Pre-Nursing Student with A Big Question

beckinben, CNM · Mar 22, 2007

I just wonder if you end up doing more things that a labor and delivery nurse might do instead of all the things that you have trained for in school? I was looking up one public hospital in Georgia that stated Nurse Mid-wives were only responsible for a very small percentage of their yearly births.

I don't think that I end up acting as the labor nurse, except for when I choose to do so. For example, I will do quite a bit of labor support (if I can, and if the woman desires that) which could be seen as a nursing role. I see labor support as the role of everyone involved, including me, and I really enjoy doing labor support. I think I do more in terms of patient comfort measures, like changing chux pads or getting water/snacks, than almost all the physicians I know do, but I choose to do that, too. I do those things in addition to what I was trained for, not instead of.

CNMs are responsible for about 7% of all births in the US, which is a small number, but there are still a lot more OBs out there than CNMs, and the numbers are increasing every year. In New Mexico, the number is much higher - closer to 30%. Since Georgia was the last state to give CNMs prescriptive authority, I am not sure how friendly the climate is towards CNMs there. Why the numbers are so small can be related to a lot of factors, including political, economic, and legal issues. And many CNMs do choose to not do births as part of their practice - I have friends who teach, who do just gynecology, who do counseling, who do just prenatal/postpartum care, who specialize in menopause care, and some who do just labor and delivery.

I hope that answered your question.

Becki

sequelae · Mar 22, 2007

by all means, go study what you think you are suited for (in your case labor and delivery). if you decide to be a nurse-midwife i believe you will have a "dual role" of being a nurse in addition to being a midwife; you perform both functions ideally.

but i think to be sure that you are going to be doing things that you were

trained in school, you should before committing yourself to working in a certain institution/hospital, CHECK THE JOB DESCRIPTION of the position you are going to be applying for. if is says that your job will be different to what you were trained to do, then by all means, dont accept the job.

BAtoCNM · Mar 22, 2007

I can't speak for the field, as I'm not in it yet, but the CNM that I shadowed at an urban safety-net hospital was a midwife, not an L and D nurse. There were 2 L and D RNs assigned to her cases, and the 3 of them worked together, but the CNM was the primary practitioner responsible for her laboring patients. This same set-up applied to the OBs as well, who were assigned 2 L and D RNs but were the primary practitioners responsible for their patients. At least here, it doesn't make sense to hire a CNM with a Master's and pay her upwards of $80K if she's going to do the same job as an RN.

midwife2b · Mar 27, 2007

I WANT to be "nursey"; that is why I didn't go to medical school.

My patients are nurtured and supported and their birth plans are respected by me and the nurses I work with (even if the birth plan guarantees a trip down the hall to the OR LOL)

That is what makes me different from the docs.

That is the attraction women have to midwives if they have not had a good experience with the doctor the first time around.

There are still many women who believe that midwifery care does not include pain management. About half my patients receive epidurals or intrathecals at some point.

I feel I am providing a great service in our community!