Interested in becoming a CNM..many questions!

queenanneslace, ADN, MSN, APRN, CNM · Feb 11, 2013

What do folks think about jumping into a specialty like OB right away, vs doing med-surg for a year or two? (there is an opening at the hospital where I go to school and they are willing to accept new grads)

If you can get hired in OB or L&D right away, do it. It can be a challenge sometimes to get those L&D jobs right out of school.

Is anyone familiar with working with midwives in the hospital setting, and if so could you shed some light on your experience?

It depends on the type of practice. There are very large CNM practices who share call, spend most of their time in clinics and a few 24 hours shifts in the hospital each month. Then there are smaller CNM practices that work more like family practice docs - on call for their patients, much more call time, but fewer patients. And there are solo CNM practices that work in hospitals. They're on call 24/7 - sometimes with an MD that takes call so they can take a day off.

A CNM may spend more time labor sitting with a pt than an MD will. This depends on the practice though.

I love CNM practices. I love what CNMs do. They have great outcomes with their patients. Some of the politics of working in the hospital make it difficult for them to do what they do, but I admire them even more for it.

For the practicing midwives out there, could you offer any advice to someone in my situation? Older student, with family, etc. How do you balance home and work life?

Before I went into nursing, I worked with a CPM and attended homebirths. All I can say is in that model there is no balance. I'm hoping that nursing will provide me with some of those little luxuries in life like: time off. Or a shift. That ends.

It's do-able. If you want it, it will be do-able.

Good luck to you!

Tinabeanrn · Feb 11, 2013

Congrats on passing school, thats awesome! I think Job shadowing at least 2 Midwives would be your best bet. You can see what they do and ask there scope of practice and how intense it will be. I know in Michigan at U of M the Midwife program goes by number of births, which is too unpredictable with a family. Unless you have someone to watch your little guys at a moments notice. I am Not a midwife but I do have experience working with them as a student and as a patient of a midwife. I love them! They bring nursing to labor. Cant get any better than that. You dont have to deliver little ones, if being on call is going to be too much for you. You can work in an office and just see women in the office. But that sort of defeats the purpose of being a Midwife right? So you might want to look into Womens health Nurse practitoner. You would not deliver little ones, but you would do a lot of family planning and GYN stuff. If you know that you want to do womens health or OB, starting in Labor and Delivery is a great idea. And you can rotate to the womens health floor as well. I really dont think you need to do Med/Surg if you know you dont want to do anything along those lines. Although it wont hurt doing a year of med/surg just to be sure you hate it, lol, which you will! Let us know where you end up.

I<3PedsRN · Feb 11, 2013

It depends on the type of practice. There are very large CNM practices who share call, spend most of their time in clinics and a few 24 hours shifts in the hospital each month. Then there are smaller CNM practices that work more like family practice docs - on call for their patients, much more call time, but fewer patients. And there are solo CNM practices that work in hospitals. They're on call 24/7 - sometimes with an MD that takes call so they can take a day off.

Thank you! Good to know there are different options regarding amount of time on-call. I feel like that is my biggest deterrent.

I<3PedsRN · Feb 11, 2013

They bring nursing to labor. Cant get any better than that.
So true!!
You dont have to deliver little ones, if being on call is going to be too much for you. You can work in an office and just see women in the office. But that sort of defeats the purpose of being a Midwife right? So you might want to look into Womens health Nurse practitoner. You would not deliver little ones, but you would do a lot of family planning and GYN stuff. QUOTE]
Yes, I was thinking along with shadowing a midwife or two, it would be cool to shadow a nurse who works in an OB/GYN office. THank you so much for responding and giving things to think on. This is such a huge decision I feel, and I just want to make the right one for me and my family.

