There are 3 distinctly different types of midwives in the United States:
CNM (Certified Nurse Midwife)– A board certified nurse with advanced training and education to deliver babies and care for pregnant women. Many CNM’s also provide well-woman care such as PAP tests. The governing organization, which certifies and registers these midwives, is the ACNM (American College of Nurse Midwives). The ACNM now owns the additional titles of DEM (Direct Entry Midwife) and CM (Certified Midwife) but this is an area of confusion since many traditional midwives refer to themselves as DEM or CM. Because CNM’s must work under the direction, license, and/or supervision of a board certified and licensed physician they do not (in Southern Nevada) deliver babies at home. Many CNM’s in other areas of the USA are also CPM’s.
CPM (Certified Professional Midwife)– A board certified independent care provider with advanced training and education to deliver babies and care for pregnant women. CPM’s may also provide well-woman care, well-baby care, counseling, and other services throughout life. They have additional training and certification in nutrition, naturopathy, and emergency care. The governing organization, which certifies and registers these midwives, is NARM (North America Registry of Midwives). Because CPM’s are not required to work under the direction, license, and/or supervision of a physician they do not ordinarily (in Southern Nevada) deliver babies in the hospital. Many CPMS’ in other areas of the USA are also CNM’s.
Other Midwives– There are only two certified midwifery board organizations that are recognized nationally; the ACNM and NARM, so by default other midwives are not officially sanctioned, certified, or otherwise registered in Nevada. Since there are no laws controlling who may or may not deliver babies or call themselves a “midwife” in Nevada, it is important that you question these midwives carefully to determine skill and experience.
In some states (such as Arizona, South Carolina, Florida, Washington, New Mexico, New Hampshire and Oregon) there are state educational and licensing programs formally establishing independent midwives as recognized health professionals in the community.
Midwifery Model of Care Philosophy
Pregnancy, childbirth and breast-feeding are normal, natural functions of a woman’s mind, body, and emotions, all of which are equally important, and will proceed to an uncomplicated end in most cases. We believe the midwife’s job is to assist the birthing couple in their journey through pregnancy, labor, birth and beyond by monitoring that natural process.
Cases involving complications, which cannot be handled safely in the home, will be referred to persons trained to deal with obstetric difficulties. Childbirth is a family-centered event and the midwife’s role is to enhance, not to usurp, the family’s power of unity. Except where there is an issue concerning the safety of the mother or child, the parents should have the experiences they desire, and specific parental requests regarding that birth experience are encouraged.
Couples must maintain the full responsibility for their own health care and for the outcome of the birth. Assistance will be given for information on nutrition, exercise and childbirth education but you must assume the responsibility of maintaining your own excellent health care. Home birth couples must take extra responsibility in this area since technological help is not immediately available as it is for those birthing in the hospital. The midwife is a skilled specialist in attending normal birth, giving care and advice to the mother in her pregnancy, labor and birth. She should care for the mother and child after the birth and should be able to detect any obvious abnormality in the mother and in the newborn baby and refer or obtain medical help if necessary. She should be trained in the use of emergency measures in the absence of medical aid to the limit of her education and experience. She maintains respect for the integrity of the birthing family and the naturally bestowed ability of a woman to bear a child. Out of respect for the birthing process, she believes that interference is an unwise interruption of the body’s normal function. She carefully watches and guides, assisting the family to give birth in the way that is of their choosing, respecting the sacredness of the family and its rites of passage.
Informed choice, not merely informed consent is suggested. You are “clients”, never “patients”. Any decisions regarding options are yours to make. At the same time, there are limits to what we are willing to take on as a responsible care provider. When and if these limits are reached, you will be notified immediately.