Are you considering becoming a Nurse-Midwife? There is much confusion about this nursing specialty.
This nursing path is extremely rewarding for both midwives and patients, and midwifery ultimately results in better outcomes for mothers, babies, and public health. Since 1990, the countries around the world that have been most successful at improving maternal health have done so through the deployment of midwives.
If you'd like to learn more about the Nurse-Midwifery career path, check out this podcast from RN Radio that I came across, a podcast for nurses and students who are passionate about learning and staying informed. In the episode below, RN Radio interviews Julia Lange Kessler, DNP, CM, FACNM, Director of the Nurse-Midwifery/Women's Health Nurse Practitioner program at Georgetown University School of Nursing & Health Studies, to discuss myths and misconceptions that surround midwifery in the United States. For example, Dr. Kessler explains that some people ask her if midwifery is legal, and others don't know that midwifery requires higher education. Others still think that midwifery is restricted to only home births, when in reality midwives can deliver babies in hospitals, birthing centers, or private homes. What is the first thought that comes to your mind when you think about midwifery?
Alabama is either the worst or second-worst state to be a CNM (Mississippi might be worst, I can't remember). I talked to an Alabama midwife a couple of years ago at an annual meeting and she said they're really trying to change the laws, but that it's an extremely uphill battle. So sad.
AspiringNurseMW, what did you mean when you said "When people ask me OB vs. midwife I will almost always say OB?" Just curious, I couldn't figure that out.
Yes it's my understanding the Duggers are studying to become CPMs, a different kind of midwife with education that solely focuses on out of hospital birth. In some states they are actually recognized, like here in NJ where they are licensed (hence someone mentioning their friend is an "LM"), and in some states they are not. In states where they aren't recognized, if they did become involved in a bad outcome that faced legal scrutiny, they are treated the same as a layperson in terms of the law. The lack of strict educational standards in CPM programs, compared to CNM/CM programs, has been described here very well by the poster cayenne06, who used to be a CPM.
Aw, I feel famous now!
But yeah, anyone interested in the CPM vs CNM thing should search my posts on this topic. I've detailed it at length, lol. I practice as a CNM (I work at Planned Parenthood, don't do OB anymore) but still have an active CPM cert. For some reason I am pretty sure I will always keep it active, even though I never plan to practice as a CPM again. Guess I'm just holding out hope that we will find a way to fix the mess that is non-nurse midwifery education in this country, and maybe someday I can be of service for that cause.
My point is, these CNMs did not even TRY to practice holistically.
Sure, it's great they can first-assist at c/s. But so can RNFA. You don't need an expensive (and very highly-skilled/educated) CNM for that.
I would rather see them at least try to encourage natural low-intervention birth. But they didn't. Plenty did "social" inductions just the same as the OBs did.
At least this is what I saw in the hospitals where I worked. And to me, that was a missed opportunity for our patients. The medical model was controlling their practice. Sad if you ask me.
I decided I was the one mistaken. I may have misunderstood the role of the CNM. I thought they encouraged more low-intervention birth and took care of healthier patients. I must have been very wrong. I used to want to become one, but after what I saw, changed my mind.
I am truly sorry you've had that experience. One of the problems with CNM education is a lack of opportunity for students to learn and experience low-intervention midwifery. Maternity care, whether practiced by OBs or CNMs, is a field where old school practices die hard. Hell, many facilities still struggle with routine episiotomies and perineal suctioning!
However, I don't believe the role of a midwife is simply to encourage low intervention birth, and I certainly do not think their scope should be limited to low risk moms who want a natural birth. Some of my most satisfying midwifing has been for women who had many medical and/or psychosocial risk factors. In fact, wanting to reach these women was the main reason I left home birth midwifery to become a CNM. There is something very beautiful about home birth, but to be honest, these healthy, affluent, educated home birthers did not need me as much as the low income teenager with GDM, or the migrant farm worker who presents to the ED with no prenatal care. I still love those natural births, and I LOVE providing hands on labor support for any woman (epidural, nitrous, natural, whatever). But caring for the IDDM with pre-eclampsia, or the heroin addict who presents at 7cm at 33 weeks- it really puts the whole thing in perspective.
Midwives are also much more than baby catchers. I work at Planned Parenthood, doing everything from menopause care to IUDs to abortions, and everything in between. Midwives have the skills and training to make a huge impact on public health, and I've never felt so professional satisfied as I do in this job! I miss those juicy 2am births, but I can't imagine ever leaving this job!
Alabama is either the worst or second-worst state to be a CNM (Mississippi might be worst, I can't remember). I talked to an Alabama midwife a couple of years ago at an annual meeting and she said they're really trying to change the laws, but that it's an extremely uphill battle. So sad.
