FNP vs. CPM?

Specialties CNM

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I'm an RN currently in school for family nurse practitioner. I'm also enrolled in a direct-entry nurse midwifery program. I'm not sure what I'm going to do when I get out of school. The midwifery program is mostly for my own knowledge about birth. Birth is my passion. I plan on having more kids and I want to be educated before then. I'm just wondering if I did want to pursue a career as a CPM how that would affect me being an FNP. Would I risk my license even if I was not currently practicing as an FNP? I've been told that FNPs can be CNMs but I don't want to go that route because I do not support medicalized birth or hospitalization of moms and babies for low-risk deliveries.

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Specializes in LDRP.

Seren21,

CNM's are a diverse group of practitioners. While some do support the medical model of childbirth, the vast majority practice whatever variant of the midwifery model they feel most comfortable with. The midwifery model views childbirth as a normal, healthy process. The CNM is not limited to the hospital. Many practice in or own birth centers-these are places where you have a low risk population with low intervention birth. Some CNM's do home births as well.

I would recommend contacting a birth center and actually speaking to a CNM that delivers out of the hospital. CNM's have prescriptive authority and can practice in all 50 states, where CPM's have limitation is these areas. Good luck in your endeavors, Shannon:)

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Specializes in Emergency Department.
I'm just wondering if I did want to pursue a career as a CPM how that would affect me being an FNP. Would I risk my license even if I was not currently practicing as an FNP? I've been told that FNPs can be CNMs but I don't want to go that route because I do not support medicalized birth or hospitalization of moms and babies for low-risk deliveries.

You don't have to support medicalized birth or hospitalization as a CNM. That's the beauty of being a CNM-- you can practice wherever you want! If you're a FNP and a CPM you must be absolutely careful about what you do in each role and by that I mean you can't allow your scope of FNP to seep over into what you're doing as a CPM (you can't prescribe versed say, for a long prodroming primip) and vice-versa (you can't catch a baby under your authority as a FNP). Not being absolutely clear of what you are doing at the time you are doing it could result in some trouble.

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Specializes in Emergency Department.
CNM's have prescriptive authority and can practice in all 50 states, where CPM's have limitation is these areas.

We are not limited, we have absolutely NO prescriptive authority :chuckle

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Specializes in L&D, QI, Public Health.
You don't have to support medicalized birth or hospitalization as a CNM. That's the beauty of being a CNM-- you can practice wherever you want! If you're a FNP and a CPM you must be absolutely careful about what you do in each role and by that I mean you can't allow your scope of FNP to seep over into what you're doing as a CPM (you can't prescribe versed say, for a long prodroming primip) and vice-versa (you can't catch a baby under your authority as a FNP). Not being absolutely clear of what you are doing at the time you are doing it could result in some trouble.

The bolded can be a little tricky.

OP, now that you know being an CNM doesn't necessarily support a medicalized approach, have you considered getting both your CNM and FNP?

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I think it would be neat to be a FNP and a CNM. Then, you could be like a country physician, they used to treat a little bit of everything for the family and deliver babies, too.

There may be some people who think my view of this is Pollyana-ish, and well, that's just too bad.

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Specializes in Psych, ER, OB, M/S, teaching, FNP.

I think your biggest problem would be the blurring of the two scopes of practice. Even if you are not acting as an FNP in a certain situation, you could be held to a higher standard if there were any problems.

Try reading "Baby Catcher" by Peggy Vincent. She was a CNM that did home births. Not to ruin the book for you but she had a "friend' that wanted a homebirth and the woman was very high risk. The woman said she would see an MD and have a hospital birth but wanted Peggy to be her doula. She agreed and never "saw' the woman as a patient. Long story short, bad outcome and even though Peggy was acting as a doula, she was sued as a midwife because she had training and experience at a higher level. It was the end of her home birth practice.

i agree with other posters, see what CNMs can do in your area and see if that is the way you want to go.

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Specializes in Dialysis.

You should also realize that there is a difference in CNM schools. Some are totally geared toward hospital birth, training midwives as "mini OBs" or "medwives" as I've heard them called lol. I can't say for sure which schools are this way, but I know that Frontier is not. They prepare their midwife students for homebirths also. The homebirth CNM that I assist went to Frontier. She started in the hospital, then switched to homebirths. :)

Kate in IN

Homebirth assistant/nursing student

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Thanks to everyone who replied - very helpful information all around! I really appreciate it. I'm planning on finishing my FNP program and when my kids are older I'm going to look into going to the Frontier school. Sounds like they have a really good correspondence program and I'd have a leg up if I already had my FNP degree. I've realized that my life right now is not conducive to having a busy homebirth practice but it's something to think about and look forward to for the future!

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