or Connect
Mothering › Mothering Forums › Pregnancy and Birth › Birth and Beyond › Birth Professionals › Tribe for Midwifery Students 2008!!
New Posts  All Forums:Forum Nav:

Tribe for Midwifery Students 2008!! - Page 9

post #161 of 1798
*
post #162 of 1798
Lisa - I hear you completely. Some of my favorite, best memories in school have been of highly medical births that midwives have helped make absolutely wonderful and magical.

I love that midwives have a place in hospitals, too, especially for women that won't/can't be at home.

Sarah
post #163 of 1798
*
post #164 of 1798
Exactly. The birth of my second daughter was magical. The lights were dimmed, I scrubbed in, we had the music going, and the OB talked to the baby about what was happening. I was right there as the OB lifted her up just enough that I could lift her out. I was the first to hold my daughter and my partner was second. All was calm and gentle. When the bleeding and placenta issues started up we already had a lovely dynamic going in the room. Total respect.

That said, I used to worry that I would lose myself and my homebirth heart in school for CNM. What if I become medicalized to the degree that I forget the magic of gentle physiological birth? Now I am thinking that my convictions are strong. My gentle spirit is strong. And there is a local homebirth CNM to remind me that it can be done.

I don't want to highjack this thread to be a conversation between Sarah and I, but I do know that a year ago I was searching for threads that discussed the issue of CPM or CNM and it was hard to find. I hope that others can appreciate it.

In gratitude for this thread,
L
post #165 of 1798
Quote:
Originally Posted by A&L+1 View Post
Exactly. The birth of my second daughter was magical. The lights were dimmed, I scrubbed in, we had the music going, and the OB talked to the baby about what was happening. I was right there as the OB lifted her up just enough that I could lift her out. I was the first to hold my daughter and my partner was second. All was calm and gentle. When the bleeding and placenta issues started up we already had a lovely dynamic going in the room. Total respect.

That said, I used to worry that I would lose myself and my homebirth heart in school for CNM. What if I become medicalized to the degree that I forget the magic of gentle physiological birth? Now I am thinking that my convictions are strong. My gentle spirit is strong. And there is a local homebirth CNM to remind me that it can be done.

I don't want to highjack this thread to be a conversation between Sarah and I, but I do know that a year ago I was searching for threads that discussed the issue of CPM or CNM and it was hard to find. I hope that others can appreciate it.

In gratitude for this thread,
L
I, personally, love this conversation.

As a woman who desperately wants to be a midwife, but keeps changing her mind between CNM and CPM, this conversation reads like my inner dialogue. I did choose CPM, though, mostly because of autonomy issues and because I do not wish to practice in a hospital. (You lovely CNMs have that ground covered! )

I go back and forth--my CNM would be less time, more money and potentially more stability. Definitely more transferrable from state to state. But, here in FL (at least in my area) the relationship of CNMs to OBs is tenuous at best. This worries me. My CNMs actually dissuaded me from becoming a CNM because their own dreams had been deferred because of the local climate.

So, I've decided on CPM. In my state, there's a very good law and rule (limiting in scope, but honestly, it's protective) and LMs are autonomous care providers, which really appeals to me.

I also sometimes think of going to med school because we need more MDs (Midwives in disguise). But, the thought of so much school really gives me reason for pause. I like to consider all my options though.

Does anyone else (obviously not on THIS thread) notice the divide between CNMs and CPMs? Here it is very stark. I even had a CNM intimate to me that if you were not a nurse first then you were an illegal "lay" midwife (which is clearly not true). I have heard CPMs call CNMs MEDwives. I hate the divisive nature of the profession. Thoughts on how to bridge those differences in practice and our own biases?
post #166 of 1798
I agree about the separation between CNMs and CPMs/DEMs. I have no idea of a real solution. Though, I will say that I personally know some CPMs who are likely MORE 'MEDwife'-like than most CNMs...so in my mind, route of education and titles after your name don't really mean much in regard to how you may approach birth.
post #167 of 1798
I've wondered the same thing Amanda. The initials don't tell the whole story.

