Is CNM right for me?

[peytonsmom]

Good morning. I have been reading this forum today and I have a few questions. (this might get long sorry!) I'm currently taking pre-reqs for a BSN track. Part of our "assignment" for applying to the program is to have a career plan. Since I have decided to go back to shcool for nursing, I have been torn between two fields, CNM, and FNP. I really think FNP would bore the snot out of me. I need to be hands on and have something happen during the day kwim? But I have some questions about whether the CNM path is really right for me.

A little bit of backstory for you, my only experience with a CNM was when I was pg w/ my son. She worked in the same office as the OB and I saw both of them while I was pg. Both of them saw patients and delivered at the hospital. Whomever happened to be on call was the one that delivered you.

I had a horrible pregnancy. I had PIH before 20 weeks (family history of PIH and pre-e) and spent the last three months of my pregnancy on bed rest (and I had GD so I coudln't even EAT lol). I was on a crap load of meds to try and keep Peyton in as long as possible. They breifly considered taking him at 32 weeks (seriously enough to give me the steriod shots) but a 2nd med stablized my bp finally. I made it to 37 weeks when all heck broke loose w/ my bp and was induced. Both OB and CNM suggested getting the epi as not being in pain might help w/ the bp issue. The CNM was the one on call when I was induced but she quickly called in the OB when it was clear things weren't going to go smoothly.

I ended up pushing for 3 hours and having a vacuum delivery when Peyton took a turn for the worse (and ended up w/ 4th degree tears OUCH!).

Okay so you can see that I didn't really have the kind of pregnancy and delivery that most moms seeking a CNM are looking for lol. I am totally okay w/ how things happened because at that point it wasn't about my birth experience, but just having a healthy baby.

So my first question is from a patient perspective, does my having such a high intervention birth turn them off since I didn't personally experience what I hope to give them?

My next concern is that i'm not a super crunchy granola type person. In general I feel like women are made to have babies and if you don't need the interventions then don't use them. BUT on the other hand i'm not anti medical intervention either. I just want the mom to have the birth experience she desires. If that means getting the epi or other pain mgmnt so be it. I guess I kind of look at my views as a hybrid or midpoint between the ultra crunchy CNM stance and the ultra medicine, labor in a bed on your back w/ stirrups stance.

So I guess my question is, is there room (and jobs) for that kind of position and school of thought?

TIA!

[Barkow]

I don't think your own birth experience should have anything to do with what your future patients would think of you, and it doesn't even need to come up. Many midwives have never given birth at all, so you shouldn't feel like you have to model a certain type of experience.

Midwives typically care for low-risk pregnancies, and yours had more going on that made it higher-risk and thus reduced your ability to have a more typical midwifery experience. On the other hand, they didn't immediately run you back to the OR but gave you the chance to deliver lady partslly, so I still wouldn't call this an unsuccessful midwifery encounter by any means.

There is definitely room for all types of midwives, and I see many different styles where I work. Working in a hospital might offer a good blend of supporting women in the experiences they want, while having interventions there if necessary. Good luck!

[zahryia, LPN]

If your desire to be a CNM is to work with mom to attain a positive birth experience-given the optimal circumstances- and to ensure a healthy baby , then I would say being a CNM is right for you.

[mommy2boysaz]

If CNM interests you, go for it!

Your prior experiences will only increase your empathy for patients who have similar outcomes to yours.

I am the mother of 3; 2 of which were natural births and 1 was a Cesarean for breech. All born in a hospital. All good experiences.

I attempted to breastfeed all 3 times, each time without success. I had a strong desire to do so, but experienced lots of pain and frustration and was unable to continue longer than 6 weeks. I am still a strong proponent of breastfeeding. Just because I was unable to pull it off successfully doesn't mean I won't encourage other moms to give it their all, after I become a CNM! -But, I will certainly be supportive of those who are unable to make it work. I fully understand the disappointment and guilt involved, because I've been there!

I am not the "crunchy granola" type either. I've been an OB nurse for over 10 years, though, and have seen enough of physician and midwife care to know that more women deserve a midwife who will put their desires above their own. That's why I'm doing this. If my patients want an epidural, fine. I will make certain that they are fully informed of the risks and benefits first, but then, if they still want it, I will make sure they get it. If they don't want it, I will be there to encourage them and offer alternatives to help them avoid it. That is what being a midwife is all about!

Good Luck with your decision!!

Oh, and BTW, another big consideration in choosing between FNP and CNM might be the hours and the call time. Most FNPs I know have pretty much 9-5 type jobs. The CNMs I know are on call almost 24/7... Lots of late night deliveries!

[bebeleche]

I ditto what others have said, but will add (as an FNP) that FNPs definitely don't sit around doing nothing all day. However, since you state being an FNP would "bore the snot" outta you, I think you have already decided which career path to pusure. Follow your heart. . .

[peytonsmom]

I guess the way I said that sounded derogatory but I didn't mean it that way! The FNP's I have met in my community are almost always in a doctor's office setting. I don't think I'd be as interested in just treating office calls etc as I would doing that and also having the experience of the unexepcted deliverys. I tend to thrive on the unexpected so for me starting off your day w/ doing routine patient exams and then getting called out because someone is in labor sounds more up my alley. I hope that made sense. I didn't mean to sound like all FNP's have a boring job, I just think for my type of personality i'd do better in something more unpredictable.