New Poster - Midwifery first and Nursing later?

queenanneslace, ADN, MSN, APRN, CNM · Mar 5, 2013

This is such an interesting question!

The thing that keeps CMs from being recognized as CNMs is their lack of an RN. In the state where I live all CNMs are licensed as Advance Practice Nurses - and are required to have an RN to be licensed as a CNM. (This is the case with most states - or some variation of this).

So your question is very interesting. If you went back and completed the RN education, got licensed as an RN, could you be licensed as a CNM? It think it would require some petitioning of the BON. But I also think a CM could make a pretty good argument that they're sufficiently qualified - technically - to practice as a CNM. The CM and CNM demonstrate the same competencies, complete the same graduate requirements, and take the same credentialing exam.

Though the RN requirement (for licensure) could be the hang up.

It it blasphemous of me to admit on the allnurses site that I'd love to see the CM recognized by more states?

I don't know the answer to your question - but I've enjoyed pondering it.

biggolp · Mar 6, 2013

Thank you for your reply, queenanneslace!

I know it's an interesting question and currently really only theoretical.

I know that the CM is becoming more and more popular here in NY as people that are choosing midwifery later (as a career change) already possess a Bachelor's in a non-nursing field and don't require nursing school to pursue midwifery.

I also know that it is expanding to more states, but, I don't know how fast that will happen.

Like you pointed out, CMs are sufficiently qualified to theoretically practice as CNMs because they sit side-by-side in school, receive the exact same training, and take the same test to be certified by the same board.

What do you mean when you say: 'It would require some petitioning from the BON'?

What kind of petitioning? And why?

Isn't anyone (who gets accepted and satisfactorily completes nursing school) entitled to sit for the N-CLEX and become and RN?

Thanks for you feedback.

I appreciate it!

midwifetobe85 · Mar 6, 2013

Thank you for your reply queenanneslace! I know it's an interesting question and currently really only theoretical. I know that the CM is becoming more and more popular here in NY as people that are choosing midwifery later (as a career change) already possess a Bachelor's in a non-nursing field and don't require nursing school to pursue midwifery. I also know that it is expanding to more states, but, I don't know how fast that will happen. Like you pointed out, CMs are sufficiently qualified to theoretically practice as CNMs because they sit side-by-side in school, receive the exact same training, and take the same test to be certified by the same board. What do you mean when you say: 'It would require some petitioning from the BON'? What kind of petitioning? And why? Isn't anyone (who gets accepted and satisfactorily completes nursing school) entitled to sit for the N-CLEX and become and RN? Thanks for you feedback. I appreciate it![/quote']
Hi there! I also think this is an interesting question. I considered the CM pathway but ultimately decided to pursue the CNM since I didn't know if I'd stay in NY or not. As it turns out I'm very happy in MA now, so it was a good decision for me. I completed a second degree ABSN and just applied to midwifery school.
I actually had also considered, applied to, and was accepted by Downstate and think they have an excellent program. I was very impressed with their commitment to direct-entry midwifery. If I could stand to live in NYC I would definitely have gone.
As for your question, I don't know the answer but I would suspect the petitioning would be with the AMCB or the ACNM, not the BON, regarding changing your license to CNM after you attend a nursing program. And yes, if you attend an accredited nursing program you will be able to sit for the NCLEX and upon passing you will be a registered nurse. At that point you'd be an RN and a CM. Downstate's curriculum for the CNMs and the CMs was a little different. The CNMs had a handful of graduate level nursing courses that the CM students did not, otherwise it was basically the same program. If I were you I would get in touch with the midwifery program at Downstate. They would probably be experts in this area and could at least point you in the right direction.
Hope this helps!

biggolp · Mar 6, 2013

Thank you midwifetobe85!

I had other questions for SUNY as well, so I will add this one to my list.

I did not get a response when I emailed them, though.

Do you suggest I call or do you have a different email address than the one on their website?

Thanks again!

midwifetobe85 · Mar 6, 2013

Thank you midwifetobe85!
I had other questions for SUNY as well, so I will add this one to my list.
I did not get a response when I emailed them, though.
Do you suggest I call or do you have a different email address than the one on their website?
Thanks again!