I've chosen DEM (I imagine I'll eventually get my CPM) because I am much more drawn to homebirth and the apprenticeship model of learning. I just can't picture myself going to nursing school etc... and besides, if I was gonna, I should have eight years ago when my daddy offered to pay my way. And the state where I live... I think there's only a couple of CNMs who attend homebirths due to backup issues.

I do think it would be neat to be able to offer the continuity of yearly paps and such but oh well. I also think it would be neat to be a chiropractor and a midwife- but I can't do it all, ya know?
post #168 of 1798
Quote:
Originally Posted by busybusymomma View Post
I also think it would be neat to be a chiropractor and a midwife- but I can't do it all, ya know?
I was just telling someone that in addition to being a midwife, I wanted to be massage therapist and herbalist! Maybe not right away, as I have enough on my plate with midwife schooling....but someday!


post #169 of 1798

Any info on AVIVA

I am drawn to AVIVA http://avivainstitute.org/health.htm and am wondering if anyone out there has looked into them. I am going to start back into teaching CB classes and doula work so I think it is time i chose a school to work with toward my Midwifery training.
post #170 of 1798
Quote:
Originally Posted by onlyboys View Post
Does anyone else (obviously not on THIS thread) notice the divide between CNMs and CPMs? Here it is very stark. I even had a CNM intimate to me that if you were not a nurse first then you were an illegal "lay" midwife (which is clearly not true). I have heard CPMs call CNMs MEDwives. I hate the divisive nature of the profession. Thoughts on how to bridge those differences in practice and our own biases?
It can be hard. In Washington, CNMs and LMs are both licensed independent providers. CNMs in Washington don't need a "supervising" doc, just a referral doc (and that's an ACNM thing, not a WA thing). Our CNMs at my hospital have a good relationship with the local LMs, as do our docs for the most part (OT, but my thesis topic is qualitative research in the attitudes of receiving providers towards home birth transfers, and I'm doing the work with the OBs at my hospital). But I think there's a lot of attitude among the public that creates a dichotomy where there doesn't need to be one. LMs had hospital privileges at one site in Seattle, for example, which further blurs the distinction and was great -- but then the hospital was bought by an anti-midwifery hospital and the OB unit closed. I'm tired of the medwife label, myself -- jsut because I plan to catch babies in hospitals doesn't mean I won't be a midwife. Sometimes that's harder, to negotiate a midwife birth in the context of a hospital, but I feel that CNMs can be resented as part of the "Establishment".
post #171 of 1798
I love the discussion of CPM and CNM. I honestly used to really turn my nose up at the idea of becoming a CNM. I don't feel that way anymore AT ALL though. I am on the CPM path and really enjoying it, but I am also lining up things in my life so that I could go the CNM route if I choose to in the future. I don't know what the future holds, so I want to keep my options open.
post #172 of 1798
I've chosen DEM/CPM. I'd also love to be able to do well-woman care, but I can't do it all either. I'd also love to be able to go into the village areas here and offer physicals, eye checks, etc., but my first love is midwifery. I can always learn those other things later. DEM is also the only way I can do my education by this much distance. I can read the nursing manuals for things I want to supplement with.

There is so much division between CPM/CNMs. The first midwife that I met was a homebirth CNM from Australia that was living here. She was everything but a MEDwife. Hands off, etc. And then there's the CPM that my sil's have all used and she's quite a medwife!


ETA: I have a friend who thinks that the ONLY midwives are CNMs and the others are "lay" as in totally untrained.
post #173 of 1798
There is a lot of hostility towards the LM here from the CNM's and the LM's really could care less about the CNM's, they are too busy with what they do. I've been pondering this lately b/c it upsets me. What upsets me is that women are being steered away from some amazing homebirth midwives b/c of this and that is sad.

