid education but the apprentice route is only as good as the quality of the preceptor and the drive of the student. In some states/areas CPMs are respected, in others they're seen as a dangerous threat to the midwifery community.

2.) the lifestyle is brutal and the pay low. This is true for all home birth practices - and perfectly okay if it's where you want to practice but there are no back up options. I am grateful that as a future CNM I can share call in a birth center or hospital setting, switch to well woman/gyn care, work in public health, or teach on the college level. I do hope to have a home birth practice some day but I'm glad I have options.

3.) As a CPM, you can only practice legally in about half of the states and as such there's a much higher risk of legal prosecution.

I feel that although my CNM education has, at times, been more medicalized than I'd prefer, overall the quality has been high and the info evidence-based. It's also a long haul as you mentioned - I've been at this for 5 years and am now close to finishing my CNM program. But I feel the flexibility to work in any setting or state, to be respected by the medical community, and to have the potential to earn an excellent salary all while pursuing my passion has definitely been worth it.

queenanneslace

queenanneslace, ADN, MSN, APRN, CNM

Specializes in Nurse-Midwife. Has 10 years experience. 302 Posts

.... how CPM's have been so fulfilled and happy on the decision they made to get that credential. I've researched several successful birthing centers that now have staffed midwifery students and no one seems to be regretful about becoming a CPM vs a CNM...

This made me laugh out loud. You need to talk to more CPMs. I know very few who are 'fulfilled and happy' and have no regrets about pursing the CPM over CNM. You need to talk to more midwives!

Now, in a public forum, or standing in front of their birth center, they might not be so forthcoming about their ambivalence about the profession. But I would say a good HALF of my CPM friends have completely left the profession - some becoming CNMs and others just doing something else. And I know a few CPMs who feel absolutely stuck and trapped and aren't sure how to get out.

cayenne06, MSN, CNM

Specializes in Reproductive & Public Health. Has 10 years experience. 1,394 Posts

This made me laugh out loud. You need to talk to more CPMs. I know very few who are 'fulfilled and happy' and have no regrets about pursing the CPM over CNM. You need to talk to more midwives!

Now, in a public forum, or standing in front of their birth center, they might not be so forthcoming about their ambivalence about the profession. But I would say a good HALF of my CPM friends have completely left the profession - some becoming CNMs and others just doing something else. And I know a few CPMs who feel absolutely stuck and trapped and aren't sure how to get out.

Probably half of my CPM class went back to become a CNM. I know plenty of CPMs who have rewarding, lucrative careers, but they a) live in states where they are licensed and get insurance/medicaid reimbursement, AND b) work insane hours and/or took over an established and busy practice.