Is the field of midwifery dying in the states?

mom2michael, MSN, RN, NP · Mar 20, 2008

I really wanted to be a CNM for a very long time, long before nursing school. I too live in Missouri and I have found, at least in my area, there are no CNM's, nor will I doubt there will be for many years. We are a bit...non progressive in my neck of the woods. CNM's are still viewed as baby birthers that only do home births, come riding in on horses and have magic potions. No one takes them seriously here and it's really - very sad.

When I go back to school, I'll be going back to become a FNP so I can still see, treat and hopefully follow pregnancies, but I know realistically until I'm in a position in life to move to a more "CNM" friendly state or area of the country, I can not pursue my dreams yet in life.

I'm not sure it's a dying profession everywhere in the country though, because when I look at the ACNM website and check out the jobs - there are many to choose from, just not so much in the midwest.

rhiannonwolf · Mar 20, 2008

Hi Mom2Michael,

I moved from Missouri to Kansas a year ago because my five year old son has autism and there are much better services for him across the stateline. However, I know that in St. Louis there are alot of midwives that practice and I know in Central Missouri there are lay midwives still doing homebirths under the guises of a physician. Good luck with your endeavors of becoming a midwife, I think what I will do is I am going to do a post-master's FNP after my CNM. I have to go really slow through school though because of my family situation.

Missouri has alot of restrictions against advanced practice nursing. It is really sad. Here in Kansas its like the wild west compared to Missouri as far as scope of practice and FNP's and CNM's. I know they are practicing where I am located, there are just not alot of them. However, I know that in a few years my husband and I are moving to the west coast so I know I can practice out there.

Take care!

Sincerely,

Rhiannon

hoppermom3 · Mar 20, 2008

We have a CNM who delivers at our small rural hospital (in Missouri). she has been here aobut 4 years I think and has built up a good solid practice. The patients and staff LOVE her.

I don't know that the hospital was necessarily looking to add a midwife; rather, things just kind of fell into place.

Tomi

ktliz · Mar 20, 2008

I'm also an aspiring midwife (just starting nursing school next year though) and I'm constantly researching the field as well. I'm curious as to what you've heard or read that has made you feel this way. My understanding is that there are TONS of jobs available, even for new grads, if you are in the right area or willing to relocate.

I worry about my career choice because time with my (future) family is a big priority for me and I'm not sure how call is going to work with that. I take comfort in the fact that I could always do the job of a WHNP even with the CNM instead. (Women's health is generally more appealing to me than family health.)

rhiannonwolf · Mar 21, 2008

I hope you are right about the field of CNM's. It seems like all I read are articles of hospitals firing their CNM's and OBGYN"s not wanting to collaborate with them because of liability issues. Insurance coverage ranges from 20,000 to 25,000 a year! It just seems scary to me, however, if I find the right job I am willing to pay the price because it is the only thing that I want to do or see myself doing the rest of my life. As far as family obligations, my children will be in gradeschool by the time I have a thriving practice so those 3:00 a.m. in the morning phonecalls won't be as difficult to answer since they won't be babies.

ktliz · Mar 21, 2008

It seems like all I read are articles of hospitals firing their CNM's and OBGYN"s not wanting to collaborate with them because of liability issues.

You're right. I know that where I am (GA) there is a lot of that going on but GA is overall an awful state for advanced practice nurses. However, I'm not going to let that scare me out of becoming a midwife. There are women out there who NEED care providers like us and the more great midwives there are out there, the more the demand for them will grow.

Good luck with your program. :)

Libekh · Mar 21, 2008

I think that midwifery is actually picking up in the states. With the recent documentary the business of being born there has been a lot more buzzing about birthing choices and the midwifery model of care. If you go to the ACNM website when talking about the upcoming annual meeting they basically comment on what an exciting time it is for midwifery as it is really getting acknowledged. I am a 2nd year CNM student living in California but I am moving to Missouri this summer so I think even the small number of us who have posted could make a big change by increasing midwifery activity in Missouri. Now in terms of supporting a family, CNM is not the highest paying of all of the advanced practice options- if I were wanting to make more money I would do the CRNA route, I think NP's and CNM's make about the same.

**LibraSunCNM, BSN, MSN, CNM** · Mar 22, 2008

In my opinion the outlook for midwifery in the U.S. is only getting better and better! The Business of Being Born documentary has done a lot for midwifery awareness, and if you look on the ACNM's website job listing, there are constantly new jobs being added, from all around the country. I'm not worried about our future profession, personally.

mom2michael, MSN, RN, NP · Mar 23, 2008

I do hope that someday, CNM's become the norm for mom's rather than a far fetched idea for them.

I live hours away from St. Louis and/or KC and both places I know have CNM's and have awesome CNM's, but alas, I live too far to make that a reality for me.

I live in very rural Missouri where CNM's are not supported at all. I work with a great OB nurse who will graduate this spring, only to have to move when she is done because no one wants a CNM here where we live and work. It's sad, but it's a reality.

I still do not think it's a dying profession though, I just think some places are a bit more progressive than others and I think eventually moms will force hospitals and OB departments to make choices and get CNM's in practice. I just don't see it happening in the time frame I need for it to happen.

So, for now, I will get my FNP and I will give all that I can give to that field and when the time is right, I'll go back for a post masters and get my CNM.

epiphany · Mar 23, 2008

I'm also an aspiring midwife (just starting nursing school next year though) and I'm constantly researching the field as well. I'm curious as to what you've heard or read that has made you feel this way. My understanding is that there are TONS of jobs available, even for new grads, if you are in the right area or willing to relocate.

There ARE tons of jobs available. Every graduate I know has more than one offer. My clinical site has already offered me a job when I graduate. My feeling is that I will get into a place I like, not just any job. I am speaking for the East Coast region - NY, NJ, PA, DE, etc. I am surprised at why people are so worried. You don't see midwives because there are relatively not that many of us, not because we are not in demand.

clhRN2b2010 · Mar 25, 2008

I have to say that I agree that midwifery will become more common. Yes, malpractice is sky rocketing and OB's are falling left and right In my state there is no limit on lawsuits, and they are sick of it. Many OB/GYN have stopped delivering and focused their practice on well woman and GYN surgery. I actually think that bodes well for midwives here. Women are still having babies! Hopefully, the low risk pregnancies and births will be shuffled toward the MW's and the remaining OB's will be left to handle the high risk stuff that they do so well. It's an opportunity for MW's to share their skills and philosophy with women who otherwise would not have known to seek out their services.

In addition, I will continue to do whatever I can to introduce women to the idea that birth is a joy and an event to be experianced and celebrated...not avoided at all costs through technology. I want women to believe that they are capable and strong and ready for this challenge of being a Mother. It is a culture shift and we are the generation who will need to rock the boat in order to change it's course.