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What is a Nurse Midwife?

In the United States a Certified Nurse-Midwife ("CNM") is an Advanced Practice Nurse \who has specialized education and training in both Nursing and Midwifery. CNM's function as primary healthcare providers for women and most often provide medical care for relatively healthy women, whose birth is considered uncomplicated and not "high risk," as well as their neonate. Certified Nurse-Midwives, in most states, are required to possess a minimum of a graduate degree such as the Master of Science in Nursing, or Post-Master's Certificate. As of 2010, all Certified Nurse Midwives will be required to hold a graduate (Masters) degree. Most recently, the first Doctor of Nursing Practice (DNP) program has become available for Certified Nurse-Midwives.  Additionally, Certified Nurse Midwives must also hold an active Registered Nurse license in the state in which they practice. Certified Nurse Midwives practice in hospitals and medical clinics and may also deliver in birthing centers and attend at-home births. They are able to prescribe some medications, treatments, medical devices, therapeutic and diagnostic measures, et al. in all 50 states. CNMs, while their specific scope of practice will vary depending on which state they are licensed to practice, in most states they provide medical care to women from puberty through menopause including care for their newborn, antepartum, intrapartum, postpartum and nonsurgical gynecological care.   Certified Nurse Midwives may work closely, or in collaboration, with an Obstetrician and Gynecologist who provides consultation and/or assistance to patients who develop complications or have complex medical histories or diseases. Often, women with high risk pregnancies can receive the benefits of midwifery care from a Certified Nurse Midwife in collaboration with a physician. Currently 2% of nurse-midwives are men. The American College of Nurse Midwives(ACNM) accredits Certified Nurse-Midwifery education programs and serves as the national specialty society for the nation's Certified Nurse Midwives. Midwife means "with woman" and thus is the mantra for the ACNM, "With women for a lifetime". The American College of Nurse-Midwives (ACNM) estimates that soon, one in ten babies in the U.S. will be delivered by certified nurse-midwives.Worldwide, midwives deliver more than two-thirds of births.



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Graduate Nursing

Advanced education in nursing is done at the master's and doctoral levels. It prepares the graduate for specialization as an advanced practice registered nurse (APRN) or for advanced roles in leadership, management, or education. Areas of advanced nursing practice include that of a nurse practitioner (NP), a certified nurse midwife  (CNM), a certified registered nurse anesthetist (CRNA), or a clinical nurse specialist (CNS). Nurse practitioners work assessing, diagnosing and treating patients in fields as diverse as family practice, women's health care,  emergency nursing,  acute/critical care, psychiatry, geriatrics or pediatrics while a CNS usually works for a facility to improve patient care, do research, or as a staff educator. The Clinical Nurse Leader (CNL) is an advanced generalist who focuses on the improvement of quality and safety outcomes for patients or patient populations from an administrative and staff management focus. Doctoral programs in nursing prepare the student for work in nursing education, health care administration, clinical research, or advanced clinical practice. Most programs confer the Ph.D in nursing and Doctor of Nursing Practice (DNP).

Licensure Examination

Completion of any one of these three educational routes allows a graduate nurse to take the NCLEX-RN, the test for licensure as a registered nurse, and is accepted by every state as an adequate indicator of minimum competency for a new graduate. However, controversy exists over the appropriate entry-level preparation of RNs. Some professional organizations believe the BSN should be the sole method of RN preparation and ADN graduates should be licensed as "technical nurses" to work under the supervision of BSN graduates. Others feel the on-the-job experiences of diploma and ADN graduates makes up for any deficiency in theoretical preparation. Regardless of this debate, it is highly unlikely that the BSN will become the standard for initial preparation any time soon, because of the nursing shortage, hospital lobbyist, and the lack of faculty to teach BSN students.



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