CM versus CNM

[UmmSamiyah]

Hello all,
I haven't been here is a while ! But I got accepted to this Accelerated Nursing program but my real goal is to become a midwife. I have also been toying with the idea of eventually becoming a Pediatric nurse practitioner. But what is the difference between being a Certified Midwife and a Certified Nurse midwife. Like, if I just go online or find a midwifery school that offers certification as a midwife do you think that will suffice? And are there any that I can attend while maintaining a good mommy status?

[onlyboys]

If you are a nurse first, then you are a CNM. If you aren't, and you are trained formally at a school where your education is accredited by a place recognized by the ACNM, then you can be a CM if you pass the certification exam. Some states are not yet recognizing a CM to practice.

Most of the women who do the CM degree have a degree in something other than nursing and do not wish to get their RN degree before they go on to midwifery...

If you are going to be a pediatric nurse practicioner, then you would need to do an additional certificate program to get certification as a midwife.

Hope that helps!

[onlyboys]

And, SUNY has some programs where there are some classes in distance education that would work well if you were short on time. But, midwifery is very time consuming, so if that's an issue to you, then you might want to take your time getting there. :)

[Midwife Kris]

But what is the difference between being a Certified Midwife and a Certified Nurse midwife. Like, if I just go online or find a midwifery school that offers certification as a midwife do you think that will suffice?

This page gives a couple of links on the differences between CM and CNM: http://acnm.org/careers.cfm?id=80 A CM doesn't require the nursing degree but probably is a master's degree in some other health care profession, but the CNM does (N= nurse ;) ). A CM is different than a CPM/DEM (which is not a certifcation by the ACNM organization but designated by NARM.org).

Wouldn't it be nice if we could all just be "midwives" without the mumbo jumbo title confusions?! LOL.

[vermontana]

Are you planning on trying to practice in New York state? If you are, you will have to do some research, because the laws/regulations regarding licensure of CMs can be kind of difficult to navigate. It is unfortunate, but it seems like the most reliable way to ensure your future as a practicing midwife in NY is to go the CNM route. But, that only ensures your future as a CNM with a hospital practice....good luck finding a physician to back up a homebirth practice. If you just go online and find a midwifery school that offers cert. that will definitely NOT suffice in NY (if you want to practice legally). Currently NY accepts degrees from the Natl College of Mid. in Taos, NM, and perhaps some credits from other MEAC accredited schools, but again, you'll have to do some research. If, however, you're not going to be in NY, then a lot of that won't matter. It is really important, though, to figure out the status of midiwfery in whatever state you're planning on practicing in. and pursue your education with those laws in mind. It sucks that it isn't easier to do. It sure would be nice if all of us who wanted to be midwives could pursue the educational path that suits us best, learn what we need to learn, and go out and serve women and families, and not get all caught up in the mumbo jumbo and titles and legal webs that bog us down.
By the way, where in upstate NY are you? I am in "way upstate", too, east of Watertown.

[UmmSamiyah]

I am in Binghamton.
Would I be able to get my degree as a nurse then go through a program to get a CM but still take an exam to be a CNM? This is so confusing:scratch Ha ha all I want to do is help women give birth naturally and nurse there babies successfully!!:p
Thank you

[Midwife Kris]

Would I be able to get my degree as a nurse then go through a program to get a CM but still take an exam to be a CNM?

If you're going to nursing school why are you averse to completing the midwifery portion to be a CNM? The CM is for folks who've got a MS or PhD in Physical Therapy or Physician's Assistant or MPH, etc. The CNM is for nurses with additional midwifery training.

There are only two schools accredited by ACNM's educational body to prepare you for a CM and they happen also to prepare you for CNM. They're also in your neck of the woods. Why don't you contact their directors and see what they have to say about this idea and what degree you should really be working on if you want to be a CM and not a CNM? Another thing for you to consider is where you will practice geographically when you've completed the CM. CNMs are recognized and practice legally in all 50 states while CMs are a lesser known certification. I believe, as stated earlier, that NY might be the only place they are legally recognized by statute and if you plan on being in NY forever it's a fine choice. ACNM has a book published on CM/CNM legalities but you can also contact each state individually to find out their CM statute if one exists.