AspiringNurseMW, what did you mean when you said "When people ask me OB vs. midwife I will almost always say OB?" Just curious, I couldn't figure that out.
Hahaha! I meant when people ask if they should see an OB vs a midwife for pregnancy or regular GYN visits.
I call these "medwives". I would venture to say that these are *probably* people with lots of experience with traditional US birth factory type settings. Maybe L&D nurses who were entrenched with hospitals like that and take those practices with them in their midwifery careers.
When people ask me ob vs midwife I will almost always say OB, but that interviewing them first is of utmost importance. Because there are medwives and there are also OB who are *MDs* aka Midwives in Disguise
It is true that you can pick up some baaad habits in L&D. I don't quite understand why you would steer people away from considering midwifery care, though. I agree that the type of care you get will vary widely, but that is just as true of OBGYNs as it is of CNMs.
I am truly sorry you've had that experience. One of the problems with CNM education is a lack of opportunity for students to learn and experience low-intervention midwifery. Maternity care, whether practiced by OBs or CNMs, is a field where old school practices die hard. Hell, many facilities still struggle with routine episiotomies and perineal suctioning!
However, I don't believe the role of a midwife is simply to encourage low intervention birth, and I certainly do not think their scope should be limited to low risk moms who want a natural birth. Some of my most satisfying midwifing has been for women who had many medical and/or psychosocial risk factors. In fact, wanting to reach these women was the main reason I left home birth midwifery to become a CNM. There is something very beautiful about home birth, but to be honest, these healthy, affluent, educated home birthers did not need me as much as the low income teenager with GDM, or the migrant farm worker who presents to the ED with no prenatal care. I still love those natural births, and I LOVE providing hands on labor support for any woman (epidural, nitrous, natural, whatever). But caring for the IDDM with pre-eclampsia, or the heroin addict who presents at 7cm at 33 weeks- it really puts the whole thing in perspective.
Midwives are also much more than baby catchers. I work at Planned Parenthood, doing everything from menopause care to IUDs to abortions, and everything in between. Midwives have the skills and training to make a huge impact on public health, and I've never felt so professional satisfied as I do in this job! I miss those juicy 2am births, but I can't imagine ever leaving this job!
Thank you so much for this post! I recently just submitted my application for the CNM program at Frontier and you are describing the exact kind of midwife I want to be. I work as a labor nurse in a hospital on the south side of Oklahoma City (very low socioeconomic/high risk population). While I have seen a lot of unnecessary medical intervention/elective inductions/etc, I have also seen a lot of necessary intervention. I have labored many teenage girls that were terrified and uninformed by their OB. Each time I'd think to myself how much these girls could use the gentle touch of a midwife. In fact, One of my goals as a CNM Is to educate and empower young moms. I would absolutely love to work at a place like Planned Parenthood. I only hope I can be the midwife you are someday. :) I agree they are so much more than baby catchers!
Awesome, LaborLove! I turned down two really great full scope CNM jobs (one birth center, one hospital based, both much more $$ overall than this job but of course with crazy hours to match) when I decided to take this job. Best decision I ever made! Every affiliate is different of course, so I can only speak to PPSNE, but we are a bunch of seriously dedicated folks. It's a wonderfully supportive environment for a new grad, with tons of room for growth and expanded scope. Some PP clinics even offer prenatal care!
I didn't read the whole thread but I just have to say I love my CNM! So she's obviously a ARNP and has the education that makes me feel safe she knows what she's doing. I prefer her by far than any OBGYN. All my 3 labored were amazing and I felt so taken care of. I really didn't enjoy any of my short interactions with OBGYNs and quickly felt the different in care.
I hate it when people think about midwives as loonies that encourage people to give birth in the woods. They can't seem to wrap thier head around the fact that there are nurse midwives who can do (almost) everything an MD does, including participating in births at hospitals. I encourage People to consider using certified NURSE midwives (CNM, ARNP).
I enjoy watching the Duggars but I really don't like that they never pursued an education in nursing first and then progressed to midwifery. So many things can go wrong that I just can't believe they let people practice without going through medical school or nursing school.
LibraSunCNM, BSN, MSN, CNM
1,656 Posts
Alabama is either the worst or second-worst state to be a CNM (Mississippi might be worst, I can't remember). I talked to an Alabama midwife a couple of years ago at an annual meeting and she said they're really trying to change the laws, but that it's an extremely uphill battle. So sad.
AspiringNurseMW, what did you mean when you said "When people ask me OB vs. midwife I will almost always say OB?" Just curious, I couldn't figure that out.