I've always had a passion for women's health, especially with issues surrounding pregnancy and birth. I am on my fourth pregnancy and all of my previous deliveries were with midwives. They were fabulous experiences where my autonomy was respected and I wouldn't have it any other way.
I am just now doing pre-reqs for nursing. My vision is that I will finish up my B.S.N in three years (including next year's pre-reqs), try to get a job on an L & D floor, work for a year and then go back to school to become a CNM or perhaps a nurse practitioner specializing in women's health. My question is about the inbetween period. Is it possible for me to go directly from a B.S.N program into a CNM one with no nursing experience outside of school, and work on my CNM while I am working as a nurse?
I am also interested in doing more than prenatal care and delivering babies. I know that an increasing number of direct entry midwives offer well woman care. Is that something that I could do as a CNM? Are there any CNM's here who practice on their own or do homebirths?
One thing to consider: L&D nurses do shift work, midwives have a practice. If you are a mother of four young children, you could find child care a challenge when you are on call for deliveries 24/7. I have often considered midwifery, but the liability, overhead, hours of practice all turned me away from it while I am raising my children. Maybe someday, but for now it is nice to go to work for 8 hours, care for women giving birth, and leave work at work when I go home. I don't want anything to demand too much time and attention right now as I love raising my kids. They won't always be here, and by the time they leave, I'll have the years of experience to branch further into a career.
I have two and one on the way, the first pregnancy ended early
I agree with you whole heartedly and career decisions in my family are family decisions. My husband will be retiring to be a stay at home dad so that the children will have the benefit of one parent at home for them full time.
I would strongly sugest that you work as a nurse before beocmeing a midwife. We work with several midwives at my hospital and for the most part they are good. All of them , save but one were L&D nurses for a long time before beocmeing midwives.
The one that did'nt work as a nurse is aweful. She has very poor assessment skills and really just doesent get it.
I like her just fine personaly but I hate workign with her professtionaly becuse she makes big mistakes. I also have had many diffacult situations with her becuse she does'nt know what she is doing. I know that other nurses feel the same way and last week one of her back up doc's made a huge seen yelling at her and refuseing to work with her.
I can't say that all midewives need experance on L&D before goign back to school I can only say that the one I know of really should have been an L&D nurse first.
Maybe someday, but for now it is nice to go to work for 8 hours, care for women giving birth, and leave work at work when I go home. I don't want anything to demand too much time and attention right now as I love raising my kids. They won't always be here, and by the time they leave, I'll have the years of experience to branch further into a career.
My feelings exactly. I thought I would get through nursing school, then go right on to work on my MSN. Once I started working in L&D, I realized I didn't want the added responsibility of being a midwife, and working their long hours, while my kids are still so young. I get enough autonomy working night shift, and will have years of experience if I do decide to go back to school for midwifery. :)
There are programs you can get through with no nursing experience, but I would definitely recommend some L&D experience first. Not only will it help with your skills, it will help you gain employment as a CNM. We have a nurse working in GYN right now, who graduated from Vanderbilt as a CNM/FNP. She's younger than me. She's having a hard time getting experience because no one will hire her as a midwife w/o it, and no one wants to hire her in L&D because they know she will leave as soon as she gets a little experience.
We really don't mean to be discouraging, SeekingNur. I can tell you honestly, most of the L&D RN's that I work with at some point have considered midwifery. And yes, we have all had our share of deliveries where the doc didn't make it and we did the delivery (in most cases of the precipitous deliveries, it is more just attending the delivery and catching while the woman's body gives birth to the new life - as it should be). We all CAN deliver a baby. It is just that sometimes the emergency happens and a special intervention (intercession) is required, as in the case of a true shoulder dystocia where the body will not deliver without breaking somebody's bone, or an unknown vasoprevia that bleeds out and you need a surgeon within minutes or the baby is dead.
I just spent a shift helping a woman push for 3 hours, and the baby didn't budge one centimeter (and believe me, we pulled out all the tricks in the book with positions and such). The midwife called the OB, and he came in and placed forceps and the baby delivered in one push with only a 2nd degree tear. I have seen enough that I really do not need to be the one where the buck stops.
Yes, medical doctors and homebirth midwives come from different philosophies of care, but I figure I give the care I want to give my patients, still be a good nurse, and respect birth plans all within the hospital where the backup for emergency situations is close at hand. With some of the more gruff old docs, I try to keep them out of the room until all they have to do is gown up and catch.
Good luck with your plans. Think carefully about the career choice you are making. Depending upon the state you practice, the statute of limitations can be 18-25 years from the time of birth - a long time to be held accountable. As a labor nurse, it can be a job without being an all consuming career for me right now. As an added benefit, it is a job that I love.