Personally, I think it is a great thing to be a CNM. Women need to have midwives in hospitals. I know my heart couldn't take working in that environment and my passion is homebirths but I feel no animosity towards CNM's and am glad that there are wonderful, gifted women called to that.
post #174 of 1798
mamas, just FYI: I've been told off by the mods before for saying MEDwife. something about no name calling in the UA.
post #175 of 1798
Thank you all for this discussion of CNM/CPM! I'm sure it's been discussed before but I was hesitant to bring it up because as I lurked on the thread, everyone seemed to be on the CPM route and I was fearful of being looked down upon for choosing the CNM route. (I found it funny that many of you mentioned the atmosphere to be opposite around here, at times). I suppose I felt like I would be regarded as too medical for this lovely group if I followed the CNM path but it sounds like everyone is very accepting of each individual's choice!!

Sorry that I can't remember names right now, but someone mentioned entering the CNM world & being fearful of getting sucked into the medicalization of it all. This is my fear, too! Maybe this group is where I'll find my strength to "trust birth" instead of "cover my butt," if I can be cliche.

One more question for the CNMers....do you have to do a lot of independent reading & studying (outside of your program's curriculum) to learn about alternative means of care? For example, off the top of my head, how to deliver a shoulder distocia? Everything I've read suggests getting Mom on hands & knees and doing a technique to dislodge the shoulder. I have no idea what an OB would do (pull real hard? use instrumentation?) but what do they teach CNMs? I'm sure there are better examples but you get my drift, right?
post #176 of 1798
Quote:
Originally Posted by majikfaerie View Post
mamas, just FYI: I've been told off by the mods before for saying MEDwife. something about no name calling in the UA.
Hmmm. We're not name-calling, though, just worrying about the divisive nature of midwifery and it's accompanying biases/language. I could be wrong, but I think we're well within the UA to contemplate why these things happen and what can be done.

Maxmama--this sounds ideal! FL is such a funny state. There is an LM who has hospital privileges, and I know of a CNM who works with an OB and does homebirth. I even have heard tales of a OB taking call for a LM who was at a birth and delivering the baby at the woman's home! GASP! I love the idea of your thesis. Mine is on personality type and its implications for better midwife/client interactions. Not quite as bridging as yours.

It sounds to me like the key here might be more interaction between midwives of all backgrounds and educations. I hardly interact with the CNMs in our town, but perhaps reaching out to them, possibly contacting them about observing a few births and getting to know them might go a long way to helping the relationship. Unfortunately, I think LMs in this city are perceived as "competition," though I may be wrong about that. I hope I am.

Thanks for all the thoughts!

On a personal note, I attended prenatals yesterday at clinic can I just say that I think I like prenatals more than labors/births? Is that weird? It's such a time of investigation and counseling and just really getting to know the women that we are serving. I did Leopold's on six different women yesterday, and got to assist in three paps! I saw some variations from normal with regard to gynecology, and that was very interesting! I got to brush up on FHTs and what an acceleration and decel sounds like. Also, we had a woman who is opting to complete prenatal care with us, then go to the hospital for birth, and I got to see how the midwife handled that and really listened as she was open and kind and affirming. It gives me hope that perhaps a truly collaborative relationship is wanted by some women--women love our prenatal care yet want to be in hospital for the birth, and we should be able to honor that.

All in all, I adored my prenatal day (my first) and I am proud of myself that I was able to get through the "touching" part of midwifery. I had told the midwife I was with yesterday that I wasn't sure if I wanted to, and she frankly THREW me into it. It was perfect, she didn't give me the option just said to the client, "And now, Amanda will check the baby and we'll see if we get similar findings." I couldn't quite say no at that point! She really knew what I needed and I love that.

