Mothering Forum banner

1 - 11 of 11 Posts

·
Registered
Joined
·
1,669 Posts
Discussion Starter #1
<p>I like many here am an aspiring midwife, I am a pre-nursing student and had it all planned out that I would get my RN first then my CNM and go from there but just recently I was told that if I get my CNM I can not attend home births, this is a major dilemma as I was looking forward to it. I wanted to be able to work in and outside the hospital. Does anyone have any advice or btdt.</p>
<p> </p>
<p>p.s. I LOOOOOVE school so either way i will finish but I would like to get clarification when it comes to the different barriers that are imposed.</p>
<p> </p>
<p>Thanks.</p>
 

·
Registered
Joined
·
193 Posts
<p> </p>
<p>Midwifery laws are state by state.</p>
<p>Look into your state midwifery practicing laws. </p>
<p><a href="http://cfmidwifery.org/states/index.aspx" target="_blank">http://cfmidwifery.org/states/index.aspx</a></p>
<p> </p>
<p>If a CNM cannot attend homebirths in your state, after you get your RN you can then get the licensing and education you need to practice as a midwife in your state.</p>
<p> </p>
<p>Having an RN can always serve you well as a credential for the rest of your life.</p>
<p> </p>
<p> </p>
<p> </p>
 

·
Registered
Joined
·
3,473 Posts
<p>Agreeing with sweet p.  These things vary from state to state.  Also, I know a CNM or 2 who also got their CPM certification, just for the very reason you mention.  Well, they *could* do homebirth as CNMs--but only with physician backup/collaboration.  As CPMs they could be independent practitioners, no phys. backup needed.  Anyway--you can find CNMs to talk to, and/or look into the regs for nurse-midwives in your state.</p>
 

·
Premium Member
Joined
·
17,022 Posts
<p>When I lived in Maryland, only CNMs could attend homebirths; CPM weren't recognized by the state to practice legally.</p>
<p> </p>
<p>Here in NY, you can be a CNM or a CPM as long as you get licensed.</p>
 
  • Like
Reactions: ishereal

·
Registered
Joined
·
5,492 Posts
What I have noticed is even in states where CNMs are independent providers, insurance or other things contrive to mess with that independence(probably a way to sue to get these things corrected) and the the thing is that there is more money and benefits to be had working for a group practice in a hospital , so then midwives enter into a contract with doctors in order to have hospital privileges and trade away their ability to do home births.<br>
So besides steady money, insurance and unemployment, retirement, paid vacation and sick leave, rotating schedule with others on call ( so you don't have to be on call 24/7 )<br>
Another piece of this is where to get home birth experience and training, I would recommend looking for a practice now to work with in the future. I had a friend who wrote her own loan repayment by working in a full scope practice that included home and birth center births, it was in an underserved area and qualified for state and fed funds toward student loans.
 

·
Registered
Joined
·
1,669 Posts
Discussion Starter #6
<p>Thanks a million ladies!!! I totally forgot about the possibility of getting my CPM after I get my RN license, thats makes since and yes I agree that having my RN provides a little cushion so to speak. :) I had an RN tell me over the weekend that I want to become well versed in high-risk deliveries and not "normal" births when it comes to the hospital. </p>
 

·
Registered
Joined
·
2,136 Posts
<p>As other have mentioned, each state is different.  Here in Illinois there are no CPMs (not legal, anyway), but CNMs are licensed in all 50 states, and we have several that attend home births in the area.  Plus, the CNMs can continue to act as your care provider if you need a transfer to the hospital, which is always nice.  Anyway, just another thought to consider.  Either way, I agree that you'll never regret having an RN!</p>
 

·
Registered
Joined
·
1,669 Posts
Discussion Starter #8
<p>This was my thinking, that if I had my CNM then in the event that one of my moms had to transfer to the hospital, I could stay with them because I am all too well versed in how one is treated when you have to transfer to a hospital after attempting a home birth...</p>
 

·
Registered
Joined
·
5,492 Posts
Other than in an illegal state, and then it may be a matter of pick and choose you can accompany clients to the hospital. There are exceptions usually having to do with small local hospitals. I have worked with CNMs in the past and really no difference in reception , actually sometimes more flack having to do with misunderstandings about scope of practice, especially because of the restrictive agreement contracts that hospital based CNMs sign, the details are rarely shared and just shortened to some sort of comment about being restricted from home births --- and that gets generalized into a belief that all CNMs have the same restrictions. And of course they are "midwives" and get painted with the same brush of prejudIce that any midwife if faced regardless of training.<br>
I say look into the states you plan to live in and look at their laws, here in AZ CNMs are advanced practice nurses and not required to do anything special to keep their license up oth than meet the ACNM ongoing requirements, and what ever your training that is the scope of your practice and degree of ability to RX, so if you work in a full scope clinic and see everyone men women children, then you are and advanced practice nurse with CNM and basically the scope of a nurse practioner.... Changes your hireablity you could work in clinics, or with different docs in offices someplace that would not be in competition with you doing births and not even care.<br>
Oh and I forgot in my state the school loan repayment is included in our LAWs and docs and CNMs are the only eligible ones for those funds .
 

·
Registered
Joined
·
194 Posts
<p>CNMs in our state have to choose between homebirth and hospital privileges.  To have privileges you must have an agreement with and O.B., and those doctors cannot get malpractice insurance if their affiliated CNMs do homebirth.  Some hospitals even have it their contracts that anyone who does homebirth cannot have privileges, even if they are doctors.   So, no, you can't go to the hospital with your client and be anything more than a doula if you are an independent CNM.</p>
<p> </p>
<p>One group practice of midwives here gets around this blockade because they are a group of 3 CNMs and 2 CPMs.  The CPMs do the homebirths and if they have to transfer they call one of the CNMs on call.  The CNMs can only work at the birthing center or the hospital. </p>
<p> </p>
<p>As for rotating call, there is no reason you can't get a group of CPMs together to do the same thing!  We have several practices in our state with 4 or more CPMs.</p>
 

·
Registered
Joined
·
7,557 Posts
<p>Texas is actually a great state to be a CNM, or a CPM. CNMs can certainly attend homebirths or birth center births. The only thing you won't be able to do is have hospital privileges if you also have a homebirth practice.</p>
<p> </p>
<p>I worked with a few CNMs in the Dallas area and they were all autonomous practitioners with large client bases.</p>
<p> </p>
<p>HTH!</p>
 
  • Like
Reactions: ishereal
1 - 11 of 11 Posts
Top