Midwifery Certification

Many newborns start their lives with midwives.

Midwives have been "with woman" through pregnancy, labor and delivery of newborns since ancient times. In primitive societies, these wise women utilized the mysteries of their traditions, combined with knowledge handed down from one generation to the next, and guided women through the various rites of passage known as the childbearing years.



Today, midwives are in demand by women who seek the personalized care they bring, as well as the likelihood of excellent outcomes. According to MANA (Midwives Alliance of North America), in the United States, about 10 states prohibit direct-entry midwifery "by statute, judicial interpretation, or stricture of practice"--therefore it's a given that midwives who wish to practice legally reside in a state appropriate for their goals.

Clarifications and Choices

Midwives can be certified, licensed, registered, permitted or lay practitioners. Choosing which of these is usually determined by the background of the person hoping to become a midwife. If her background is in nursing, she will likely be more inclined to follow the path of the nurse-midwife. If he has worked with lay midwives in other cultures or third-world countries, he may seek direct entry.

Direct entry appeals to those who want to focus solely on well-woman care and all aspects of midwifery without undergoing additional training as a nurse. More direct-entry midwives are in practice worldwide, but in the United States, CNMs outnumber them. Many nurses already have RN or LPN qualifications, so it's a natural progression for them to go into nurse-midwifery. Whichever path they choose, excellent training is available through accredited programs.

Direct Entry

Not all direct-entry midwives opt to be credentialed, but for those who do, graduation from an accredited midwife education program and passing a state or national exam will result in the status of licensed midwife (LM) or certified professional midwife (CPM). Some candidates may bypass training if they can document or demonstrate they have met all the certification requirements of the North American Registry of Midwives (NARM). CPMs and LMs usually practice in home or clinical settings, but may also work in hospitals. Each candidate in the United States will need to contact her state for specific requirements if she does not wish to pursue the national certification available for CMs (certified midwives) via the American College of Nurse Midwives (ACNM).

Nurse Midwives

Nurse midwives are registered nurses who graduate from a recognized ACNM accredited program and pass a national certification exam. This may be part of their attainment of a master's degree. Certified nurse midwives (CNMs) usually work in hospitals, but some may attend home births or those that take place in birthing centers.

Training Programs

Training for CNMs is available at 39 programs in the United States and Puerto Rico, many at major colleges and universities. Fewer options are available for those seeking the direct-entry route. Preferably, candidates will consider the benefits that come through attending accredited programs.

The Midwifery Education Accreditation Council (MEAC) lists two programs and eight institutions which meet their requirements. Training for either nurse-midwifery or direct entry typically lasts three years, contingent upon clinical opportunities available to the students.

Considerations

Aside from the location or state in which they hope to practice, midwife aspirants will want to consider such things as state or national reciprocity with respect to their credentials. Also, some areas may become "saturated" with working midwives by the time a student graduates and processes through to licensing or certification. Many students will attend distant programs then return to their area, where the demand may be higher. Because midwifery is becoming more respected again, the outlook is promising.

References

• North American Registry of Midwives: Certification
• Midwifery Education Accreditation Council: FAQ for Prospective Students
• American Midwifery Certification Board: Changes in Certification 2010/2011
• Midwives Alliance of North America: Direct-Entry Midwifery State-by-State Legal Status
• American College of Nurse Midwives: Certification

Resources

• Midwifery Today Magazine: News and Views
• Bastyr University Department of Midwifery: Schooling
• Bastyr University Seattle Midwifery School: Prerequisites for Direct Entry
• "The Midwife Challenge"; Sheila Kitzinger, Editor; 1988
• "Midwifery & Childbirth in America"; Judith P. Rooks; 1999