Midwifery. How does it work in the US?

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Specializes in Plastics. General Surgery. ITU. Oncology.

My daughter is in her second (of three) years of Midwife training. When qualified she will be able to deliver babies as an independent practitioner, including home births, and will also undertake pre-natal and post-natal care.

I have seen no mention of Midwives on the forum. Does the US have them? It's a seperate training and speciality here leading to a degree in Midwifery only, not in general nursing.

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Specializes in LTC.

Yeah we have them, and they're not nurses..some states require you to be an RN first...

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Specializes in Plastics. General Surgery. ITU. Oncology.

Ah OK. Midwives were registered (licensed) BEFORE nurses in the UK and still have their own registration.

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Specializes in L&D, Antepartum, Adult Critical Care.

Hya;

In the U.S. there are two types of midwives. The lay midwife is not a nurse but someone who has taken courses in midwifery. This type of midwife is not licensed as a nurse and most institutions will not recognize them for practice.

A certified nurse midwife (CNM) is a Registered Nurse with additional formal education in the specialty of obstetrics. Many are Masters prepared, a program that may take 2-3 years to complete. The CNM may have private practice and/or be affiliated with a hospital/birthing center. Depending on the state the CNM may have privileges to prescribe medications and assist with operative deliveries. They provide primary care for women in the antenatal, intrapartum and postpartum care as well as well woman care.

It sounds like your daughter is training as a CNM.

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Specializes in Plastics. General Surgery. ITU. Oncology.

That would be the US equivalent although as I said the training is seperate in the UK and the registered midwife isn't a registered general nurse.

Must be from the differences in nurse training over here. Same with Children's nurses or Psychiatric nurses. If you train in that speciality then you can't work in General (med/surg) nursing as you are only entered in one part of the Register (a national database of qualified nurses and midwives)

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Specializes in L&D, Antepartum, Adult Critical Care.

Oh that is interesting. Here in the U.S., basic training is a minimum of two years with rotation through the various specialties to maximize exposure and ultimately produce a well rounded nurse. Of course there are many levels of education here but one does not get into a specialty until after one has graduated and acquired their license.

A CNM is considered an Advanced Practice Nurse (APN) and gains certification and license to practice as such after successfully completing the program and examination.

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Specializes in NICU.

Check out this forum--it's for certified nurse midwives:

https://allnurses.com/certified-nurse-midwives/

There's also a 3rd route taken called "Certified Professional Midwife" for folks that are not RNs, but they aren't recognized everywhere and they generally do only home births. They are pretty controversial though.

Personally, I think I'd look more at the experience and training/education that the person in question has. As a NICU nurse, I know I'd be too much of a control-freak to have anything but a hospital birth, but I know it's a valid choice for many low-risk women.

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Not all states accept midwives. In Alabama it's illegal.

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Specializes in OB.
Not all states accept midwives. In Alabama it's illegal.

That is untrue. Certified nurse-midwives practice in all 50 states. Direct-entry midwives, meaning midwives that are not CNMs, are different. Some states recognize their training and may provide limited legal rights to practice. In other states, direct entry midwives are not recognized as legal practitioners. This may be the case in Alabama.

To answer INurseUK, midwives deliver around 7-10% of the babies in the U.S., but the majority of American women go to obstetrician-gynecologists (unfortunately in my opinion! I'm an aspiring midwife). But the numbers are starting to rise for a variety of reasons and it's my hope that midwifery care becomes more the the norm for healthy women.

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That is untrue. Certified nurse-midwives practice in all 50 states. Direct-entry midwives, meaning midwives that are not CNMs, are different. Some states recognize their training and may provide limited legal rights to practice. In other states, direct entry midwives are not recognized as legal practitioners. This may be the case in Alabama.

To answer INurseUK, midwives deliver around 7-10% of the babies in the U.S., but the majority of American women go to obstetrician-gynecologists (unfortunately in my opinion! I'm an aspiring midwife). But the numbers are starting to rise for a variety of reasons and it's my hope that midwifery care becomes more the the norm for healthy women.

Unless the law has changed recently my understanding is it is illegal for a midwife to assist in a home birth and I have never heard of a hospital permitting one to assist in a hospital birth (at least not in my area). Those wishing to use a midwife usually travel to a surrounding state or do so in secret. There have been groups try to change the law with no success.

I have been trying to look this up and keep finding conflicting reports....some say yes it's legal and others (including news reports) say it is illegal. I'll keep looking.

Finally found it....CNM may assist with a hospital birth under the supervision of a physician but none are allowed to assist in a home birth.

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Specializes in OB.
Unless the law has changed recently my understanding is it is illegal for a midwife to assist in a home birth and I have never heard of a hospital permitting one to assist in a hospital birth (at least not in my area). Those wishing to use a midwife usually travel to a surrounding state or do so in secret. There have been groups try to change the law with no success.

I have been trying to look this up and keep finding conflicting reports....some say yes it's legal and others (including news reports) say it is illegal. I'll keep looking.

Finally found it....CNM may assist with a hospital birth under the supervision of a physician but none are allowed to assist in a home birth.

Right. This is what I was saying. Midwives are few and far between in Alabama, CNM or otherwise, but CNMs are legally allowed to practice, in this state only in hospitals. There are no states in the U.S. where CNMs are not legal in any setting.

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Specializes in Intermediate care.

yes- we have midwives galore!!! :-D

And no, i don't believe it's illegal for midwives to do home births. Living in Wisconsin we have a very large Amish community. Most of the time they do it on their own at home, (kinda scary...) but sometimes call in a midwife and the entire community uses money from the "community money" fund to pay in cash for hospital bill. (Honestly i remember this from high school when we had cultural diversity day haha)

They only go to hospital if there are complications. I personally think it is pretty risky, and i wouldn't do it but if they are aware of the risks of it, and sign maybe some consent form?? then i don't see a problem with it. Its completely their own and personal choice.

i could be totally wrong in this but i swear i thought i heard that somewhere.

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