Hi Michellelizabeth!
I completely agree with LilyRoseRN and queenanneslace. It really depends on the state. I'm a newly admitted student midwife at Frontier Nursing U (I start in July). It's a highly esteemed distance program, definitely worth looking into. Frontier.edu
I'm originally from NY where I know many holistically minded home birth CNMs who are totally independent. They write prescriptions, legally carry o2 and all the necessary meds to births, and only consult with physicians as they see fit. I'm now located in the MA though, and there are no home birth CNMs as far as I can tell. Apparently, for a long time CNMs were required to have a 'written collaborative agreement' with backup MD, which basically meant they needed a physician to sign a form stating that they would be their backup. Unfortunately, good luck finding an MD who wants to tied to a home birth midwife (with a legally binding contract). I also think that many of the MD's malpractice insurance companies specifically stated that they could not work with a home birth midwife. Recently, the law was changed to a verbal collaborative agreement, which is the way it works in NY. If I understand the situation correctly, CNMs could start to do home birth in MA now, but the law is quite new and I don't think there are any yet. There are however two great birth centers in the area that I'm hoping to do part of my training at. I also know for a fact that there are CNM home birth practices in Maine, New Hampshire, Maryland, New Jersey, Rhode Island, and New York as I said. I'm also pretty sure there's at least one in Vermont.
I'm still trying to find a source that breaks down each state but, in general, it seems the conservative states tend to be more conservative about midwifery practice and home birth. This list offers some basics on each state - ACNM Library
You can also go here to look up nearby home birth CNM practices or birth centers: Find a midwife
Hopefully that helps! Are you planning on studying nursing for undergrad or going back for a nursing degree afterwards? If you're already a home birth minded aspiring midwife, nursing school may be psychologically tough for you, as it was for me. I originally majored in French and returned to school for an accelerated BSN a few years later when I realized that midwifery (specifically home birth/birth center midwifery) was my calling. I never had aspirations to be a nurse and in many ways nursing philosophy (which is rooted in the medical model, not the midwifery model) conflicted with a lot of my beliefs. It's meaningful work to be sure, but it felt pretty far removed from my dreams of home birth midwifery. It's also hard, rough work with plenty of issues of its own. I will say though, I made it and I'm still very glad to have chosen this pathway and am so excited to finally be starting midwifery school! If you're certain about midwifery I'd recommend that you do major in nursing if you can and just get it done with. Who knows, you may actually enjoy it too.
Let me know if you have anymore questions!
