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Nurse Midwife

By an allied health world contributing writer

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What is a midwife?

Oftentimes when people envision midwives they imagine a professional who assists a laboring woman give birth in her home or at a birthing center, and who doesn’t use any type of drug interventions to block the pain. While there certainly are midwives who function in this capacity, it may be surprising to learn that midwives have a very wide realm of practice which includes serving as primary care providers not just for pregnant women but for women throughout their lives.
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Certified Nurse-midwives (CNMs) and Certified Midwives (CMs) have graduate degrees and are the only type of American midwives Midwifeallowed to practice in hospitals in the United States, although a small percentage of them also practice in birthing centers and at home deliveries. Both CNMs and CMs serve as primary care providers for women throughout the lifespan, which includes prenatal care, attending women at birth, visiting them after the birth of their child (either at home or in the hospital), providing all types of contraceptive services, providing basic gynecology care and regular primary care. A woman who is hospitalized for gynecological or other medical reasons might be co-managed by a CNM/CM and a physician, but would most likely be primarily under the care of a physician at that point.

Nurse-midwives can work as nurses, which comes in handy for finding work while in midwifery school. However, the tasks that a nurse-midwife performs in her job are different from the tasks a nurse performs. This is why nurse-midwives define themselves as people who have been educated in two separate professions, nursing and midwifery.

The governing organization for certified nurse-midwives and certified midwives is the American College of Nurse-Midwives (ACNM). This group outlines the standards for the profession. CNMs and CMs are educated together in the same educational programs and can perform the same duties. Currently, however, certified midwives are only legally allowed to practice in three states, New York, New Jersey, and Rhode Island. CNMs, on the other hand, are legal in all 50 states, the District of Columbia, and most U.S. Territories (like Guam and Puerto Rico).

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What is the history of midwifery?

Midwifery is quite possibly one of the oldest professions, and is mentioned in the Bible in the story of Moses. This profession boasts a long history of caring for women during pregnancy and childbirth. In rural and urban areas where mothers had little access to health care, nurse-midwives provided them with primary care. The involvement of nurse-midwives reduced the rates of maternal and infant mortality and also improved the overall health of women, which was especially noted with regard to underserved populations. It wasn’t until the early part of the 20th century that the medical profession became regularized and births began taking place at hospitals. In the 1970s, the acceptance of nurse-midwives within mainstream health care settings increased drastically. Many women were not satisfied with having a hospital birth and wanted a more home-like experience. Midwives today provide compete care for all women, not just those who are pregnant or in labor.

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