State University of New York Downstate Medical Center (MS)
Health Sciences Center at Brooklyn
College of Health Related Professions
Midwifery Education Program
Box 1227, 450 Clarkson Avenue
Brooklyn, NY 11203
718-270-7742
ronnie.lichtman@downstate.edu
http://www.hscbklyn.edu/CHRP/Midwif/
Program Directed By: Ronnie Lichtman, CNM, PhD

Baystate Medical Center
Midwifery Education Program
689 Chestnut Street
Springfield, MA 01199
(413) 794-4448
Barbara.Graves@bhs.org
www.baystatehealth.com/midwiferyed
Program Directed By: Barbara W. Graves, CNM, MN, MPH, FACNM

[vermontana]

If you go through a program to be a CM (a lay-midwifery, direct entry type program), you can't just take a test to become a CNM. To become a CNM, you first have a nursing degree, then go on to get your masters in nurse midwifery. There are a lot of schools where you can do that, however, if you're at all interested in homebirth be aware that very few educational opportunities exist for CNMs interested in homebirth. The title CM is exclusive to NY state, as far as I know. It is the state's way of, sort of, accepting non-CNM route midwives as capable practictioners. To become a certified CM in NY, you have to fulfill the state's own set of requirements. If you do a web search for NY friends of midwives or "legality of midwifery inNY" or something similar you should be able to find some resources (sorry I don't know any off the top of my head). I do belong to the NY Friends of Midwives yahoo group and the women on that group have a LOT of info, you should join!

[Midwife Kris]

If you go through a program to be a CM (a lay-midwifery, direct entry type program), you can't just take a test to become a CNM.

A CM is not an alternative title for a direct-entry midwife. The title was created by the American College of Nurse-Midwives and it's reserved for health care workers with advanced degrees and graduate midwifery education.

To become a CNM, you first have a nursing degree, then go on to get your masters in nurse midwifery. There are a lot of schools where you can do that, however, if you're at all interested in homebirth be aware that very few educational opportunities exist for CNMs interested in homebirth.

That is true. Yale offers one home birth oppportunity as part of it's educational process for nurse-midwives and the Frontier School of Midwifery and Family Nursing encourages out of hosptial training as a rule.

The title CM is exclusive to NY state, as far as I know. It is the state's way of, sort of, accepting non-CNM route midwives as capable practictioners.

CM is not exclusive to the state, but NY may very well be the only state currently recognizing this additional process for credentialing.

[UmmSamiyah]

If you're going to nursing school why are you averse to completing the midwifery portion to be a CNM?

Metromidwife, I am not averse to anything...I am just trying to get as much information as possible and understand it.

But I didn't know Yale offered any courses for practitioners that want to do homebirths. I will further look into prospective programs, because Yale is on my list (of course it is Yale). Like i said, I have already gotten accepted to a nursing school and i wanted to know what would be the most beneficial route as well as the quickest to becoming a midwife. but with two kids and responsibilities I know that might not be possible.

So is onlyboys statement true?

If you are a nurse first, then you are a CNM

Because someone else said that "if you go through a program to be a CM you can't just take a test to be a CNM". I will go to those websites suggested also.

[vermontana]

A CM is not an alternative title for a direct-entry midwife. The title was created by the American College of Nurse-Midwives and it's reserved for health care workers with advanced degrees and graduate midwifery education.

I guess I wasn't very clear in what I wrote. I wasn't trying to say that a CM is the same thing as a DEM. But, as I understand it, the state of NY does accept and grant the CM title to midwives who have completed lay midwifery training at some MEAC accredited schools like the Nat. College of Midwifery. There are several CPMs in the state who are not necessarily "health care workers with advanced degrees and graduate midwifery education" ,who are now CMs. I am still learning the confusing nitty gritty regarding legally acceptable education paths in NY, and I am not totally clear on how it all works, but I do know that some DEM/CPMs have acquired CM certification, I think basically through a challenge process, showing they have completed comparable training/education.

[muslima0midwife]

Wouldn't it be nice if we could all just be "midwives" without the mumbo jumbo title confusions?! LOL.


I SOOOOOOOOOOOOOOOOOOOO AGREE!!!!:thumb :yeah:

Umm Samiyah PM me inshallah... we can talk further or email me:
muslima0midwife@email.com

[Midwife Kris]

Metromidwife, I am not averse to anything...I am just trying to get as much information as possible and understand it.

Great! I thought you were looking for ways to be a CNM and a nurse without the CNM education ;) Which if you do the CM program and as a nurse you might as well be a CNM LOL, doesn't sound like a way to save time :P

But I didn't know Yale offered any courses for practitioners that want to do homebirths. I will further look into prospective programs, because Yale is on my list (of course it is Yale).