We really don't mean to be discouraging, SeekingNur. I can tell you honestly, most of the L&D RN's that I work with at some point have considered midwifery. And yes, we have all had our share of deliveries where the doc didn't make it and we did the delivery (in most cases of the precipitous deliveries, it is more just attending the delivery and catching while the woman's body gives birth to the new life - as it should be). We all CAN deliver a baby. It is just that sometimes the emergency happens and a special intervention (intercession) is required, as in the case of a true shoulder dystocia where the body will not deliver without breaking somebody's bone, or an unknown vasoprevia that bleeds out and you need a surgeon within minutes or the baby is dead.
I just spent a shift helping a woman push for 3 hours, and the baby didn't budge one centimeter (and believe me, we pulled out all the tricks in the book with positions and such). The midwife called the OB, and he came in and placed forceps and the baby delivered in one push with only a 2nd degree tear. I have seen enough that I really do not need to be the one where the buck stops.
Yes, medical doctors and homebirth midwives come from different philosophies of care, but I figure I give the care I want to give my patients, still be a good nurse, and respect birth plans all within the hospital where the backup for emergency situations is close at hand. With some of the more gruff old docs, I try to keep them out of the room until all they have to do is gown up and catch.
Good luck with your plans. Think carefully about the career choice you are making. Depending upon the state you practice, the statute of limitations can be 18-25 years from the time of birth - a long time to be held accountable. As a labor nurse, it can be a job without being an all consuming career for me right now. As an added benefit, it is a job that I love.
I appreciate and respect your advice. It has reinforced to me exactly what direction I want to go. Thank you.
If you are interested in a wide spectrum of options, perhaps after your BSN you could work in an independent birth center. I currently work in one, and really, as far as births go, I feel like a midwive's apprentice. I have learned so much, and have also learned how to deal with emergencies outside of the hospital.
In our daily practice, we not only provide well woman care, but *all* woman care--meaning not only do we do paps, birth control, etc, but also UTIs, URIs, wart removal, earaches, etc. We have a doc who does some of the more complicated cases, and we don't hesitate to refer to a specialist when something is beyond our abilities. But for 90%+ of our population, their urgent care is relatively easy.
As a CNM you have so many options; homebirth, birth center, or hospital birth. In my state (perhaps it is like this in all states, I don't know), you must be an ARNP to be a CNM. So theoretically you can provide not just pregnancy care, but could work in some sort of women's health clinic as well. I have a background in medical floor nursing, so I really like that we don't just see women for pregnancy care. I enjoy that we are able to fulfill the complete medical needs for most women.
If I would have gone straight through school, then through a CNM program, I would have missed out on alot. As is, I now have alot of experience with births. We only attend around 120 birth a year; and I have a very close relationship to our midwife. After the birth, if there is anything I have questions about, she will explain it. During the birth, or during a repair, she'll often talk me through what she is doing (this is also for the benefit of the woman and her support people, naturally). While a woman is in labor, there is generally a nurse and a midwife for one client. So there is ample opportunity to see the midwife work, to provide care for the entire labor and birth (I often take call for 24-48 hours or more, so if a labor goes long, I see it from beginning to end), and to learn and explore the process.
When I do choose to go on to midwifery school, I will bring all this experience with me. I can't help to think that it will benefit me as well as my clients. I will soon start to work in a hospital part time, doing postpartum work. Although I think that my heart lies outside of the hospital, I know that that environment also has alot to teach me and I am eager to work there and see how things are really done there (I have never worked L&D or Mother Baby in a hospital environment).
Depending upon the country that you go to, many will accept an ADN certificate, as long as you passed your RN. You should contact the equivalent of the Board of Nursing to see what the requirements are. Sometimes, whether you have your ADN *or* your BSN, they will still require you to take additional classes and take their own certifying boards. So really check out your options before you go the BSN route.
If you are interested in a wide spectrum of options, perhaps after your BSN you could work in an independent birth center. I currently work in one, and really, as far as births go, I feel like a midwive's apprentice. I have learned so much, and have also learned how to deal with emergencies outside of the hospital.
In our daily practice, we not only provide well woman care, but *all* woman care--meaning not only do we do paps, birth control, etc, but also UTIs, URIs, wart removal, earaches, etc. We have a doc who does some of the more complicated cases, and we don't hesitate to refer to a specialist when something is beyond our abilities. But for 90%+ of our population, their urgent care is relatively easy.
