CNM's vs. DEM

[Earthylady]

I've had two previous homebirths with a direct entry midwife. We've moved out of state and am now planning another homebirth and *here* they have CNM's that do homebirths.

What should I expect to see differently from what I'm used to? The only experience I've had with CNM's were hospital CNM's and they were not far off from an OB mentality, really.

My DEM let me go my whole pregnancy only being seen twice, she basically sat back during labor and she didn't try to manage anything, she was just there to encourage and help if needed.

Any questions I should specifically be asking when I interview CNM's?

Thanks!

[mrsdewees]

Honestly, it depends on a midwife-to-midwife basis. There are some CNMs who are "hands off" however, I think it's not as common as you'd find with a DEM.

There comes a huge issue here because of the catch-22 of licensing. CNMs accept insurance and carry malpractice and all those nice things, however, they usually have to adhere to state laws and regulations (i.e. not doing primary VBACs or attending postdates etc). Again, I won't say this is always the case. There are DEMs that are too medical and I'm sure CNMs that are extremely hands-off. Just from my experience, CNMs do tend to usually be more intervention-friendly.

It's best to interview and ask and to get some referrals - or speak with some of their past clients.

edited to add: I'd ask about interventions, just like you would if you were seeing anybody. What's their policy on AROM? How long will she "let" you labor? What are her transfer guidelines? Does she use Pitocin often to help expel the Placenta? Will she do waterbirths? (some midwives won't), etc

[lunarlady]

Having birthed with both, I can tell you my CNMW was mas much more "medical" than my DEMW. The CNMW came to my birth in scrubs, and made my birth feel more like a procedure than a spiritual celebration. Obviously, however, not all MW are the same so I would just do a lot of interviews to find one you like.