Now I don't know if they actually teach midwives how to attend home births, as much as they give them an opportunity to attend one home birth. Clearly not enough to get proficient! But that might change as I understand the woman who wrote the chapter on home birth in Varney's Midwifery is a home birth CNM and now Yale staff. Yay!

Because someone else said that "if you go through a program to be a CM you can't just take a test to be a CNM". I will go to those websites suggested also.

The exam that is admistered by ACMB (the accreditation body of ACNM) is the same whether or not you're heading for CM or CNM. What you get in the way of certification depends on your preparation. That is, if you've been prepared as a nurse and midwife and met the requirements of both you might qualify to test as a CNM. ACMB, not states, is who confers the title of CM or CNM (just as NARM confers the CPM credential, not the state).

I read a blurb from my school (National College of Midwifery) a long time ago about the graduates who also took the ACMB (then called ACC) exam to earn the CM credential for practice in NY. I seem to remember they did have an advanced degree in other fields or an advanced degree from my school, they weren't simply DEMs. I'd love to have more information also.

Good luck! The decisions on pathways to midwifery are so difficult to make!

[onlyboys]

So is onlyboys statement true?



Because someone else said that "if you go through a program to be a CM you can't just take a test to be a CNM". I will go to those websites suggested also.

The accreditation board who writes the test, which is named above, is the place where you get your accreditation whether you are a CM or a CNM. No, you cannot take a test to become a CNM, you must first go through the channels of education to be a RN/BSN then a MSN with an advanced degree in midwifery. The CM degree is a response to those people who already had a degree (usually in a healthcare field) who also wanted to become a midwife.

The CM and the CNM candidates take the same test. Is that clearer? Sorry, the bureaucracy is intense surrounding midwifery.

In FL, CNMs mainly work in a hospital setting. I do not know of any who are not also LMs (midwives in FL have to have licensure), who do homebirths. Around here, it seems that the CNMs provide the well-woman care for the birthing centers and may do some birthing center births, but for the most part, they work out of hospitals. They are very bound by the laws of the land, and the norms of the place where they are practicing. For me, the "autonomy" of licensed midwifery is appealing, while the job security and the monetary issues is appealing for nurse-midwifery.

I guess you really have to figure out where you want to practice and who you want to work with. Figure out the laws in NY regarding homebirth and who can attend and who cannot, and figure out what kind of training is most appealing for you.

If you wish to practice homebirth midwifery, then you might be better off getting a DEM degree/licensure or whatever is the law in NY.

If you wish to practice in a hospital, then CNM is the only way to go.

But, if you are thinking of getting your RN first, with the accelerated program, then you would be redundant in thinking about getting the CM degree as it is the same (essentially, in education) as the CNM degree, with the "issue" of not being legitimate in all states, yet.

The issue of time and disruption is one that I am constantly mulling over... If I get a degree as a CNM, then it will take me about 3 years, start to finish, and this includes my required births. If I get a degree in licensed midwifery, then it will take me 3 years, and I am nowhere near guaranteed my births. The rules are much more stringent on CPMs/LMs than CNMs for some strange reason, though CNMs have to do other things for their practicum that LMs don't.

The plan, as of today, is to get a CNM degree (mostly because I can do most of it closer to my house), then get what is called "licensure by endorsement" which is a 4 month course which will allow me to take the NARM to become a LM as well. A little redundant in the end, but the path which seems to keep me home (in my town) as long as possible.

Good luck figuring all this out!

[onlyboys]

oops!

[angington]

CNM's don't exclusively practice in hospital in NY. It is legal for CNM's to attend homebirths in NY and many do both. There are several downstate, in NYC and Long Island. Not sure of what the birth situation is like where you are, so it may be harder for you to find a back up doctor in your area.

A pro to the CNM credential is that it is NYS law that CNM's must be covered by your health insurance. If they aren't "in-network", then the insurance company is mandated to pay them at an "out-of-network" rate (usually 80%). This may get you more clients because they they don't have to worry about paying for the birth completely out-of-pocket.

http://www.ins.state.ny.us/rg050409.htm

[UmmSamiyah]

[QUOTE=onlyboys]But, if you are thinking of getting your RN first, with the accelerated program, then you would be redundant in thinking about getting the CM degree as it is the same (essentially, in education) as the CNM degree, with the "issue" of not being legitimate in all states, yet. QUOTE]

I didn't know that.
Now it all makes sense. i thought getting a CM would be easier and faster if I already had a BSN/RN. So okay, just to get this all straight...a DEM is a Direct-Entry Midwife, a CPM is a Certified Practical Midwife and a LM is a licensed midwife?

