How OB nurses work with CNMs

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Hi there! Had a question about how OB nurses work with CNMs in the labor room and in the postpartum floors of the hospitals. In the labor room, do the nurses do the observations of mums and lady partsl examinations, fetal monitoring and the midwives oversee care and come in and out to offer advice? Or is the midwife there all the time with the mom perhaps without a OB nurse?

On the postpartum do the CNMs do rounds and then the postpartum nurses help moms with more of the practical side of things? I'm just curious how the interaction in hospital is different from a OBGYN doctor and nurses compared to CNMs and nurses.

Many thanks

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Specializes in OB.

Are you from overseas?

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Yes. I’m a UK midwife who is emigrating this year to NY. We don’t have OB nurses, just midwives and doctors on our labor wards so I was just wondering how it all works within the team in US hospitals. I have a place on a CNM program which I’m excited for as it’s more expanded than my role in the UK. But I have a few questions of how the team works together over here. Thanks so much!

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Specializes in OB.
24 minutes ago, vimmie said:

Yes. I’m a UK midwife who is emigrating this year to NY. We don’t have OB nurses, just midwives and doctors on our labor wards so I was just wondering how it all works within the team in US hospitals. I have a place on a CNM program which I’m excited for as it’s more expanded than my role in the UK. But I have a few questions of how the team works together over here. Thanks so much!

No problem, I figured as much. Generally speaking, in the hospital, each patient has a nurse who performs their bedside care---gets them on and off the monitor, starts their IV, gives meds, puts in a catheter, gives postpartum nursing care, etc. The CNM would order the meds and do lady partsl exams since they're the provider---although in small enough hospitals the RN may do lady partsl exams or even insert internal monitors if the CNM isn't in house all the time. The CNM delivers the baby, obviously. The nurse is the one with the patient the majority of the time and the CNM will be in and out depending on how much labor support they do---some practices, CNMs do none, some are really hands-on. On postpartum, you're correct---the CNM does daily rounds and discharges but the postpartum nurse does the bedside care. Make sense?

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Hi Vimme, first of all CONGRATULATIONS on gaining a place on the CNM program. I am a UK Nurse Midwife too. I was thinking of doing the same as you but went on a different route. I just got my CGFNS report and the Nursing board have given me the all clear to take the NCLEX.

I just want to kindly ask how many years is the CNM program and did the school acknowledge your UK degree?

Thank you.

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Thank you so much LibraSunCNM! I thought it would become apparent when I started clinicals but it’s great to have a rough understanding of the roles.

Amvictorious- that’s great! Where are you moving to/moved to? What bought you state side? Sadly, because I’m a direct entry midwife my midwifery degree is not acknowledged in anyway (apart from it being a bachelors level qualification) and I can’t sit the nclex. To give myself full flexibility I’m doing an accelerated masters in nursing and then a three year DNP in nurse midwifery. I’m working at a London hospital currently.

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Hi Vimme, I used to work at Barts Health hospital. I immigrated to Florida couple months ago. I'm preparing to take the NCLEX but I will definetly do some research on pursuing the CNM program.

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Nice! Best of luck with the NCLEX. I hear that it’s all in the preparation. Will you go into L&D nursing or another specialty?

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It will on depends on my research on the CNM Program.

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Specializes in OB.
13 hours ago, vimmie said:

Thank you so much LibraSunCNM! I thought it would become apparent when I started clinicals but it’s great to have a rough understanding of the roles.

Amvictorious- that’s great! Where are you moving to/moved to? What bought you state side? Sadly, because I’m a direct entry midwife my midwifery degree is not acknowledged in anyway (apart from it being a bachelors level qualification) and I can’t sit the nclex. To give myself full flexibility I’m doing an accelerated masters in nursing and then a three year DNP in nurse midwifery. I’m working at a London hospital currently.

Good luck! I'd be curious to hear how different midwifery is here vs. the UK from your perspective once you start clinicals.

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I’m looking forward to comparing the two ways of working but with the two very different healthcare systems I feel it might be comparing apples to oranges.

Im looking forward to having full prescription powers as we only have a narrow range of drugs we can give without a Dr prescription in the UK (no abx or pitocin for example) and the range of women we care for is different in the UK (just pregnant women and postpartum for 28 days instead of complete well women care.

But it I feel that the barriers to access care are higher for disadvantaged women in the US and the OB/midwife relationship might be a bit less supportive as the midwife numbers (relative to the UK) are smaller and from what I’ve read.

Anyway- they are my assumptions before I start. Looking forward to learning a lot from my experience on the other side of the Atlantic.

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