You're welcome! The thing to know about Downstate is that administratively, they're a mess. Good luck getting a polite admissions person who has any idea of what is going on. Also their email responses can be slow too. BUT the good news is the midwifery faculty is wonderful, intelligent and supportive, just very busy. Ill see if I can find the right email..

biggolp · Mar 7, 2013

Thanks for the heads-up about Downstate's faculty, as opposed to their administration.

Let me know if you find an email address for them.

Thanks!

queenanneslace, ADN, MSN, APRN, CNM · Mar 8, 2013

As for your question, I don't know the answer but I would suspect the petitioning would be with the AMCB or the ACNM, not the BON, regarding changing your license to CNM after you attend a nursing program.

I was just thinking about various state laws - would a state board of nursing award a license to a CM and an RN - because technically they only recognize CNMs. Yes. Perhaps the way to go would be to get the AMCB to re-designate the credential as a CNM.

As I write this, it all seems so silly - getting an RN after the CM to satisfy state licensing requirements. I hope more states get on board with licensing CMs and permitting them full scope midwifery practice. That would be so wonderful.

biggolp · Mar 8, 2013

As I write this, it all seems so silly - getting an RN after the CM to satisfy state licensing requirements. I hope more states get on board with licensing CMs and permitting them full scope midwifery practice. That would be so wonderful.

Perhaps as more states recognize CMs this would not be necessary, but, as of now, perhaps the ACMB has to consider this point.

I'm sure I'm not the only one with this issue.

Right now, with my Bachelor's in NY, I have to fill the same prerequisite courses (give or take) in order to get either into an ABSN program or into a CM program.

Considering the fact that what I really want to do is midwifery, getting my nursing degree seems like a waste of time, money and effort.

queenanneslace, ADN, MSN, APRN, CNM · Mar 8, 2013

Considering the fact that what I really want to do is midwifery, getting my nursing degree seems like a waste of time, money and effort.

I can really relate to this sentiment - and for me it was exactly how I felt 10 years ago. I don't really know what changed - but I no longer feel this way. I'm happy to be an RN and looking forward to working as an RN.

One of my professional goals - my career goals - is to get more states to recognize the CM. I believe this would open the door to a lot of great new midwives. The prospect of becoming a midwife (a CNM) for those who are non-nurses is either incredibly expensive - or requires multiple hoops to jump through. I've done both - the incredibly expensive RN-MSN/CNM route (quit after one semester and a $10K investment) - and the multiple hoop route - have a BS, completed ADN/RN program, now applying for MSN/CNM programs. (I also attended a MEAC accredited midwifery program and apprenticed for a few years - whole nuther can of worms, there.)

I just wanted to tell you I could relate to the feeling of nursing being a hurdle - I remember sitting through a lecture about chest tubes and thinking "No way would I ever have had the patience for this when I was first starting out on my path to midwifery." There is a lot of nursing that does not relate to midwifery. When all I wanted to study was pregnancy and birth, nursing school seemed like an unpleasant but necessary hoop to getting where I wanted to be.

I'm not sure what changed - maybe I've been up all night too many nights in a row attending births to have satisfied my birth craving - but I've found nursing school useful and beneficial. And right now, I'm happy to have done this.

BUT - If my state legally recognized CMs and allowed them full scope of practice along with CNMs, I would have chosen that route. I know many midwives who would have chosen the same thing.

Hoping the future brings some positive changes in this regard!

biggolp · Mar 10, 2013

Thanks, queenanneslace, for sharing!

I actually feel incredibly spoiled to be living in the only state that gives full credit to CMs and I would DEFINITELY pursue a CNM degree if that were not the case.

However, having a late start (I'm 33), and knowing that what I want to do is midwifery, AND LIVING IN NY, I really think CM is probably the way for me to go.

I am still considering going for my ABSN (adding a year and a half to my education) and doing it RIGHT, however, I'm really undecided if it makes sense (in light of the above).

I'm thinking of applying to an ABSN program (or two) when I apply for midwifery. If I don't get into midwifery right away, at least I'll get my BSN meanwhile...

lauras219 · Mar 15, 2013

I was interested in the CM route and asked the Midwifery Institute of Philadelphia about bridging the gap between a CM and CNM if I ever decided that I wanted to become a CNM. This is what they replied,

"To bridge from CM to CNM, you would have to become an RN (which could be through an accelerated nursing program) and submit proof of that licensure to the American Midwifery Certification Board (AMCB) and they would switch it over."