As a CNM you have so many options; homebirth, birth center, or hospital birth. In my state (perhaps it is like this in all states, I don't know), you must be an ARNP to be a CNM. So theoretically you can provide not just pregnancy care, but could work in some sort of women's health clinic as well. I have a background in medical floor nursing, so I really like that we don't just see women for pregnancy care. I enjoy that we are able to fulfill the complete medical needs for most women.
If I would have gone straight through school, then through a CNM program, I would have missed out on alot. As is, I now have alot of experience with births. We only attend around 120 birth a year; and I have a very close relationship to our midwife. After the birth, if there is anything I have questions about, she will explain it. During the birth, or during a repair, she'll often talk me through what she is doing (this is also for the benefit of the woman and her support people, naturally). While a woman is in labor, there is generally a nurse and a midwife for one client. So there is ample opportunity to see the midwife work, to provide care for the entire labor and birth (I often take call for 24-48 hours or more, so if a labor goes long, I see it from beginning to end), and to learn and explore the process.
When I do choose to go on to midwifery school, I will bring all this experience with me. I can't help to think that it will benefit me as well as my clients. I will soon start to work in a hospital part time, doing postpartum work. Although I think that my heart lies outside of the hospital, I know that that environment also has alot to teach me and I am eager to work there and see how things are really done there (I have never worked L&D or Mother Baby in a hospital environment).
Depending upon the country that you go to, many will accept an ADN certificate, as long as you passed your RN. You should contact the equivalent of the Board of Nursing to see what the requirements are. Sometimes, whether you have your ADN *or* your BSN, they will still require you to take additional classes and take their own certifying boards. So really check out your options before you go the BSN route.
Hope that wasn't too long and rambling...
Lori
Yes, this sounds more like it. I really don't want to work in a hospital environment for any longer than I have to, if I have to. Midwives in my state have a relatively good amount of autonomy . I've researched the ADN option and for me it makes more sense to get the BSN. Why? Well, the two programs take the same amount of time. I'm due at the end of November with my third child. I could enter the ADN program in January, but my baby would be two months old. I'm not willing to do that. So I'd have to wait another year to apply. During that year I could finish up pre-reqs for the BSN program and apply there. No matter what. I'm not doing anything for that year so I might as well fulfill the prereqs and go for my BSN, you know? I am very clear on the regs for the country I am going to, I would have to be a CNM to practice there. Midwives have much more autonomy there and their scope of practice is broader (some provide abortions), but you must be a CNM to practice.
I am not interested in the hospital model of birth so I'm not sure what I will do. Regardless I think I will spend time apprentencing with a local midwife. I've known one or two CNMs who left the hospital to practice homebirth after learning that model of care from DEMs. I hope that my practice in our new country will be based on that model. I'm pretty sure I will spend some time with midwives there learning the ropes as well, I'm still learning the language anyway and I will need to see the details of how they do things. It's complicated because I have to plan for practicing there and the small possibility that I will need to practice here if we are forced to stay. I appreciate every bit of advice everyone has offered, though it's given me much to chew on. This place is an excellent resource.
I am so very glad to see people interested in caring for women as they should be cared for in life. Are you going to be missionaries or does family bring you to another country? Best of luck to you and your family. It is soooo great for the kids that their dad will get to stay home with them, too. My husband did for a while in our marriage and everyone loved it.
I am so very glad to see people interested in caring for women as they should be cared for in life. Are you going to be missionaries or does family bring you to another country? Best of luck to you and your family. It is soooo great for the kids that their dad will get to stay home with them, too. My husband did for a while in our marriage and everyone loved it.
I am American, but my husband was not born or raised here. We have decided that we would like to raise our family in his native country. It's a beautiful place where we'd have the opportunity to do a lot of good. My husband is a school principal and has been involved in educating children for almost two decades. He loves children and is a dedicated father.
I feel really blessed that our family has the option of ensuring that our children have a loving, competent caretaker for the home while I can pursue my career goals AND I will be able to have spent at least the first 2 years of each child's life at home with them. They will have to spend some time in day care while we transition, but it's at the school where my husband is principal and the teachers and staff are like family for us. It's not my ideal of staying home and homeschooling the kids until they are much older, but it's one fabulous compromise.
She's having a hard time getting experience because no one will hire her as a midwife w/o it, and no one wants to hire her in L&D because they know she will leave as soon as she gets a little experience.
SeekingNur
96 Posts
I have two and one on the way, the first pregnancy ended early
I agree with you whole heartedly and career decisions in my family are family decisions. My husband will be retiring to be a stay at home dad so that the children will have the benefit of one parent at home for them full time.