Certified Nurse Midwife as a Profession
A Certified Nurse Midwife (CNM) is a healthcare professional who specializes in helping women and their families with pregnancy, childbirth, and postpartum care. CNMs are trained to provide comprehensive obstetric care with a philosophy of gentle prenatal and postnatal care as first principles. With over 20 years experience in palliative care nursing, the CNM understands that these unique opportunities to deliver high quality maternal health care are rare for most health providers.
The CNM was developed by the collaborative efforts of groups within the American College of Nurse-Midwives, The Society for Maternal-Fetal Medicine, and the American Midwifery Certification Board. In recognition of the advancement in maternity care and in response to national demand for midwives, a number of states have either passed legislation or are working to pass legislation regarding the licensure and certification of CNMs.
Certified Nurse Midwives use evidence-based research to develop individualized care plans, which they feel is based on their patients' personal needs and goals. They work collaboratively with other practitioners in order to provide comprehensive obstetric health care. CNMs base their practices on four key principles of health care: dignity and respect, comfort, individualized care, and evidence-based practices.
CNM services are cost effective for Medicare. Evidence shows that the use of midwifery services leads to significant savings for the government health care programs such as Medicaid and Medicare because midwives can assure successful home births at lower costs than hospital births when CNM services are used. Some of these savings are also realized by the families who choose this type of delivery. A study done by Oregon Health & Science University found that cash pay patients saved an average of $1,926 compared to delivering in a hospital using traditional physician services. In addition, Medicaid pays an average of $7,718 for a non-hospital birth.
Offering CNM services does not have to be expensive. Many CNMs deliver their services at no cost to families or on a "fee for service" basis. Some services can be provided on a sliding scale based on family income. The American College of Nurse-Midwives recommends that CNMs should never charge families more than they can reasonably afford.
The use of midwifery care is increasing among health care providers in the United States. Trained CNMs are available to assist healthy women in labor who are at risk for difficult labors, as well as those patients with chronic health problems. These CNMs are also knowledgeable about complementary birth practices such as water births, hypnobirthing, fertility meditation and other techniques that can better prepare the mother and fetus for childbirth.
CNM services should be viewed by healthcare providers in a holistic manner. Midwives should help providers develop a plan of care and incorporate their skills into deliveries to insure the best possible outcome for both mother and baby.
The care provided by certified nurse midwives is available worldwide. Certified Nurse-Midwife programs have been established in many countries such as England, Scotland, India, Australia and New Zealand. Canada has been incorporating CNMs into their healthcare system since the 1970s. In 2010, CNMs attended 19% of births in Canada. Their use of alternative birth practices and their emphasis on the health and safety of the mother and baby have made them a valuable addition to traditional midwife services.
Alternative birth practices used by CNMs include: water births, hypnobirthing, and other alternative birthing methods. Evidence shows that midwives can provide these types of services at an affordable cost with positive outcomes for both mother and baby.
Certified Nurse Midwives and certified midwives are two different titles for two different types of professionals. Certified nurse midwives are health care professionals, who use birth techniques that are not taught in medical school, such as hypnobirthing. Certified midwives are certified nurses and generally have more training than CNMs. Licensed professional midwives (LPMs) are physicians who do not treat mothers during labor who work with CNMs to provide prenatal care.
The term "certified nurse-midwife" is often used interchangeably with "certified nurse-midwife" and is a legal requirement that the health professional's license be issued by one of the five state boards of nursing or by a state board of medicine.
While there can be confusion regarding the terminology of midwifery, each country has distinct differences. In the United States, CNMs are certified with a master's degree and can celebrate births in hospitals and homes, while certified midwives have a bachelor's degree (not all programs offer it) and can only attend births in homes.
CNM services should be viewed by healthcare providers in a holistic manner. Midwives should help providers develop a plan of care and incorporate their skills into deliveries to insure the best possible outcome for both mother and baby.
Hyman, Dr. Diane K. (2004). "The New Midwifery: Pregnancy and Birth in the Era of Managed Care." New York, NY: Routledge.
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2.American College of Nurse-Midwives (2010). "Diversity & Inclusion." Retrieved from:http://www.midwife.org/ACNM_DiversityInclusion.pdf
3. American College of Nurse-Midwives. (2010) "Informed Consent: A Patient's Guide." Retrieved from:http://www.midwife.org/InformedConsent_PatientsGuide_20091215171946.pdf
4. American College of Nurse-Midwives (2010). "ACNM Fact Sheet: Certified Nurse-Midwife Licensure Scope of Practice."Retrieved from:http://www.midwife.org/ACNMfactSheet_LicensureScopeofPractice_20100811153233.pdf
5. American College of Nurse-Midwives (2010). "ACNM Fact Sheet: Certified Nurse-Midwife Scope of Practice." Retrieved from:http://www.midwife.org/ACNMfactSheet_ScopeofPractice_20100811153054.pdf
6. Access to Midwifery Coalition. http://www.acnm-midwives-acnm.org/page/page/204241
7. Martin, Donna (2008). "The Evolution of Midwifery Care: A History of American Midwifery." Retrieved from:https://books.google.
Conclusion
8. "About Nurse-Midwives (CNMs): Licensure". Retrieved from:http://www.midwife.org/ACNM_aboutMidwives_Licensure.pdf
9. "About Certified Nurse-Midwifery: Licensure". Retrieved from: http://www.midwife.org/ACNM_aboutCertifiedNurseMidwifery_Licensure.pdf
10. American College of Nurse-Midwives (2010)."About The American College of Nurse-Midwives: Scope of Practice". Retrieved from : http://www .midwife .org /AboutTheAmericanCollegeofNurseMidwives_ScopeofPractice .