help settle an arguement?

[Ruthe]

Does anyone know approximately how many births a midwife attends before certification (if she's certified?) How many births (approximate) a certified OB has attended before certification? Can residents attend a "delivery" by themselves at some point during their residency? (meaning, deliberate, sanctioned; not by accident.) Thanks in advance.

[Reha]

I only know a part of the answer (the requirements for midwives).

In order to sit for the exam to become a CPM, you must attend a minimum of 40 births total (20 assisting, 20 acting as primary under supervision) in addition to a few other requirements. In addition to this, states that offer licensing may require additional births (here in Oregon, to become licensed, you must attend a min. of 50 births, so 10 additional over the NARM requirements).

I truly have no idea about the OB's.

[mwherbs]

docs in training are so over worked yes the responsible one will not always be in the room- but mind you docs are really never by themselves

[wifeandmom]

Originally Posted by Ruthe

Does anyone know approximately how many births a midwife attends before certification (if she's certified?) How many births (approximate) a certified OB has attended before certification? Can residents attend a "delivery" by themselves at some point during their residency? (meaning, deliberate, sanctioned; not by accident.) Thanks in advance.

Last question is easiest. Residents are allowed to attend births by themselves under indirect supervision of the attending physician. That means the attending is ultimately responsible for the resident, but they do not have to be right there in the room. One attending will typically supervise several residents, and by the end of residency, there is often absolutely zero interaction with the attending and patient directly.

Board certification in obstetrics is more complicated that 'number of births attended'. They first take written boards, and I didn't find a number of births right off hand for taking written boards. That alone does not make one board certified though.

They take oral boards after completion of their residency, and only then are they considered board certified in obstetrics. The short answer to your question for oral boards looks like this:

The case list must include 40 office practice patients and a minimum of 20 hospitalized or short-stay gynecological and 20 hospitalized or short-stay obstetrical patients with significant problems as defined on pages 52-57.

They must list ALL cases, but the above cases are what they'll be asked about specifically.

Towards the very bottom of this: Current Bulletin is where you find the link for the current bulletin. If you click on that and start reading around page 54 or so, you will see how they are supposed to compile their case lists. They have to have a certain number of cases, but only 2 per category can count towards the minimum number of cases. That means they can't have 20 OB patients all with uncomplicated deliveries and say that's their 20. They have to have at least 10 different categories covered on the list since no more than 2 per category counts towards the minimum.

Some of the things considered 'significant problems' off of the list include:

1. Breech and Other Fetal Malpresentations
2. Intrapartum Infection (Amnionitis)
3. Puerperal Infection
4. Third Trimester Bleeding
5. Multifetal Pregnancy
6. Cesarean Hysterectomy
7. Premature Rupture of Fetal Membranes at Term
8. Preterm Premature Rupture of Membranes
9. Preterm Delivery
10. Hypertensive Disorders of Pregnancy (Chronic Hypertension, Preeclampsia, Eclampsia)
11. Second Trimester Spontaneous Abortion
12. Cardiovascular and/or Pulmonary Diseases Complicating Pregnancy 13. Renal Diseases and/or Neurological Diseases Complicating Pregnancy 14. Hematological Disease and/or Endocrine Diseases Complicating Pregnancy

I do know an OB/GYN residency is 4 years after the intern year. I also know that my DH had over 800 cases in the 18 months of clinicals during anesthetist school. So, if he had 800 in 18 months, and they do 4 years...they will easily care for a lot more than 800 over the course of 4 years. Obviously not all of their cases will be births, or even pg women, since OB/GYNs do a lot more than just pg women and births.

[Ruthe]

Thanks all! That's helpful.