English Midwife

Trauma Columnist · Oct 23, 2006

Hi and welcome. In the US, certified nurse midwives are advanced practice RN's - meaning they have at least a master's degree in nursing and several years of experience.

The exact job duties are determined by the state in which you practice. I am an advanced practice nurse but in adult health so I'm sure there will be some CNM's come along who can describe their typical days.

Just wanted to welcome you.

JentheRN05, RN · Oct 23, 2006

:welcome:

Kelky · Oct 23, 2006

Hi! I'm an English midwife working as an RN in L&D in GA. It's very different. I can give you details later, right now I'm rushing out to work.

Tanvi Tusti · Oct 23, 2006

Hi all, thanks for your replies. There are 2 routes to becoming a midwife in the UK. First, be an RN, get a few years experience, then do an 18 month-2 year specialist degree in midwifery, or direct entry, which is a degree 3-4 years in length, no prior experience needed.

Id love to use my skills in a positve way in the US but do midwives do deliveries over there, do they have professional autonomy? Thanks in advance.

xx

rbytsdy · Oct 24, 2006

Midwives here can operate under very different circumstances. Some work in an ob practice and are essentially "another pair of hands to catch babies." Typically, with ob practices, you are delivered by whomever is on call. My SIL had 3 obs and 1 midwife in her practice. She just happened to get the midwife.... on the day she went in for her induction. Obviously, they are no all holistically oriented! Others work with ob practices but maintain their own patients. I used a group of 3 midwives that practiced along with a large ob group. I decided to use the midwives b/c I was looking for a natural and more personal birth experience. Unfortunately, the midwife that was on call was very intervention happy and I ended up with a c-section. There is a midwife in that group whom I just love. She did her midwifery in England and has a much more natural approach to birth which is what I was looking for. She is an RN midwife - I don't think she has an MSN although most American midwives do. Unfortunately, I can't guarantee she'll be there for my next birth so I plan to switch to a practice of 2 independant midwives who do either home or hospital births. I'd love to do a home birth but it's illegal for a midwife to attend an hbac in my state (NJ).

Laws vary widely by state. You can find state laws here: http://www.mana.org/ For instance, in NJ, some nurse midwives do just homebirths, some do just hospital births and some do both. Direct entry midwives are not allowed to attend births in hosipitals so they can only do homebirths or birthing center births. In Texas, midwives (nurse or direct entry) are prohibited from doing hospital births. In hospitals, midwives are somewhat restricted due to hospital protocol but some hospitals are more natural birth/ midwife friendly that others. In some states, midwives must have a doctor back up should something go wrong with their patients.

If you are interested in demedicalized birth, there are definitely opportunities. I don't know about licensing, etc so I don't have advice there (I'm still in school) but some women search high and low for midwives that won't bombard them with testing and interventions.

Tanvi Tusti · Oct 24, 2006

Midwives here can operate under very different circumstances. Some work in an ob practice and are essentially "another pair of hands to catch babies." Typically, with ob practices, you are delivered by whomever is on call. My SIL had 3 obs and 1 midwife in her practice. She just happened to get the midwife.... on the day she went in for her induction. Obviously, they are no all holistically oriented! Others work with ob practices but maintain their own patients. I used a group of 3 midwives that practiced along with a large ob group. I decided to use the midwives b/c I was looking for a natural and more personal birth experience. Unfortunately, the midwife that was on call was very intervention happy and I ended up with a c-section. There is a midwife in that group whom I just love. She did her midwifery in England and has a much more natural approach to birth which is what I was looking for. She is an RN midwife - I don't think she has an MSN although most American midwives do. Unfortunately, I can't guarantee she'll be there for my next birth so I plan to switch to a practice of 2 independant midwives who do either home or hospital births. I'd love to do a home birth but it's illegal for a midwife to attend an hbac in my state (NJ).
Laws vary widely by state. You can find state laws here: http://www.mana.org/ For instance, in NJ, some nurse midwives do just homebirths, some do just hospital births and some do both. Direct entry midwives are not allowed to attend births in hosipitals so they can only do homebirths or birthing center births. In Texas, midwives (nurse or direct entry) are prohibited from doing hospital births. In hospitals, midwives are somewhat restricted due to hospital protocol but some hospitals are more natural birth/ midwife friendly that others. In some states, midwives must have a doctor back up should something go wrong with their patients.
If you are interested in demedicalized birth, there are definitely opportunities. I don't know about licensing, etc so I don't have advice there (I'm still in school) but some women search high and low for midwives that won't bombard them with testing and interventions.

