Midwifery??

[dare2dream]

What is the difference between a lay midwife and nurse midwife??

[TheCommuter, BSN, RN]

Lay midwives do not possess any type of nursing licensure. In essence, they are lay people from off the street, typically with no healthcare education or background.

Certified nurse midwives possess the RN licensure and certification in midwivery. They typically have a BSN degree, plus completed a master's degree program in midwivery. In other words, certified nurse midwives can also be called APNs (advanced practice nurses).

[elkpark]

Lay midwives do not possess any type of nursing licensure. In essence, they are lay people from off the street, typically with no healthcare education or background.

Just to clarify/expand a little, there are training/education programs available for lay midwives, as well as national certification (CPM = Certified Professional Midwife), and many of them are deeply offended by the proposition by the nursing community that only nurses should be midwives.

However, there are also people out there calling themselves "midwives" who have little or no formal training at all, and lay midwives do practice extralegally ("underground") in many states, whereas nurse midwives are, as TheCommuter noted, required to be educated and licensed as RNs with a Master's degree and national certification in nurse midwifery. They are licensed and legal to practice (with varying restrictions on their practice from state to state) in all 50 states.

[CEG]

What is the difference between a lay midwife and nurse midwife??

There are many flavors of "lay midwife." The American College of Nurse Midwives recognizes and credentials "certified professional midwives" who do not have medical background but do have formal training and apprenticeship and meet minimum requirements and pass an exam. There are also midwives who follow a similar path and are recognized by NARM (I think it's the National association of Registered Midwives or maybe North American Registry of Midwives). There are quite a few institutions for education of these midwives. Their training is extensive and they often spend many years working under a senior midwive as training.

22 states have laws licensing these "direct entry midwives" and ensuring the public safety by setting forth standards for licensure. In the states where direct entry midwives are alegal or illegal there is no formal process for maintaining a license although many women practicing have the qualifications for licensure in other states. Laws prohibiting direct entry midwives from practice often mean they practice secretly and restricting their ability to provide OB backup care and lab/ultrasound/etc as needed. It also makes it difficult for women who desire to work with a midwife to verify that they are properly educated.

In most cases these midwives deliver babies in the home although in some places in birth centers and even in the hospital. This path to licensure seems more comparable to that of the UK although these midwives do not have a degree in midwifery.

The term "lay midwife" often is used to refer to the "granny" midwives who do not have formal training but learned their skills from another midwife. These women tend to have extensive knowledge of time-honored methods of dealing with problems.

Nurse midwives of course are registered nurses who have a master's degree in nursing and pass a national licensing exam.

Although I am a student nurse-midwife I am planning to work with a direct entry midwife during my next pregnancy due to the difficulty in finding homebirth providers in my state.

[justme1972]

Not to hijack the thread, but this field is something that lately, I have been looking into.

Mainly because it wouldn't take as long to obtain as an NNP, and from my understanding, the salary would be about the same.

I am just wondering about the liability aspect of this type of job. I know that OB-GYN's carry some of the highest malpractice insurance in the entire medical profession....so I start thinking...OB-GYN's go to school FOREVER to do what they do...and I would think that I was essentially, trying to do the same job with nowhere near as much training.

I know that OB-GYN's do way more than deliver babies, but still....

...just not sure of what to do.

[LynnetteCPM]

I am a Certified Professional Midwife- narm.org -and recognized in my state as a direct entry midwife who provides home birth.

As a previous poster mentioned, yes there are some women who practice midwifery without a credential or license. Often they do want that credential or license, but the state that they live in won't provide it to them. But to categorize all non-nurse midwives as "lay" or "off the street" is to not be aware of the increasing and improving professionalism of direct-entry, non-nurse midwives.

Usually non-nurse midwives provide home birth (and some can have birth centers). Few nurse midwives provide home birth- it is very regionalized and more offer birth center births.

Check out meacschools.org and mana.org for more information

[CEG]

Not to hijack the thread, but this field is something that lately, I have been looking into.

Mainly because it wouldn't take as long to obtain as an NNP, and from my understanding, the salary would be about the same.

