UK Midwife Married US Citizen

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Hi. It's my first post on here!

I got married this year to my American husband and I have my green card now (woop!) and will be moving over next year.

I have a UK BSc Midwifery and 5 years of post grad experience in the UK. But unfortunately no nursing degree (as with most UK midwives nowadays).

I want to be able to have the option to work all over the US and despite being a community midwife for 18 months, attending home births etc, I do not wish to do this in the US. I wish to be in the hospital.

Am I right in thinking that my only option is to go back to school (looks like 15 months) to complete an accelerated nursing program and then do the NCLEX. Become a L&D nurse and then perhaps go on to become a CNM in the future?

There is not other way around it? I could probably pass the NCLEX with a few months of study and reading and I would want to just go into L&D nursing.

It's just frustrating to have to do 15 months of expensive education to only do the same job as I do now, with less responsibility because I wouldn't be the lead provider.

I understand that a nursing qualification would be useful as it's always good to learn more broadly and I will be receiving double the salary I do at home. I just want to make sure I'm not missing anything.

Any advice would be gratefully received! If there is anyone that has been in a similar position and made the move with similar qualifications I'd love to hear your story.

Thank you so much!

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I should preface this by saying that I'm not a midwife, nor am I an expert in this area. However, this is my understanding:

If you do choose to go the Certified Nurse Midwife route, then yes, you'd need to complete an RN program and then a CNM graduate program. It would likely be less expensive for you to complete a 2-year community college associates degree program than an accelerated bachelors degree. You could also consider direct-entry CNM programs, which are basically the bachelor's RN program and master's CNM programs combined; they tend to be a bit faster, but a bit more expensive.

Your other option, which I know even less about, would be to do a 'Direct Entry Midwife' program, which is a midwife role for people who are not nurses but are still licensed. This could be an appropriate option for you; however, they face far more restrictions than nurse midwives, and they are only allowed to practice in certain states. In contrast, CNMs (nurse midwives) can work in all states, and in some states they can work without physician oversight and have full prescriptive authority.

Doing a cursory search, this site seems to have pretty comprehensive information about becoming a 'direct entry' (i.e. non-nurse) midwife, including the laws regulating midwives in each state:

State By State | Midwives Alliance of North America

Just to clarify something that may be confusing due to the terminology: In the US nursing world, a 'Direct Entry Masters Program' means a Certified Nurse Midwife or a Nurse Practitioner program where the Bachelor's Degree for your RN and Master's Degree for your MSN are combined into a single three-year program. By contrast, this 'Direct Entry Midwife' role is a completely non-nursing role. Please realize that the 'Direct Entry Certified Nurse Midwife' program and the 'Direct Entry Midwife' program are two completely different things, even though they have almost the same name (which is ridiculous); the former awards you both an RN and a CNM license, whereas the latter awards you a non-nursing license.

You may get some helpful perspectives if you pose this question on the OBGYN forum under specialties; I'm sure they know more about the different types of midwives than I do.

Unfortunately, you may find that some managers would be hesitant to hire you for an L&D RN position, despite your experience. Given the fact that all of your experience is in the provider role, they may be concerned that you'll have a hard time transitioning into the RN role (and specifically not overstepping your scope of practice). For that reason, if you do go the nursing route, you may have the best experience if you just do a 'Direct Entry CNM' program (since you'd skip the bedside L&D nursing altogether and go straight to a midwife role).

Congratulations on your marriage and welcome to the US!

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Thank you so much adventure_rn! Your information is super useful. Where in the US are you based?

Yes, what think what I want is a 'Direct Entry Certified Nurse Midwife' program is what attracts me the most. The lack of autonomy as a L&D RN would probably be hard long term.

It's great that the midwives still work with L&D nurses as in the UK midwives do it all, all the charting, IV management and catching babies. We don't have prescription powers though and unless you want to go into management, there is a lack of opportunity to learn new skills. So I love the more encompassing role of the CNM that also includes well women care for all ages, not just pregnancy related.

My long term goal would be to perform more of a WHNP role but with the option to catch babies, perhaps working with planned parenthood or similar. But my understanding is that most places would employ both a WHNP CNM?

I can't wait to come over to the US and progress on my nurse-midwifery journey.

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I'm currently living in the southeast, although I've also worked in the pacific northwest.

From what you've described, it sounds like the nursing route would make the most sense for you long-term. To be honest, the nurses on the OB forum would probably be much better at answering your specific questions. I've worked in NICU, which is OB adjacent, but that's the extent of my knowledge.

https://allnurses.com/ob-gyn-nursing/

All the best, and keep us updated!

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Many thanks for all your help! I have reposted on the other forum.

NICU is fascinating! Spent some time there as a student and loved it. You guys do a wonderful job.

Thanks again for your advice :-)

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