should I take nursing courses also?

[MamaRabbit]

(warning, VERY long)

I've been looking at the requirements that it would take for a foreigner to be legally licensed where I live (Thailand). Here's what I've found:

THE test:

For someone who is not a Thai national to practice legally in this country, the biggest obstacle is passing the licensing test. If the person is a midwife (without nursing background) she must pass:
1.2 Subjects for examination by the practitioner of the midwifery profession
1.2.1 Mother and Child Nursing
1.2.2 Obstetric Nursing
1.2.3 Laws
(1) Related Health Care Laws
(2) Professional Nursing and Midwifery Laws

Not so hard, except that the entire oral and written exam is in the Thai language. Thai is the 6th hardest language in the world to learn, and very very few people can learn Thai well enough to pass an exam like this. I think my language skills will be good enough in a few years? My Thai is better than most of the other foreigners I know, and I can only speak at a 6th grade level and read/write at a 2nd grade level. I only know a few foreign doctors who've passed the Dr exam. The test is the same whether I'm a nurse, nurse-midwife, or midwife. Yikes. So I need nursing. Maybe? Keep reading.

The education:
For a non-national, a person must have “a degree or a certificate equivalent to a degree in nursing, midwifery or a combination of both from a foreign country and a license for conducting the profession in the respective country. The person must pass a test at a level satisfactory to the Committee.

This regulation makes sense, though I’m not sure what certificate equivalent would be accepted depending on transcripts, etc. (I'm about to enrol with AAMI). I plan on getting my CPM and getting licensed. But even if I do that, they could possibly not accept the education? And I really don't get why they list the nursing and midwifery separate if it's the same test.

I'm thinking this country just doesn't want foreigners to work in the medical field here. Which is a shame, because other than its' Drs, nurses, etc. that get trained overseas, the training is poor, especially for midwives!

Should I get an RN? Like an associates? I really really don't want to go the nurse route. Or should I just study the books, do the recommended assignments, etc and hope that's enough?

Also, I think I do want a little more than just midwifery. I really want to be able to go into the villages and tribal areas that don't have access to good medical care. I'd love to be able to do a basic physical (men and women) and basic well-child care as well. Cancer and poisoning (like lead) is very high due to illegal chemical dumps in these areas. I'd like to be able to recognize signs of cancer, etc. so I can recommend them to go to an area that has better medical care (sometimes a 4hr motorcycle ride through the mountains).

Is this all just nuts? Do I need nursing? Or is this more advanced than nursing? Should I just study it on my own? I've been stewing over this for months. I've read Paths to Being a Midwife, and that clarified that I want to be a CPM without the nursing. But that's the nursing related to midwifery. Do I need other nursing. Aaaack. Someone help me out here. Maybe sum this up for me? Someone who's got an RN and can help out too?

[birthdancedoula]

Minus living and working Internationally (which I hope to do someday) I have had the same thoughts as you about which route to midwifery to pursue. My heart is hands down with direct-enrty, Certified Professional Midwifery but the more I looked at laws and the ways in which I hope to one day practice, I bit the bullet and went to nursing school. I'm currently enrolled in a CNM program and in 2.5 years will hopefully pass the boards and be able to practice as a Nurse-Midwife.

Now I realize you may not want to pursue nurse-midwifery but having a nursing degree as a stepping stone to practice midwifery is not a bad idea at all. In fact, I think in an International setting it has the potential to open many doors for you. It will broaden your knowledge of all aspects of healthcare, not just maternal-child healthcare. The other great thing about having a nursing degree under your belt is that should you ever decide to get out of the birth field, your options are wide open if you have an RN.

Speaking as someone who had mulled over these issues for years going back and forth between the CPM vs. the CNM route, going to nursing school was the absolute best career move I could have made. Throughout nursing school I was able to keep my focus and not become jaded by the medical model. And now, in my practice as a birth center RN, I am committed to helping moms birth sans intervention.

It can be done. You just have to think of nursing school as a drop in the bucket of your overall midwifery goals. Best of luck mama!!

[mcsarahb]

I agree with the first poster. My heart is with home birth and birth centers, as well, but I went for the CNM for the added benefit of a much broader practice scope. School is quite difficult for me on an emotional level (training in the hospital) but I think in the long run it will be very worth it.

Good luck, whatever your decision!

[MamaRabbit]

Thank you! You both gave me something to think about.