Thanks so much for all that info. I'll read through the link you gave me and have another think about things. I would love to go back to midwifery at some stage so I need all the help I can get. Thanks again and I hope you somehow get your home birth!

CEG · Oct 24, 2006

The American College of Nurse-Midwives (www.acnm.org) has a section for foriegn midwives who want to practice in the US. I think the minimum requirement for licensure is a Master's degree, except for those who were practicing prior to that requirement. I'm not positive though. Good luck to you!

rbytsdy · Oct 24, 2006

Thanks so much for all that info. I'll read through the link you gave me and have another think about things. I would love to go back to midwifery at some stage so I need all the help I can get. Thanks again and I hope you somehow get your home birth!

Did I mention that some midwives are "traveling midwives?" That's how some women get to have their homebirths.

When you get here, you might want to check out groups that are very "natural" minded like La Leche League, Holistic Moms Network and the International Cesarean Awareness Network. Once you get licensed as a midwife here, that will be a great way to hook up with women who are interested in your approach to birth. Believe me, we need more midwives like you in the US. San Francisco is know for its "hippy/ natural/alternative" ways so I have no doubt you'll do well there. Are you sure you don't want to move to the East Coast???? :lol2:

Tanvi Tusti · Oct 24, 2006

Did I mention that some midwives are "traveling midwives?" That's how some women get to have their homebirths. San Francisco is know for its "hippy/ natural/alternative" ways so I have no doubt you'll do well there. Are you sure you don't want to move to the East Coast????

Thr traveling midwife sounds like a great idea, I guess it means that she goes wherever there is demand, is that right? My husband is from Seattle so thats where we will probably end up eventually although who knows lol.

I'm very much in favour of the non medicalised approach to birthing and like nothing better than delivering a home or water birth. Just love it and to see the joy on the parents faces after a birth that THEY planned is out of this world.

Thanks for your support. :icon_hug: :D

Kelky · Oct 24, 2006

OK as an English midwife working as an OB RN here's my input. I came from a unit in the UK where we did 'team' midwifery, so I often (not always) met the women before they went into labour. We rotated in and out of the hospital to homes and antenatal clinics as needed as well as staffing the hospital.

Here the RN's in the hospital have done some sort of post reg certification or training in OB, they are not midwives but do deliver babies in emergency situations. My role is to provide nursing care to the laboring woman and call the doc in as she gets close to delivery, then basically be his handmaiden, and then provide post partum care, do notes etc until the mom is transferred to the PP floor. In the unit I work women have to be continuously monitored, all have IVI's, it is very 'medical' and I do less labor support and more monitor watching and trying to keep up with the endless documentation and charting. Women always deliver in lithotomy and the docs even though they've seen these women throughout their pregnancies are very detached. I have to admit I find it stressful and demoralising and am moving to PP.

I did have my second baby over here with a group of midwives attached to a large OBGYN practice, and my experience was that they were autonomous and I never saw a Dr in my pregnancy, they only took on low risk women though. I had to have a hospital birth, I was told home birth is illegal in GA and I wasn't bothered enough to look into it. In the hospital I was looked after by OB Rn's and my midwife was hovering around (the docs in my experience don't do that andI don't know if the MW's always do but it was late evening). I was free to move around and monitored intermittently, and did not have to have an IVI. I was allowed to drink fruit juices etc in labor too. I delivered in a standing squat at my midwife's suggestion. I was visited then on M/B by the midwife and discharged by her the next morning, but there is no home visiting like we do, in fact I don't think I saw her again till my 6 wk check.

Tanvi Tusti · Oct 25, 2006

Thanks kelky, for you reply, it sure does sound different although having done a bit of reading, I think there are some opportunites to practice midwifery in a less medicalised environment. It's sure given me a lot to think about. :icon_roll :uhoh3: