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#1 of 6 Old 12-20-2013, 04:50 PM - Thread Starter
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This is my first post here and I will admit I'm a bit nervous. 


I am currently an undergrad working on a BSN. The ultimate goal was a Master's in Midwifery. Then the other day, the idea occurred to me that I could just skip the whole CNM route and do a direct-entry route for a CPM. The reason being, I don't really want to work in a hospital.


Anyway, I have scoured NARM and googled as much as I can and I still have questions. Do I *have* to attend a Midwifery school/program or can I simply complete an entry-level PEP as an apprentice? 


This leads to more questions. If I can complete a PEP as an apprentice, how do I go about finding a preceptor willing to take on an entry-level student?


Many thanks!



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#2 of 6 Old 12-28-2013, 01:53 PM
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Anyone have any advice?
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#3 of 6 Old 01-04-2014, 02:26 PM
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CNMs do not have to work in hospitals.


What type of education are are you looking for? How is your BSN program going?


No, you don't *have* to attend a school to become a CPM. Is that the type of education and training you are looking for? Does this type of education meet your standards? Do you believe you will be able to serve your patients well and comprehensively with the education and scope of practice of a CPM?


There's a lot more to this than working *in* or *not in* a hospital.


What is the appeal of "skipping the whole CNM route"?  There are quite a few CPMs who end up going back to school to become CNMs because they wanted a broader education and scope of practice.


Things to think about.

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#4 of 6 Old 01-09-2014, 02:16 PM
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If you know you're going to end up staying in Oregon, the PEP route could work. If there's a possibility you might move someday, you should consider attending a MEAC school, as some states are starting to require that as part of their licensing process.

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#5 of 6 Old 02-07-2014, 07:26 AM
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You could actually work as a homebirth midwife after getting a CNM...and at that point, if you ever HAD to work within the hospital setting (a midwife in our area was a homebirth midwife for years and then her husband lost her job, they needed insurance, and she moved her practice to a very crunchy hospital setting), you could.

You could very easily, especially in a state where there is a large population of midwives, get a great education with the PEP process. I purposely sought the tutelage of several different midwives, who worked differently from one another, so that I learned more than I would by being limited to one teacher.  That said, in whatever hospital you were placed to do your clinicals as a CNM student, you would ALSO be limited to the protocols and practices at that one place... which can be VERY limiting, depending on the protocols!

Though what was mentioned above, that you may in the future only be allowed licensure if you have been to a MEAC school (SO limiting and biased and annoying, and not conducive to anybody but family-less people, as there are VERY FEW MEAC schools in existence!), is true.  There is absolutely talk of that.  So...if you have the ability to move around and seek an MEAC school, that might be a consideration, as well.

A thought... There are different skill sets to hospital birth and home birth, even "normal" birth within those settings.  I would strongly encourage you to apprentice for six months to a year with a busy homebirth midwife in your area if you DO get a CNM.  Birth Emergency Skills training is a good place to go, too... as it deals with out of hospital skills and emergencies.  The TOOLS you have at an in-hospital emergency can differ greatly from those in an out of hospital setting.

Mama to two awesome kids. Wife to a wonderful, attached, loving husband. I love my job-- I'm a Midwife, Doula and Childbirth Educator, Classes forming now!

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#6 of 6 Old 02-07-2014, 12:34 PM
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We were just talking about CNM vs CPM around the table at the clinic last night! CNM, in general are *not* able to attend homebirths simply because the protocols are so limiting, and also because, once you have spent the time and money to get there, it isn't very tempting to give up a very good salary for a very poor one, not to mention the appeal of set work schedules. Just sayin'. 

The MEAC thing is annoying on some levels, but I do believe (obviously, since I've gone that route!) that it's worth it. We have had a couple PEP candidates come to our school, planning to stay 3 months in order to speed up the PEP process, and they have all decided to stay and complete the MEAC program instead. It isn't family friendly, but midwifery isn't very family friendly either. 

In the end, for me, it comes down to:

CNM                                          CPM

better salary                            lower salary

greater scope of practice          smaller scope of practice

set schedule                           erratic schedule, but one you *can* limit

hospital protocols                    autonomy to set your own protocols (within state-imposed limits)

bigger educational investment   smaller educational investment (of course, only to obtain the credential, nothing to do with life-long                                               learning!)



We currently have a student at our school who is a CNM, actually. He needed to actually attend some births in order to get a better job, because his hospital doesn't allow CNM's to catch babies. 

The former students from our school who are wanting to further their mainstream education want to increase their scope of practice and offer more holistic care (be able to offer care to the whole family, or to women not in the childbearing cycle, or to have prescriptive privileges, etc), are heading towards being nurse practitioners. Some are leaning towards medical school down the line. 

You should talk to midwives of both schools in your area. Midwifery varies so much from state to state! There's always a way to get to where you want to be. Sometimes it's a little tricky to find it, but you can! 

For greater things are yet to come...

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