Oct 25, 2010

All About Midwives, Mostly

What is a Midwife?  

There is more than one type of midwife. 
  • Certified Nurse-Midwives: These women are trained as nurses and have done additional study in midwifery. Many are graduate students. They often offer complete prenatal care as well as attending births. Most CNMs deliver in hospitals and many are affiliated with an obstetrician's office. Around 3% of CNM attended births occur in birth centers or at client homes. The American College of Nurse-Midwives oversees CNMs.
    Find a CNM
  • Certified Professional Midwife: A midwife who has passed rigorous competency testing by the North American Registry of Midwives (NARM) is awarded a CPM certificate. A CPM is an independent practitioner. CPMs usually provide complete prenatal care and attend births. CPMs work primarily in home birth and freestanding birth center birth situations. The requirements to become a CPM are different depending on how the midwife began her career.
    Learn more at NARM's Homepage
  • Direct Entry Midwives: An independent practitioner who has learned midwifery through study, apprenticeship, a midwifery school, or a college program that is not a nursing program. These birth attendants usually provide complete prenatal care and attend births at home or in free standing birth centers.
  • Licensed Midwives: Midwives licensed to practice midwifery in a particular area. Normally a state. Several states in the United States provide licenses. They normally provide complete prenatal care and primarily attend births in homes or free standing birth centers.
The Midwives Alliance of North America, or MANA, is a great resource to locate a midwife. Find out if your state licenses midwives - click the link to NARM's website above and choose "state info" to find out if it does.
 This info courtesy Natural Birth and Baby Care

Doctors didn't always deliver babies.  Find out more in the History of Midwifes.

Barriers Today:
  1. Despite many new, favorable laws, direct-entry midwifery is still illegal in many states.
  2. Licensing standards, where they exist, vary from state to state, and there are no mandatory national standards for entry into practice. As a result, there is no clear definition of a "midwife" as a person who has met widely accepted educational and competency standards.
  3. The new MEAC and NARM processes are competency based; neither requires completion of a specified number of years of formal professional education or requires an academic degree.
  4. Americans generally associate an "apprenticeship" with preparation for a craft or trade, rather than a profession.
  5. The MEAC/NARM accreditation and certification processes are new, and the examination is an improved, strengthened version of an earlier examination, which was known by the same name and did not require a positive response.
  6. There is very little reliable data about direct-entry midwives and their practice. It is impossible even to state with accuracy and confidence either the number of direct-entry midwives who are practicing or the number of births they attend.
  7. Direct-entry midwives' sharp criticism of the medical profession combined with their physical isolation from the mainstream health care system has made it difficult or impossible for many of them to acquire adequate medical backup.
The United States provides the world's most expensive maternity care but has worse pregnancy outcomes than almost every other industrialized country.
Midwives are attending more births—5.5 percent in 1994, compared with 1.1 percent in 1980.
The cesarean section rate is falling, from 25 percent in 1988 to 21 percent in 1995.

Labor was induced in 14.7 percent of women in 1994, up from 9 percent in 1989.
Eighty-five percent of women had electronic fetal monitoring in 1994, up from 68 percent in 1989.
This info courtesy Midwifery Today.

A story: My Illegal Home Birth: Giving birth at home was weird, magical and a felony. http://bit.ly/d3H0Zi

The laws in Idaho about midwives is a bit squishy.  Legally, a direct entry midwife cannot be paid to deliver a child.  If they are just there and help without money, no biggie.  Just like if I had a friend there that just helped.  While there are people working behind the scenes to remedy the midwifery laws in our state, things don't always go as planned.

The prestige of the name: We Are All Midwives

Midwifery All Around: A Traditional Birth in Arkansas

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