Q: What is a midwife?
A: A midwife is a skilled practitioner and expert in normal pregnancy and birth. Midwives follow the Midwifery Model of Care, viewing pregnancy and birth as a normal, healthy process and providing individualized, non-invasive, continuous support during labor and delivery; additionally, midwives provide well-woman primary and gynecological care. Midwifery care focuses on maintaining health, preventing disease, offering counselling when needed, and educating and empowering women to make informed decisions about their care. Most midwives are licensed and certified through either the American College of Nurse-Midwives (ACNM) or the North American Registry of Midwives (NARM). Midwives are independent practitioners who work in close collaboration with physicians, and many midwives have admitting and prescription privileges, depending on which state they’re practicing in.
Q: What is the Midwifery Model of Care?
A: The Midwifery Model of Care is based on the fact that pregnancy and birth are normal life processes. The Midwifery Model of Care includes: 1) Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle; 2) Providing the mother with individualized education, counseling, and prenatal care, and continuous hands-on assistance during labor, delivery, and postpartum; 3) Minimizing technological interventions; and 4) Identifying and referring women who require obstetrical attention. (Copyright © 1996-2004, Midwifery Task Force, Inc., All Rights Reserved.)
Q: What is the difference between a CNM and CPM?
A: This is something that confused me a great deal when I was first investigating the route of education I wanted to take. In the US right now there is not one single national standard for certifying and credentialing midwives, but rather, two seperate credentials for licensed midwives: CNM/CM and CPM.
CNMs/CMs are certified and credentialed through the ACNM. CNMs are midwives who possess a nursing education and nursing degree first and then go on to obtain a midwifery education—usually through a Masters degree or post–baccalaureate certificate program. CMs are also credentialed through the ACNM, but are direct-entry midwives, i.e. they become midwives directly, without first having a nursing education. In terms of education and credential, CNM and CM are synonymous. CNMs/CMs usually practice in hospitals and Birth Centers, but are not limited to those venues.
CPMs are direct entry midwives who are credentialed through NARM upon completion of their midwifery education—usually through a certificate program. CPMs, like CNMs/CMs, are skilled practitioners and qualified to provide the Midwifery Model of Care, usually in homes and out-of-hospital settings.
Unfortunately, because there is no national standard of practice for all midwives right now, the protocols and practice guidelines for CNMs/CMs and CPMs vary widely from state to state. To check the status of midwifery in each state, visit the Citizens for Midwifery State by State page.
For a more detailed discussion of the intricacies of licensing and the differences between CNMs/ CMs and CPMs, read the following post: Why the ACNM needs more CMs
Q: Why did you choose to become a CNM/CM instead of a CPM?
A: I chose to become a CNM because I felt it would keep the widest number of options open to me, no matter what state I might end up living in someday, or what venue I want to practice in. The vast majority of women in our country give birth in hospitals right now. A smaller percentage of those women give birth in Birth Centers, and an even smaller number gives birth at home. Obstetricians deliver 90% of all vaginal births in this country, while midwives deliver the remaining 10%, in hospitals, Birth Centers and homes. I feel that the greatest need for change is in hospitals, therefore, I think I will probably start my career off in a hospital. While I ultimately want to become a homebirth midwife someday, I feel like the bigger fight is in hospitals right now, where women are often robbed of their dignity and power, and birth choices are limited and curtailed (if they exist at all). I think that change comes from within, therefore I want to work with the system, as part of this awful system, in order to change the system, one birth at a time. True, this might be wildly ideallistic, but I want to at least try. Who knows where the wind will take me.
Q: Are midwives always women?
A: Nope! Midwifery and the Midwifery Model of Care denotes an attitude towards pregnancy, labor and birth which can be held by members of both genders—even by doctors! There is a man in the class ahead of me in my midwifery program. The world could certainly use more male midwives.
Q: Have you ever given birth before?
A: Yes! You can read my birth story HERE.
Q: What’s your favorite color?