[onlyboys]

You got it! And, if CNMs can practice in homebirth practices in NY, then you are good to go!

[Midwife Kris]

So okay, just to get this all straight...a DEM is a Direct-Entry Midwife, a CPM is a Certified Practical Midwife and a LM is a licensed midwife?

Sheesh! Isn't it crazy?

DEM = direct-entry midwife aka non-certified nurse-midwife (s/he might be a nurse, but not a CNM!)
CPM = credential granted after meeting standards and passing NARM exam
LM = state license (some states license or document or register midwives)

So a DEM could also be an CPM and a LM... a LM is a DEM and might also be a CPM (if the state requires)... a CPM is a DEM who might also be a LM (if the state she is in licenses midwives). It's no wonder with all this confusion it's hard for prospective midwives to decide what they want to be and how to go about it, let alone mothers understand and find us, and nevermind asking ACOG to get it straight ;)

[UmmSamiyah]

Haha, this really confusing. But I kinda like the challenge :wink Thank you guys.

[megny]

A pro to the CNM credential is that it is NYS law that CNM's must be covered by your health insurance.

Actually, this law applies to both CMs and CNMs. The state does not distinguish between the two for insurance coverage... In fact, all of their "midwife" related terminology was supposed to be changed to refer to a "licensed midwife", not a "nurse midwife"... I don't know why it wasn't so in this opinion statement. You can see this, though, in the references to the actual laws that they analyzed to come to that conclusion.

Just wanted to clarify, as a NY homebirth mama who knows insurance reimbursement can be a big struggle... (but shouldn't now, thanks to this
official statement)

[Unreal]

Hey Monique ;)

There are a bunch of midwives in the area--including one in Vestal that does homebirths and is not a CNM.
You might want to talk to her, as well as the midwives at Lourdes and Wilson to see what they all have to say.

fwiw...we are going with Jeanette (the CM) for this babe (!!! gawd I feel like a loser--it has been soooo long since I talked to you!!!) and planning a homebirth in May. She is awesome and I'm sure would be glad to talk to you.

There is also a local Birth Network that just started up. They meet once a month at the PAL center. This month's meeting is tomorrow night from 6:30 to 8. There are 2 midwives along with a handful of doulas and childbirth educators that will be there.
Oh yeah...and I'll be there ;)

[katiecnm]

I would highly recommend a distance learning program to get your CNM (if that's what you decide you want to do). I chose to go the CNM route because I was interested in women's health in general as well as pregnancy and birth; a CNM can also provide care for babies up to one year of age as well as some primary care. If you're thinking at all about becoming a pediatric nurse practioner (and I think there should be as many PNPs as there are midwives--nurses approach healthcare from a different perspective and provide more wholistic care IMO), you might want to go ahead and get the nursing degree. I think someone else said that you can go either route (DEM/LM/CPM vs CNM) with a BSN. You've got lots of time to make your decision, so think through your options carefully. CNMs can legally attend home births in most if not all states (not positive about that). Whether or not your school endorses home birth doesn't matter. However, you might be happier in a school that accepts home birth as a viable alternative.

All that being said, I attended Frontier School of Midwifery and Family Nursing (www.midwives.org), which is a distance learning program which now offers the master's option. I LOVED it! It is very compatible with having a family. You go to KY only twice, and you can go the third time for graduation if you want. They are even beginning to make concessions for nursing mothers--when I was there the babies couldn't be on campus. My best time for studying was between 10 pm and 2 am, and I liked being able to study when it best suited my circadian rhythm. And the school is such a historic place. Mary Breckenridge did amazing things to reduce maternal/infant mortality in less than ideal circumstances.

Just my 2 cents (2 dollars?) worth.

Kate

[UmmSamiyah]

fwiw...we are going with Jeanette (the CM) for this babe

I can't believe you are pregnant again. You jerk you didn't tell me!! But I know about the birthing network, I am the breastfeeding contact. PM me!

And thank you Kate for the info on the Frontier School. I didn't know they were a distance learning school. My DH and I are toying with the idea of moving but we are not sure where because I want to go near an area that has a midwifery and pnp program that really broadens my options. I will be investigating that site as well.