I also attended birth number 11 at the birth center last week. Just 9 more until I have all my observes!
post #177 of 1798
edited for double post
post #178 of 1798
Quote:
Originally Posted by koru View Post
Thank you all for this discussion of CNM/CPM! I'm sure it's been discussed before but I was hesitant to bring it up because as I lurked on the thread, everyone seemed to be on the CPM route and I was fearful of being looked down upon for choosing the CNM route. (I found it funny that many of you mentioned the atmosphere to be opposite around here, at times). I suppose I felt like I would be regarded as too medical for this lovely group if I followed the CNM path but it sounds like everyone is very accepting of each individual's choice!!

Sorry that I can't remember names right now, but someone mentioned entering the CNM world & being fearful of getting sucked into the medicalization of it all. This is my fear, too! Maybe this group is where I'll find my strength to "trust birth" instead of "cover my butt," if I can be cliche.

One more question for the CNMers....do you have to do a lot of independent reading & studying (outside of your program's curriculum) to learn about alternative means of care? For example, off the top of my head, how to deliver a shoulder distocia? Everything I've read suggests getting Mom on hands & knees and doing a technique to dislodge the shoulder. I have no idea what an OB would do (pull real hard? use instrumentation?) but what do they teach CNMs? I'm sure there are better examples but you get my drift, right?
SD should be handled the same way regardless of provider, just FYI. The order recommended by ACOG is McRoberts (hips flexed sharply and abducted), suprapubic pressure, Woods screw maneuver, delivery of the posterior shoulder and Zavanelli (replacement of the head and CS) as a last resort. Most OBs I know throw in the Gaskin maneuver either first (before McRoberts) or immediately after. You cannot instrument or use traction with an SD and OBs know this -- or should.

Okay, back to point.

Working with a group of noninterventive OBs has given me a different perspective on birth providers. I really believe it's not necessarily the training the provider receives so much as the context in which s/he practices that makes the most difference.
post #179 of 1798
Quote:
Originally Posted by koru View Post
One more question for the CNMers....do you have to do a lot of independent reading & studying (outside of your program's curriculum) to learn about alternative means of care?
Before I was a nurse I was a birth doula and taught CBE in a birth center. All my kiddos were BAH with a CPM and I was attending births with her. I started out with a very holistic view of pregnancy and birth before I ever entertained the idea of going for my CNM. Many CNMs are like that, too. And then there are many who are L&D nurses that lean toward the CNM route because they are already catching babes before the docs make it in the hospital and they work with hospital based CNMs. There's positive and negative aspects to the CPM as well. We each have to find what path works the best for us.

As far as studying goes...I did a tremendous amount of reading/studying before I even applied to midwifery school and will continue to do so as I move through the program. I'm sure there are CNM students who don't do too much additional research into alternatives/less invasive forms of care, but at my school (Frontier) we have a wonderful forum where a lot of great information exchange happens. Not only are there students sharing, but faculty (who are often practicing midwives) share as well. We also have to take a course specific to birth centers. Unlike a lot of CNM programs out there now, at Frontier there is still an emphasis on protecting normal birth.
post #180 of 1798

was wondering...

why I wasn't getting any posts....the thread is different...lol.

explains a lot. so I am re-subbing

my re-intro is:

I am a 28 yr old midwifery student with AAMI. I am a SAHM to 4 kids ages 10,8,7 and 3 and we homeschool. I have been married to my love for almost 9years and he is in the Navy (12 yrs come Aug), we are currently living in ME.

I am currently in Wisconsin for the next couple of months to help my sister who is due with twins at the end of Feb. (planning a homebirth with a midwife who is an AAMI grad!) and we are VERY excited about that. Hoping she births before the Trust Birth conference...lol

I think that is about it. I will check back when I can and hopefully I will find time to read back all the posts I missed
New Posts  All Forums:Forum Nav:
  Return Home
  Back to Forum: Birth Professionals
Mothering › Mothering Forums › Pregnancy and Birth › Birth and Beyond › Birth Professionals › Tribe for Midwifery Students 2008!!