I started this series, Ask A Midwife, a little while back. My goal was to start a dialogue and open a forum for people to ask questions that may have always wondered. Questions about midwifery, about birth, pregnancy, breastfeeding or parenthood. Questions from doulas, aspiring midwives and student midwives, birth workers of any stripe as well as from non-birthy folks as well.  You can read the first installment here and the second one here. So far, I have received lots of great questions and we have had some good discussions about my answers. Let’s keep the ball rolling. For this installment, I have decided to answer a question from the aspiring and student midwife crowd. Please join in with us and share your thoughts.  

• What is the process to become a midwife?

This question is so complicated that I just have to chuckle every time I hear it.  Most of the time, the people asking it have no idea exactly how complicated it is.  Logically speaking, it should be simple right? A prescribed path that is clearly outlined.  Well, unfortunately, in the US this is just not the case.  It is convoluted and there are many options. Basically, it can broken down to two main options; Certified Nurse Midwife or CNM and Certified Professional Midwife or CPM. Please keep in mind that these are not the only paths, just the two most common at this time.

To become a CNM, you must first complete a Nursing degree by earning either an Associate Degree in Nursing (ADN) or a Bachelors Degree in Nursing (BSN). In my opinion, if you are just starting out and have no other college degree, go for the BSN as you will eventually need it anyway. If you already have a college degree in something else, you may choose to get the ADN and complete a “bridge” program like the one offered through Frontier Nursing University. Either way, to earn your CNM credential, you will complete a Masters level degree and be considered an Advanced Practice Registered Nurse. After earning that Masters of Science in Nursing (MSN), you will then take the National Certification exam through the American Midwifery Certification Board. You will then be eligible to legally practice midwifery in any US state.  However, depending on state laws and regulations, you may be an independent provider and be eligible for prescriptive authority or not. It may be required for you to have a supervisory relationship with a physician. This is absolutely an issue to research in your particular state. Also depending on state regulations you may or may not be able to practice in a Community Birth setting. In my state of CO, CNM’s are independent providers, are eligible for prescriptive authority and can work in a hospital, a birth center or offer home birth services. Yay Colorado! The national organization for CNM’s is the American College of Nurse Midwives and more information for aspiring students can be found here.

As I am not a CPM and did not complete this educational process, I am definitely not an expert on the path. I can share the basics and give resources.  Typically the first steps involve finding and enrolling in a Midwifery Education Accreditation Counsel approved school for the didactic portion and a CPM preceptor in your area for the hands on clinical training. After completing the training required, CPM students must also take a National exam through North American Registry of Midwives. After completion, the CPM is qualified to offer home birth services and in many states to work in free standing birth centers. Unfortunately, the CPM credential may not be recognized in all US states, as there are still states in our country where home birth itself is illegal! You can find resources about this issue here. Also be sure to check out the National Association of Certified Professional Midwives website for more information.

Is that all as clear as mud? I would highly recommend putting the time and energy to research the laws and regulations regarding midwifery in your particular state and to be honest and realistic with yourself about where and how you want to practice before you even start on the path.  Becoming a midwife is a huge responsibility and should not be taken lightly. Also, either educational path requires years of dedication and study and you want to be secure in your choice before you begin. The world needs more midwives so Good Luck!..and get started!

• What are specific skills that new midwives need to focus on?

As I just stated above, being a midwife is a heavy responsibility and one to be taken very seriously. Study, study, study! Learn hands on skills and seek out excellent learning opportunities. In my perfect world, all midwifery students would receive training in all three settings: hospital, birth center and home. However, this is not possible for most students. If you are a CNM student, this may be possible depending on your area and school.  If it is possible absolutely do whatever you can to make it happen! Expose yourself to different environments, get as much varied experience as possible, learn from more than one preceptor. There are more than one or even two ways to be a midwife so expose yourself to different styles and philosophies.

The next most important thing in my humble opinion is to Listen. Truly and openly to all the families, the babies, your teachers and yourself.  No one will know your client better than they will or do, listen to them.  It is easy to get caught up in educating clients and checking off skills that the art of listening can be lost. Do not let this happen. Your clients will easily teach you as much as you teach them if not more, if you only listen.

What things would you add? Have you already chosen your path and if so, why did you choose the one you did?

Do you have other questions that you would like to Ask A Midwife?

Image credit Jennifer Mason