How much neonate care for CNM?

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Hi,

I am very interested in becoming a CNM as I love the idea of providing care during the entire labor process. My question is, how much direct care with the newborns do CNMs get? I love the idea of working with babies but feel like I would miss the whole mommy-baby experience if I went the NNP route.

thank you!

Specializes in NICU.

I work as a NNP and with several midwives. Unless I'm very much mistaken, your role once the baby is born is to place the baby on mommy's chest and then the nurse calls the pediatrician to let them know about their new patient :)

I imagine midwives might play more of a role if it was rural medicine where there was a shortage of providers, but my experience has been that once the cord is clamped, the midwife doesn't provide direct care for the baby. I believe the scope of practice is to see newborns up to 30 days old, but this would be on the rare side. This sounds typical- my scope is up to 2 years old but I will readily admit that my expertise is nearly all within the first 6 months of life...

eta: I saw Libra's post on the other forum and she's right- if you did out of hospital births like home birth of birth center, you would probably play more of a role. This appears to continue to be on the rare side as 94% of midwife-attended births in 2014 were in the hospital...

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Specializes in OB.

I just answered your post in the NP forum, didn't see this post until afterwards. Hope it was helpful.

Thank you for your reply! First let me clarify that I am more interested in a hospital setting. May i ask about your work as an NNP? What i understood from your post is that the pediatrician is who works with the new baby after birth. does that mean that NNPs primarily care for the unhealthy babies? While I adore all babies, I'm not sure i could handle seeing helpless sick babies all the time :( I'd probably prefer a role caring for the healthy "normal" births which is why I think CNM may be more up my ally, though it is sad to hear I may not really get to care for the babies (in a hospital setting)!

Specializes in OB.
Thank you for your reply! First let me clarify that I am more interested in a hospital setting. May i ask about your work as an NNP? What i understood from your post is that the pediatrician is who works with the new baby after birth. does that mean that NNPs primarily care for the unhealthy babies? While I adore all babies, I'm not sure i could handle seeing helpless sick babies all the time :( I'd probably prefer a role caring for the healthy "normal" births which is why I think CNM may be more up my ally, though it is sad to hear I may not really get to care for the babies (in a hospital setting)!

I'm not an NNP, I'm a CNM. CNMs can care for well newborns up to 1 month of life (although I don't know any who care for them beyond the first few days). NNPs care for sick babies in the NICU---whole different (and awesome) animal.

The website for the American College of Nurse-Midwives might be of use to you---www.midwife.org. There's a ton of information about midwifery in the U.S., it's confusing so it's a nice resource to look to.

Specializes in NICU.
Thank you for your reply! First let me clarify that I am more interested in a hospital setting. May i ask about your work as an NNP? What i understood from your post is that the pediatrician is who works with the new baby after birth. does that mean that NNPs primarily care for the unhealthy babies? While I adore all babies, I'm not sure i could handle seeing helpless sick babies all the time :( I'd probably prefer a role caring for the healthy "normal" births which is why I think CNM may be more up my ally, though it is sad to hear I may not really get to care for the babies (in a hospital setting)!

If you were asking me, yes I am a NNP. Generally pediatricians care for what we call "well newborns" (healthy babies). Some hospitals utilize pediatric nurse practitioners in this role, although not that common, which is an avenue in which you could pursue.

While you will see a lot of sick babies in a NICU at a children's hospital, the vast majority of NICU babies in a community hospital are "merely" premature and need to spend time in an incubator growing bigger & learning how to drink from a bottle. This is not to say that they are not fragile or that there are no sick babies in these NICUs, but it's not quite the doom and gloom that one might imagine. Even at my very busy Level IV NICU where I worked as a nurse with 60+ beds devoted to just NICU babies, we "only" had on average one death a week. Of course it's horrible and tragic to see that happen, but it's a rare occurrence when you consider the hundreds of babies that otherwise go home.

Like Libra mentioned earlier, you are so new into this career path and you have plenty of time to do critical thought on what to do. Your goals might change with time. I personally thought I was for sure going to work in an adult ICU at a large trauma center and was all gung-ho for it after working as a nurse tech on a trauma surgery unit...until I did my pediatric rotation and fell in love with babies. Now I can't imagine doing anything else.

Best of luck. Keep allnurses posted on your progress :) we are rooting for you!

Specializes in OB.
If you were asking me, yes I am a NNP. Generally pediatricians care for what we call "well newborns" (healthy babies). Some hospitals utilize pediatric nurse practitioners in this role, although not that common, which is an avenue in which you could pursue.

While you will see a lot of sick babies in a NICU at a children's hospital, the vast majority of NICU babies in a community hospital are "merely" premature and need to spend time in an incubator growing bigger & learning how to drink from a bottle. This is not to say that they are not fragile or that there are no sick babies in these NICUs, but it's not quite the doom and gloom that one might imagine. Even at my very busy Level IV NICU where I worked as a nurse with 60+ beds devoted to just NICU babies, we "only" had on average one death a week. Of course it's horrible and tragic to see that happen, but it's a rare occurrence when you consider the hundreds of babies that otherwise go home.

Like Libra mentioned earlier, you are so new into this career path and you have plenty of time to do critical thought on what to do. Your goals might change with time. I personally thought I was for sure going to work in an adult ICU at a large trauma center and was all gung-ho for it after working as a nurse tech on a trauma surgery unit...until I did my pediatric rotation and fell in love with babies. Now I can't imagine doing anything else.

Best of luck. Keep allnurses posted on your progress :) we are rooting for you!

Sorry babyNP---just saw that you posted at the same time as me earlier today! Totally missed it. I now get that she was referring to you :blink:

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