Registered Nurse/Midwife

A certified nurse midwife (CNM) is an individual educated in the two disciplines of nursing and midwifery, who possesses evidence of certification according to the requirements of the American College of Nurse Midwives. State requirements for nurse midwifery must also be met.

For centuries women have looked to midwives to advise and assist then in childbirth. Today's certified nurse-midwife carries on this rich tradition. In addition she is also a skilled health professional, able to draw on the vast resources of modern medicine. Registered nurses with advanced education in maternity and gynecological care are certified by the American College of Nurse-midwives. Nurse Midwifery practices includes services to normal healthy women and their babies in the areas of prenatal care, labor and delivery management, well-woman gynecology, normal newborn care, and postpartum care.

In the US there are currently 29 nurse midwifery programs that are accredited by the ACNM Division of Accreditation, which is recognized by the US Office of Education. These include two pre-certification programs, nine certificate programs and eighteen master's degree programs. A registered nurse midwife annually earns anywhere from $21,580 to $70,100.

Nurse Midwifery students are registered nurses and most have had extensive prior experience in maternity and public health nursing. A student nurse midwife receives extensive instruction in clinical midwifery and advanced education in normal obstetrics/gynecology and newborn care.

Over the years, nurse midwives have maintained a superb record of safety and client satisfaction. Research shows that a woman experiencing a healthy pregnancy, labor and delivery is as safe in the hands of a nurse midwife as she would be in the hands of a physician. A recent report by the Institute of Medicine points out that nurse midwives are particularly effective in managing the care of pregnant women, and than such care results in fewer premature and underweight babies.

There are three basic types of Certified nurse midwife assisted births, which are as follow:

Doctor or Certified Nurse Midwife (CNM) assisted hospital birth:

Giving birth in a hospital with a doctor or CNM in attendance has become the standard most Americans live by. Women generally see their chosen practitioner at their office or at the hospital throughout pregnancy. Hospital procedures and requirements vary greatly from hospital to hospital.

Hospitals/ OB's provide the highest level of medical care available, and should be able to handle any crisis situation that may arise during labor and birth. OB's are trained to handle high-risk pregnancies and complications. Many are not trained on how to handle a pregnancy that progresses without complication, or in natural childbirth. The hospital birth scenario generally offers women the most technology available. Babies are monitored throughout labor and after birth with machines, mothers are generally given IV fluids instead of food or oral liquids, pain relief is immediately available, and mother's have the option of letting the nursery staff completely care for their new baby during their stay. The downside to this high level of medical management is that a lot of parents are left feeling out of the loop and without many choices. They are processed through the system instead of being treated like individuals with individual rights and needs.

Certified Nurse Midwife (CNM) or certified Professional Midwife assisted Birthing Center birth:

In some areas Birthing Centers are becoming very popular. They offer an environment that is much closer to a home like setting, while still having some medical technology on hand. They are generally not as well equipped as hospitals and are unable to handle all medical emergencies. They also may not be able to provide the same spectrum of pain relief during labor (such as epidurals). Patients generally see their practitioner for prenatal visits at the Birthing Center. A much stronger emphasis on natural birth, breastfeeding, and family bonding is usually found at Birthing Centers as opposed to hospitals. Birthing centers may also offer special amenities not found at hospitals such as labor pools and equipment designed to help women cope with labor without drugs. Care is generally more relaxed, and women are allowed greater freedom to follow the needs of their bodies during labor and birth than at a hospital. Because there is a lower level of medical technology on hand, Birthing Centers generally require that their clientele be fairly low risk. Which means, not all women will be accepted as clients.

Certified Nurse Midwife (CNM), Certified Professional Midwife (CPM), or Direct Entry Midwife (DEM) assisted Home Birth:

There are many variables in the type of care offered by a midwife that provides services for home births. The amount of medical type prenatal and labor care provided will depend completely on the midwife you select. Some midwives are as medically oriented as OB/GYNs; others view pregnancy, labor and birth as completely natural and treat it as such. Most midwives also practice with at least one assistant, or apprentice midwife. Be sure to meet all her assistants and see if you like them as well. Prenatal visits will either be done at the midwife's office if she has one, or at your home. Again, the level of medical care provided would vary greatly depending on the type of midwife you choose. Midwives are generally able to handle a wide range of complications, and will bring the medical equipment necessary to handle those complications to your home during the birth. Because not all complications can be handled at home, midwifes frequently work with a back-up OB who's care you'll be transferred into if you have a complication that would prevent you from being able to give birth at home. Women generally choose a midwife assisted homebirth because it offers them a great deal of freedom, but still affords them the security of having a medically trained professional on hand. Because midwives are unable to handle higher level medical complications they may screen out women they consider to be high risk and refuse to provide care for them. Although midwives are generally assumed to be greater supporters of natural childbirth, they may not be as hands off as some women expect.