What is a nurse-midwife?
Certified nurse-midwives (CNMs) are licensed health care practitioners educated in the two disciplines of nursing and midwifery. They provide primary care to women of childbearing age including: prenatal care, labor and delivery care, care after birth, gynecological exams, newborn care, assistance with family planning decisions, preconception care, menopausal management and counseling in health maintenance and disease prevention.
Where do nurse-midwives practice?
Nurse-midwifery care is available in all 50 states, the District of Columbia and some U.S. territories. Most CNMs are employed by a hospital or a physician practice. While some CNMs attend home births, most of the births they attend occur in hospitals or birth centers California has the largest number of CNMs, followed by New York, Florida, Pennsylvania, Illinois and Massachusetts.
What are the standards that must be met to become a nurse-midwife?
In the U.S., CNMs are required to pass a national examination for certification administered by the ACNM Certification Council (ACC). To be eligible for examination, a midwifery student must graduate from an educational program accredited by the American College of Nurse-Midwives (ACNM). These requirements ensure that U.S. nurse-midwifery education is standardized, and that CNMs meet national requirements. In addition, some states have further requirements for the practice of nurse-midwifery.
ACC Certified Midwives (CMs) are relatively new professionals to the health care field, but their education closely mirrors the education for certified nurse-midwives. They have or receive a background in a health-related field other than nursing and graduate from a midwifery education program accredited by the ACNM Division of Accreditation. CMs take the same national certification examination as CNMs but receive the professional designation certified midwife.
There are a number of midwives in the U.S. who practice without the same nationally recognized certification as CNMs and CMs. These midwives are known as "lay" midwives. Some midwives have received extensive apprenticeship training as well as formal education not focusing on midwifery.
How safe is nurse-midwifery practice?
Numerous studies have uniformly concluded that nurse-midwifery care has outcomes that are equal to that of physicians with the same type of patients. CNMs are particularly adept at providing care that helps women prevent complications and communicate with their health care providers. Moreover, ACNM Standards for the Practice of Nurse-Midwifery recognize that nurse-midwives must "demonstrate a safe mechanism for obtaining medical consultation, collaboration and referral" when questions or problems arise.
Why see a nurse-midwife?
Nurse-midwifery care is woman-centered and based on the philosophy that health care should be safe and satisfying. CNMs make every effort to respect the human dignity and cultural diversity of their clients. They are committed to promoting self-determination, the right to obtain complete information about the care and enhancing the normal process of pregnancy and birth through education and supportive intervention.
While CNMs are qualified to administer drugs, perform medical procedures and provide their clients with other technological interventions, they rely on technology only when it is medically necessary. As a result, women who are under the care of a CNM are less likely to have a Caesarean section or an episiotomy and are more likely to experience a vaginal birth after a previous Caesarean section.
