Is Midwifery/ L&D Nursing for me?

**LibraSunCNM, BSN, MSN, CNM** · Mar 17, 2016

Here is a link to the American Midwifery Certification Board, where they have a pretty nice chart detailing the 3 most common types of midwives in the U.S. Technically aside from those 3 types, there are other midwives, but if you aren't a CNM, a CM, or a CPM, you are just someone who has who-knows-what kind of training who calls themselves a midwife. So basically if you're considering midwifery (and I decided to become a midwife at 17, BTW!), you should choose one of these 3 options.

Why AMCB Certification

As you will see, the CM credential only exists in 5 states, so if you don't live or plan to live in one of those, you can forget about it. But let's say you do---CNMs and CMs are equal in terms of licensure and certification. They go through the same educational pathway for their actual midwifery training. They work in all settings---homes, birth centers, hospitals.

CPMs only work in the home birth or birth center setting. They are "regulated" in 27 states, which varies between actual licensure and simple recognition. In my opinion, while there are FABULOUS CPMs out there, the educational pathway for CPMs is deficient in a lot of basic science and evidence-based medicine.

The "duties" of any midwife in any setting will vary. Generally a home or birth center midwife works in either a solo or small group private practice. In hospitals, midwives may work in private practices, or for the hospital itself.

Hope this helps.

DreamerMW · Mar 17, 2016

Hello! This is my very first post on allnurses, I've read a few posts, so I made an account to ask this question.
Ok, so I've always been fascinated with labor & delivery. Even when I was a child. Now, I'm a 17 year old girl, and I will be going to college soon. I think L&D nursing or midwifery may be for me, but I don't know how I'd feel about giving people needles or if it'd be something I could get used to. Because of this, I thought about becoming a homebirth/ birthing center nurse/ midwife. I love helping people, and I've always felt a connection to nursing.
And now my question- What would be the duties of a midwife/ nurse in a non hospital environment? What would be the difference between the two? How would I be certified? I know these are super basic questions, but I have been looking and there is not very much information out there (that I can find, anyway), so I'm sorry if I'm being that person who went to ask real people before google. Thanks!
EDIT- I forgot to mention I was also looking at becoming a doula, but I am interested in the medical side of things. Would it be a good starting point?

If you're interested in the medical aspect of care, I would say go for Nurse- Midwifery. You're still young and as a CNM you can have a more stable, and may I say safer job.

strawberrycupcakes · Mar 18, 2016

(nevermind, still figuring out the site! My reply is now below as a quote.)

strawberrycupcakes · Mar 18, 2016

Here is a link to the American Midwifery Certification Board, where they have a pretty nice chart detailing the 3 most common types of midwives in the U.S. Technically aside from those 3 types, there are other midwives, but if you aren't a CNM, a CM, or a CPM, you are just someone who has who-knows-what kind of training who calls themselves a midwife. So basically if you're considering midwifery (and I decided to become a midwife at 17, BTW!), you should choose one of these 3 options.
Why AMCB Certification
As you will see, the CM credential only exists in 5 states, so if you don't live or plan to live in one of those, you can forget about it. But let's say you do---CNMs and CMs are equal in terms of licensure and certification. They go through the same educational pathway for their actual midwifery training. They work in all settings---homes, birth centers, hospitals.
CPMs only work in the home birth or birth center setting. They are "regulated" in 27 states, which varies between actual licensure and simple recognition. In my opinion, while there are FABULOUS CPMs out there, the educational pathway for CPMs is deficient in a lot of basic science and evidence-based medicine.
The "duties" of any midwife in any setting will vary. Generally a home or birth center midwife works in either a solo or small group private practice. In hospitals, midwives may work in private practices, or for the hospital itself.
Hope this helps.

This is super, super helpful, thank you! I'll read the link for sure, thank you for spelling it out for me! Ok, one last question. Do I need a college degree to enter one of these programs? I currently am in the process of getting my GED (long, boring story) and will take the ACT in April. I was a straight A and a few B student while I was in high school, and I don't think my ACT score will be under 27 or so. Or are these programs in place of college? Thank you!

strawberrycupcakes · Mar 18, 2016

If you're interested in the medical aspect of care, I would say go for Nurse- Midwifery. You're still young and as a CNM you can have a more stable, and may I say safer job.

Good to know, thank you!

strawberrycupcakes · Mar 18, 2016

Here is a link to the American Midwifery Certification Board, where they have a pretty nice chart detailing the 3 most common types of midwives in the U.S. Technically aside from those 3 types, there are other midwives, but if you aren't a CNM, a CM, or a CPM, you are just someone who has who-knows-what kind of training who calls themselves a midwife. So basically if you're considering midwifery (and I decided to become a midwife at 17, BTW!), you should choose one of these 3 options.
Why AMCB Certification
As you will see, the CM credential only exists in 5 states, so if you don't live or plan to live in one of those, you can forget about it. But let's say you do---CNMs and CMs are equal in terms of licensure and certification. They go through the same educational pathway for their actual midwifery training. They work in all settings---homes, birth centers, hospitals.
CPMs only work in the home birth or birth center setting. They are "regulated" in 27 states, which varies between actual licensure and simple recognition. In my opinion, while there are FABULOUS CPMs out there, the educational pathway for CPMs is deficient in a lot of basic science and evidence-based medicine.
The "duties" of any midwife in any setting will vary. Generally a home or birth center midwife works in either a solo or small group private practice. In hospitals, midwives may work in private practices, or for the hospital itself.
Hope this helps.