midwifetobe85 · Feb 18, 2013

Hello!
I am going to graduate in May from a diploma program. After HR spoke with our class recently I have alot of questions about where/what I want my first job to be. My plan when I started school was to become certified nurse midwife and I was thinking it would be advantageous to work in OB for awhile just to gain insight and experience. Now, I am reluctant to pursue this after realizing 1) the amount of schooling involved( did I wait too long to start?) 2) the amount of dedication required(I have 2 children, one with special needs and a husband that works 2 weeks away from home) I am passionate about women's health and think about becoming a NP in that field also. I guess my main concern is whether someone like me could handle the responsibility/dedication/commitment it takes. So, my question(s) is/are:
What do folks think about jumping into a specialty like OB right away, vs doing med-surg for a year or two?( there is an opening at the hospital where I go to school and they are willing to accept new grads)
Is anyone familiar with working with midwives in the hospital setting, and if so could you shed some light on your experience?
For the practicing midwives out there, could you offer any advice to someone in my situation? Older student, with family, etc. How do you balance home and work life?
Also, I was thinking of shadowing one of the CNM's in my area...thoughts?
Thanks everyone! And to those who are graduating in May...We're almost there!!

Hey EileenSN! As a fellow aspiring nurse midwife, I thought I'd chime in. Firstly, congrats on nearly being done!! Its a huge accomplishment making it through nursing school.

1.) It's never to late to pursue your passion.

2.) Having children does make everything make complicated, but I believe its possible to still find balance (maybe doing midwifery school part-time instead of full-time would allow this)

3.) If you can get L&D work GO FOR IT! Do NOT, I repeat, do NOT let any old, grumpy nurses tell you that you have to do the med-surg thing first. I was told this by so many nurses. But nearly every CNM that I've spoken to felt that being a nurse before being a midwife was not necessary and that the so-called obligatory med-surg was definitely not necessary. They all added, nursing experience in general is valuable, but don't delay your midwifery training for years on end for the sake of med-surg experience when you KNOW you want to be a midwife.

4.) I shadowed three different hospital-based CNMs. One I followed while she was attending births. She had three patients in labor and she went from room to room to room. I could see how it was less ideal than a birth center or home birth where a midwife is able to labor sit, but she certainly spent more time with her patients than OBs do. The second midwife was doing postpartum rounds in the hospital. She palpated their fundus, checked their bleeding/perineum and sat and chatted with them about how they felt physically and emotionally. It was fast/efficient but she was still very sweet and warm. The women seemed to love her. The third midwife I shadowed at her office for prenatals/gyno care. I observed her doing pap smears, pelvic exams, discussing birth control and upcoming birth plans. It was great because it showed me that I would love the office too. I also shadowed/apprenticed with a home birth CNM. That kind of practice definitely resonated with me more but I can see myself doing both kinds of work.

5.) I'm not a midwife yet (I just finished an acclerated BSN, now applying to midwifery school) but I had several students in my ABSN who had kids and they made it through the program.

You should definitely do as much shadowing as you can. Call around and ask to chat/interview them and ask about shadowing. Not everyone you contact will be available but I'm sure you'll be able to find some midwives who are enthusiastic about helping out an aspiring midwife. Good luck!

Bree124, BSN, RN · Mar 26, 2013

What do folks think about jumping into a specialty like OB right away, vs doing med-surg for a year or two?( there is an opening at the hospital where I go to school and they are willing to accept new grads)

Do it!! I went straight into L&D, and I don't regret it at all. I had a few years of high-risk L&D experience as an RN before graduating as a CNM, and that experience was amazing. I was lucky enough to work in a hospital with several CNM groups delivering there, as well as being a tertiary care center with a level 3 NICU and lots of pretermers, HELLP, etc. It was a great mix and really built my confidence, because I was able to see so many different things. Plus, the experience of working in L&D makes CNM school easier, in my opinion.

Is anyone familiar with working with midwives in the hospital setting, and if so could you shed some light on your experience?

This can vary so much. Midwives in some hospitals work very independently, and in others not so much. I think shadowing a few midwives would give you great insight into how things work in your local hospital/s.

For the practicing midwives out there, could you offer any advice to someone in my situation? Older student, with family, etc. How do you balance home and work life?

It can be tricky. I would not be able to do this job without an understanding and supportive partner. Depending on the age of your children, taking a job with call wouldn't work if your husband is out of town frequently. However, I know people who have graduated in midwifery, then took a job doing women's health care in the office without doing much prenatal care and not catching babies at all. This might work for you until your kiddos are older and can be alone at night, then you could try to find a position doing full scope prenatal care and taking call.

Good luck with your decision making!