Aside from the obvious (one being a nurse and one not) what is the difference between a Certified Nurse Midwife and a Licensed Midwife?
Is the scope of practice different?
What kind of and how much schooling does a LM get?
Do LM only do homebirths?
Can LM take on "higher risk patients" like ones with GD, pre-eclampsia, or history of "difficult" deliveries? Most CNMs I know could.
Do they use backup OBs like CNMs?
What is your personal experience with either?
Here is my experience and why I am asking;
With DS I had a CNM in a hospital - cuz that was all that was available. It was a great experience for the most part (everything except being in the hospital). It was in a birth center styled room with tub, queensized bed, dim lighting, music, etc. I had the most amazing MW in the world, I switched to her at 28wks pregnant and it was the best decision I ever made. She is indepently practicing, with a backup OB rather than within an OB's practice and I found that made a huge difference in her approach to my care. She is very proactive with prenatal care and very "hands off" in her approach - encouraged me to stay out of the hospial as long as possible, go eat, go walk, doesnt do routine IVs, offers waterbirths, etc (she used to have a birth center in teh area until the hospital refused to renew the lease). She stayed with me thru the entire labor, coaching me, giving me gingerale and cran juice, and making me feel like I could do it. My 9lb9z beautiful rolly polly DS got seriously stuck, position changes weren't doing it, she reached in to unhook his shoulder off my pubic bone (his shoulders were actually bigger than his head!!) and finally he came out in the hands and knees position (a tiny bit blue). She defended us to the cranky old nursery nurse - to make sure he came right to me and breastfeed. I had the best MW in the world, and now I am at a loss as to how to find someone just as good as her.
Now we have moved, and Florida does it differently. All the CNMs seem to practice in the hospitals - and I have heard horrible things about the hospitals and natural births down here. There is a CNM who does homebirth a little over an hour away, and birth center a little over an hour away if we manage to catch 95 without traffic, or tons of LM who do homebirths close by.
I know I don't want a hospital birth again. Birth center would be great. Home would be great, but I am a bit nervous that the next one might get stuck again. DS had minor Erbs palsy as a result of getting stuck (and the stupid delivery nurse pushing on my stomach while the MW was yelling at her to stop), and honestly I credit the MW (and our chiropractor) with the fact that he has use of his arm - an OB or a more medical CNM would have let the nurse push on my stomach to "help" the baby come out - stretching his arm and neck even further and possibly causing permanent nerve damage. I am terrified of that happening again without my MW there to make it all okay. Or that they will recommend induction (or worse) cuz the next one is "too big" - especially since I now have a "history of big babies."
I figure if I start searching and researching now, maybe I will have someone I like when I am ready to get pregnant in 6 months or so. It will hinge of finding a great MW. DH laughs, but I will not make a baby until I find someone I trust enough to catch that baby. And they have pretty big shoes to fill.
Is the scope of practice different?
What kind of and how much schooling does a LM get?
Do LM only do homebirths?
Can LM take on "higher risk patients" like ones with GD, pre-eclampsia, or history of "difficult" deliveries? Most CNMs I know could.
Do they use backup OBs like CNMs?
What is your personal experience with either?
Here is my experience and why I am asking;
With DS I had a CNM in a hospital - cuz that was all that was available. It was a great experience for the most part (everything except being in the hospital). It was in a birth center styled room with tub, queensized bed, dim lighting, music, etc. I had the most amazing MW in the world, I switched to her at 28wks pregnant and it was the best decision I ever made. She is indepently practicing, with a backup OB rather than within an OB's practice and I found that made a huge difference in her approach to my care. She is very proactive with prenatal care and very "hands off" in her approach - encouraged me to stay out of the hospial as long as possible, go eat, go walk, doesnt do routine IVs, offers waterbirths, etc (she used to have a birth center in teh area until the hospital refused to renew the lease). She stayed with me thru the entire labor, coaching me, giving me gingerale and cran juice, and making me feel like I could do it. My 9lb9z beautiful rolly polly DS got seriously stuck, position changes weren't doing it, she reached in to unhook his shoulder off my pubic bone (his shoulders were actually bigger than his head!!) and finally he came out in the hands and knees position (a tiny bit blue). She defended us to the cranky old nursery nurse - to make sure he came right to me and breastfeed. I had the best MW in the world, and now I am at a loss as to how to find someone just as good as her.
Now we have moved, and Florida does it differently. All the CNMs seem to practice in the hospitals - and I have heard horrible things about the hospitals and natural births down here. There is a CNM who does homebirth a little over an hour away, and birth center a little over an hour away if we manage to catch 95 without traffic, or tons of LM who do homebirths close by.
I know I don't want a hospital birth again. Birth center would be great. Home would be great, but I am a bit nervous that the next one might get stuck again. DS had minor Erbs palsy as a result of getting stuck (and the stupid delivery nurse pushing on my stomach while the MW was yelling at her to stop), and honestly I credit the MW (and our chiropractor) with the fact that he has use of his arm - an OB or a more medical CNM would have let the nurse push on my stomach to "help" the baby come out - stretching his arm and neck even further and possibly causing permanent nerve damage. I am terrified of that happening again without my MW there to make it all okay. Or that they will recommend induction (or worse) cuz the next one is "too big" - especially since I now have a "history of big babies."
I figure if I start searching and researching now, maybe I will have someone I like when I am ready to get pregnant in 6 months or so. It will hinge of finding a great MW. DH laughs, but I will not make a baby until I find someone I trust enough to catch that baby. And they have pretty big shoes to fill.
It always worries me considering I have huge babies. But, it't unlikely to repeat and honestly, in my situation I trusted my LM/CPM to be able to handle it much more appropriately than I would have ever trusted my OB. I don't think she would have had a clue what to do because she told me after he was born (by c-section) that she would have most certainly had to break his collarbone to get him out.
I started off with a LM when I was pg with DD2, and she was so medically minded that I couldn't stand it. Vag checks, pitched a fit when I refused the glucose test, etc... I ran away from her very quickly and ended up with a CNM who couldn't be more hands off. In my state LM's are very limited to what patients they can take, CNM's can legally do breech, twins, VBAC's, all the things LM can't do.
