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I have birthed with both. IME CNMs are, like Angela said, more medically minded. They usually work in hospitals under OBs.

CPMs usually work independently or in a small group with other CPMs, and attend homebirths.

It all depends on what kind of birth and care you are looking for. I had a much better birth with the CPM. She focused more on evidence-based care and took into consideration so much more during my pregnancy than the CNMs did.
 

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Quote:
Here many (but not all...) CNMs seem to be more medically oriented.
So does that mean that they are less trained in medical interventions? Meaning, if something went wrong (but not so wrong where you'd need to be in a hospital), do you think a CNM would have more training/knowledge/skills to handle that versus a CPM?
 

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Originally Posted by callieollie View Post
So does that mean that they are less trained in medical interventions? Meaning, if something went wrong (but not so wrong where you'd need to be in a hospital), do you think a CNM would have more training/knowledge/skills to handle that versus a CPM?
No, in fact, I would say just the opposite. In my experience, CNMs tend to rely more on medical technology. Because of the requirements of certification, CNMs are hospital trained. That means they've been taught to rely on the bells and whistles. CPMs are generally trained in an apprenticeship under a homebirth midwife. In general, I'd say they are more likely to have experience with normal birth variations and medical situations which can be resolved at home than CPMs.

If you are deciding between two individuals, however, you really need to question them each about their own training and experience. We can speak in generalities here, but a particular CNM may have significantly more hands-on in-home know-how than another CPM.
 

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Quote:

Originally Posted by callieollie View Post
So does that mean that they are less trained in medical interventions? Meaning, if something went wrong (but not so wrong where you'd need to be in a hospital), do you think a CNM would have more training/knowledge/skills to handle that versus a CPM?
No, it means that (generally speaking) CPMs trust in your body to birth naturally.

CNMs may have performed procedures or utilized technology more frequently as a result of working/training in hospital based practices...which is not necessarily a good thing. CPMs are trained (depending on their education) on many things that can be handled at home. Both CNMs and CPMs will have been trained when to recognize what may be out of their scope for handling at home.

These are just general statements; as previous posters have said - it is ENTIRELY dependent on an individual midwife's philosophies, skills, training, knowledge, and personality.

(FYI I am very much pro-natural birth and homebirth and UC and one of my fave midwives is a CNM who does homebirths...it just so happens that she trusts the birth process much like a CPM would, and even more than other CPMs in the area. With that said, I also know a homebirth CPM who is WAY too hands-on in using interventions for my taste.)

Sooooooooooo there are no absolute, finite answers to your questions. Let us know if you need help crafting questions for a midwife interview or if you'd like guidance in discussing the pros/cons of midwives you've interviewed.
 

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Originally Posted by iemaja View Post

(FYI I am very much pro-natural birth and homebirth and UC and one of my fave midwives is a CNM who does homebirths...it just so happens that she trusts the birth process much like a CPM would, and even more than other CPMs in the area. With that said, I also know a homebirth CPM who is WAY too hands-on in using interventions for my taste.)
Yup, I could say the same.

I forgot to mention training in my post. I don't know much about the specifics, but I do know that the CNMs I saw with my first pregnancy graduated from nursing school and went into midwifery. The CPM who attended my second birth got most of her training through hands-on experience in Mexico, the Dominican Republic, and Africa, as well as apprenticing at many homebirths in our area.

ETA: As far as interventions go, IMO CPMs are more likely to know less invasive or dangerous techniques for overcoming difficulties than to rely on medication or machinery. I had a few minor issues in my homebirth that would have been catastrophes in a hospital, but my CPM handled them skillfully and easily. It's all in how they respect birth. This is not intended to be a knock at CNMs, but IMO in general they look at birth as something to be managed and treated, and CPMs typically see each birth as a unique mother-baby journey that doesn't need to be interfered with unless necessary.

Again, it's all relative to the individual, but this is generally the nature of care providers who work in such different settings. Hospital midwives will know how to work within a hospital. Home midwives know how to work within the home, and will defer to the hospital when something is beyond their expertise, which is rare.
 

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Quote:

Originally Posted by callieollie View Post
So does that mean that they are less trained in medical interventions? Meaning, if something went wrong (but not so wrong where you'd need to be in a hospital), do you think a CNM would have more training/knowledge/skills to handle that versus a CPM?
IME and IMO, no. They are equally capable.

-Angela
 
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