I am just wondering about the liability aspect of this type of job. I know that OB-GYN's carry some of the highest malpractice insurance in the entire medical profession....so I start thinking...OB-GYN's go to school FOREVER to do what they do...and I would think that I was essentially, trying to do the same job with nowhere near as much training.

I know that OB-GYN's do way more than deliver babies, but still....

...just not sure of what to do.

Well, an OB goes to med school for four years then does residency for what, 4 years or so? You went to nursing school for four years, got your Master's degree for 3 years or so and have experience in the field. Then you would do another year or so to get your midwifery certificate. So in actuality you have more years of training in the field than an OB does- their residency does not consist entirely of OB.

As for the malpractice issue, CNMs do carry malpractice insurance. Although statistically they are much less likely to be sued than OBs. It's attributed to both dealing with fewer high risk situations and also forming a more substantive relationship with their patients, making them less likely to sue.

[beckinben, CNM]

Not to hijack the thread, but this field is something that lately, I have been looking into.

Mainly because it wouldn't take as long to obtain as an NNP, and from my understanding, the salary would be about the same.

I am just wondering about the liability aspect of this type of job. I know that OB-GYN's carry some of the highest malpractice insurance in the entire medical profession....so I start thinking...OB-GYN's go to school FOREVER to do what they do...and I would think that I was essentially, trying to do the same job with nowhere near as much training.

I know that OB-GYN's do way more than deliver babies, but still....

...just not sure of what to do.

Sure, liability is an issue - although my backup doc who pays for my malpractice says mine is actually pretty cheap in his opinion - we don't get sued as much, that is true. Spending time with people, listening to them, and addressing their concerns helps you not be sued. (Doesn't prevent it, but helps). Midwives tend to be good at that.

A SUBSTANTIAL part of an OB/GYN residency is surgical training. You, as a midwife, focus your training on normal (or close to normal) lady partsl births. The gap is not as wide as you might think.

[o.kiki.d]

Lay midwives do not possess any type of nursing licensure. In essence, they are lay people from off the street, typically with no healthcare education or background.

it's a shame there are such gross misconceptions about midwives, and even among nurses! I take issue with the characterization of a midwife as "typically" having no healthcare education or background. Thats overreaching and undersestimating. I also have an issue with the implication that midwifery education is not "healthcare" education. Caring for pregnant women and their families and assisting with births is very much "healthcare" and the vast majority of midwives these days have many years of education whether it includes any nursing education or not.

[bagladyrn, RN]

it's a shame there are such gross misconceptions about midwives, and even among nurses! I take issue with the characterization of a midwife as "typically" having no healthcare education or background. Thats overreaching and undersestimating. I also have an issue with the implication that midwifery education is not "healthcare" education. Caring for pregnant women and their families and assisting with births is very much "healthcare" and the vast majority of midwives these days have many years of education whether it includes any nursing education or not.

One difference I see is that with direct entry or lay midwives is that it is more difficult to quantify or determine the exact level and type of training or experience they have. This would even vary with the certified ones, depending on the certifier. With a CNM, you at least can determine that they graduated from a certain program, passed and exam and had "X" number of supervised deliveries before going out on their own.

This is NOT to say that the lay midwives would necessarily be less competent, simply that one has a way of checking.

[CEG]

One difference I see is that with direct entry or lay midwives is that it is more difficult to quantify or determine the exact level and type of training or experience they have. This would even vary with the certified ones, depending on the certifier. With a CNM, you at least can determine that they graduated from a certain program, passed and exam and had "X" number of supervised deliveries before going out on their own.

This is NOT to say that the lay midwives would necessarily be less competent, simply that one has a way of checking.

This is where state licensing is important. Even thought you don't know where someone did their training you know they met the state's requirements. Not all doctor schools are created the same either :)

[WorkofHeart8]

Well, an OB goes to med school for four years then does residency for what, 4 years or so? You went to nursing school for four years, got your Master's degree for 3 years or so and have experience in the field. Then you would do another year or so to get your midwifery certificate. So in actuality you have more years of training in the field than an OB does

But to go to medical school you need to have a bachelor's first as well, so add another 4 years.