Many people think a certified nurse midwife (CNM) is a lower stratum of healthcare professional who assists women in giving birth. While CNMs do help in the labor and birth process, their duties extend to women’s healthcare for all ages. Nurse midwives are registered nurses who specialize in providing primary health care to women from teens to the elderly. They often provide health care in isolated or rural environments, but who can also be found working at urban hospitals.
What is a Certified Nurse Midwife?
According to the American College of Nurse-Midwives, a CNM is a professional nurse who has undergone training at the graduate level, and has passed a national certification exam. This credential is different than the CM, or Certified Midwife, in that CNM’s are nurses before they enter the midwife program and people with the CM credential come to the program with a bachelor’s degree in another health area. Both have the American Commission for Midwife Education credentials. There are also other kinds of credentials for midwives. A Certified Professional Midwife is credentialed through the North American Registry of Midwives. This credential focuses on out-of-hospital births. Some midwives are state licensed. They may or may not have the additional credentials of a national organization. Lay midwives are people who have experience and training in labor and delivery but either their educational programs are not endorsed by credentialing agencies or they have decided not to pursue credentials.
How did the CNM Program Begin?
In the 1920’s there was a great need for women’s doctors in rural areas, especially in the back country of the Appalachian Mountains. Medline Plus, in an article on midwifery, reported that nurses were imported from England for the first program. The program was well accepted and proven to be beneficial, so in 1932 the first US midwifery program began. Today, midwifery programs are all based in colleges and universities.
What Are Their Duties?
Midwives care for women at all ages. While we think of them primarily assisting with birth, they perform many other services. They give physical exams, order laboratory tests, give pre-natal and gynecological care, assist in labor and birth, educate people on health care and do health care counseling. Most midwives work with an OB/GYN, consulting and referring cases that are too difficult for them to manage, for instance when dealing with a high-risk pregnancy. You find them working in hospitals, HMO’s, health departments, birthing centers and even in private practice.
How is the Care Different than Having a Doctor?
Midwife-assisted births cost less. That was true even in the 1990’s when the birth of a child with a midwife cost about $3,000 and physician-assisted birth was twice as much. Midwife care for the birth of a child today may total $8,000, but hospital care is certainly higher than that. Midwives also typically stress vaginal delivery as opposed to caesarian delivery, and use less-invasive practices and fewer medications. They do not care for women whose birth process is expected to be complicated or high-risk and, although they may work at a hospital, many assist with home births.
Midwives earn a median salary of $76,000 a year, but those just beginning in the field often earn as little as $31,000. Certification increases earning potential even in a hospital setting where they earn more than registered nurses without the certification. A certified nurse midwife is a professional who offers health care to women of all ages and is known for assisting women who prefer giving birth in a more natural, less invasive manner.