If my other reply ends up posting, ignore it, I answered my own question. Thank you so much!

cayenne06, MSN, CNM · Mar 19, 2016

Welcome to Allnurses! I am a former home birth midwife and current CNM. I have posted ad nauseum on this topic, feel free to search my posts :) Long story short, I was very drawn to "alternative" health care when I was younger (your age, actually!), and never thought I would want to work within mainstream health care. Of course, as I got older and my life circumstances changed, I was not happy with the limitations my education and certification imposed on my career path. Becoming a CPM is a dead end certification. You cannot take that and use it as a stepping stone to a higher degree or expanded practice. When I had to leave home birth midwifery because of my daughter's medical condition, I worked as a medical assistant making 10 bucks an hour. When I went back to school to become a CNM, I had to start from absolute scratch- not a single nod was given to my direct entry midwifery degree.

Become a CNM. If you want to do homebirth, you can do that in most states as a CNM. If you want to become a CPM, you will automatically qualify for that certification as a CNM, all you have to do is fill out some forms and give NARM some money.

I do greatly value my experience and education in out of hospital birth, and feel that component is lacking from CNM education. But that is more than balanced out by the breadth and scope of knowledge I gained in CNM school, and the career opportunities I have gained with this credential. Not to mention the fact that I can write prescriptions, accept insurance in all 50 states, comanage complicated patients that I would have had to refer as a CPM, practice independently OR with a collaborative team, and work in any setting I choose. I make a solid living and have a decent work life balance. And if I want to move away from the bedside someday, or go on for my phd, I can do that as a CNM.

The unfortunate reality is that direct-entry midwifery education and credentialing in our country is profoundly lacking in standardization. The quality of the education is hugely variable and the requirements for entry level competence are unacceptably low. Even setting aside the issues of practice limitations based on state laws, fairly low income potential, and the extremely circumscribed scope of practice, I could not in good faith recommend that pathway into midwifery, until and unless it is completely overhauled and brought up to, at a minimum, ICM standards.

strawberrycupcakes · Mar 20, 2016

Welcome to Allnurses! I am a former home birth midwife and current CNM. I have posted ad nauseum on this topic, feel free to search my posts :) Long story short, I was very drawn to "alternative" health care when I was younger (your age, actually!), and never thought I would want to work within mainstream health care. Of course, as I got older and my life circumstances changed, I was not happy with the limitations my education and certification imposed on my career path. Becoming a CPM is a dead end certification. You cannot take that and use it as a stepping stone to a higher degree or expanded practice. When I had to leave home birth midwifery because of my daughter's medical condition, I worked as a medical assistant making 10 bucks an hour. When I went back to school to become a CNM, I had to start from absolute scratch- not a single nod was given to my direct entry midwifery degree.
Become a CNM. If you want to do homebirth, you can do that in most states as a CNM. If you want to become a CPM, you will automatically qualify for that certification as a CNM, all you have to do is fill out some forms and give NARM some money.
I do greatly value my experience and education in out of hospital birth, and feel that component is lacking from CNM education. But that is more than balanced out by the breadth and scope of knowledge I gained in CNM school, and the career opportunities I have gained with this credential. Not to mention the fact that I can write prescriptions, accept insurance in all 50 states, comanage complicated patients that I would have had to refer as a CPM, practice independently OR with a collaborative team, and work in any setting I choose. I make a solid living and have a decent work life balance. And if I want to move away from the bedside someday, or go on for my phd, I can do that as a CNM.
The unfortunate reality is that direct-entry midwifery education and credentialing in our country is profoundly lacking in standardization. The quality of the education is hugely variable and the requirements for entry level competence are unacceptably low. Even setting aside the issues of practice limitations based on state laws, fairly low income potential, and the extremely circumscribed scope of practice, I could not in good faith recommend that pathway into midwifery, until and unless it is completely overhauled and brought up to, at a minimum, ICM standards.

You are literally the person I was just about to make a new forum post for. Ok so here's my question- I've been reading up on becoming a CNM (as posted above and other articles on google) and it seems as if you have to get a 4 year (basically) degree and then spend another year on top of that working as a RN to gain experience. AND THEN actually enter a program to become a midwife. (Of course I didn't expect it to be overnight, but I expected I would at least start off learning about midwifery, if that makes sense) I'm leaning way towards working in a birthing center, from what I've read about them, so while I am very interested in science, I'm worried I'll feel like I'm learning something I'm never going to use (a reason I didn't like high school).

I'm also worried that four or five years down the road I'll get discouraged with the process and give up. I'm worried that I will lose interest because I'm not specifically learning about my desired field, will there be a lot of people like me in nursing school?

I was hoping to become a CPM THEN go to CMN, I have no intention of working as a CPM for long at all, just using it as a bridge to CMN, if that makes sense, but if I read your comment right, it seems like that wouldn't work.

Thank you so much for your comment, I will definitely read over your other posts. Have a nice day, dear!