Certified Nurse-Midwife

What is a Certified Nurse-Midwife?

A Certified Nurse-Midwife (CNM) is a registered nurse who has completed an advanced course of study and is certified by the American College of Nurse-Midwives (ACNM). CNMs participate in a variety of services that include providing gynecological services like Pap smears and breast examinations, advising women about reproductive health and personal care, and monitoring the health of the mother and baby during pregnancy. They also perform complete prenatal care including abdominal and pelvic examinations and evaluations. Another important service that CNMs provide is educating women and their families about childbirth methods, infant care, nutrition, and proper diet and exercise. CNMs work closely with obstetricians and other physicians when medical treatments and medications are necessary.

Where do CNMs work?

Certified Nurse Midwives are employed by hospitals, birthing centers, health departments, community health centers and private physicians' offices.

What kind of education does a CNM have?

Midwives today can have many different backgrounds. A certified nurse-midwife will have:

What's the Midwife's Philosophy?

A midwife's education stresses that pregnancy and birth are normal, healthy events until proven otherwise. Midwives view their role as supporting the pregnant woman while letting nature take its course. Midwives also focus on the psychological aspects of how the mother–to–be feels about her pregnancy and the actual birth experience. They encourage women to trust their own instincts and seek the information they need to make their own valuable decisions about pregnancy, birth, and parenthood.

What does a Midwife do?

Midwives generally spend a lot of time during prenatal visits addressing a woman's individual concerns and needs and will stay with her as much as possible throughout labor. They encourage physical positioning during labor such as walking around, showering, rocking, using the birthing ball, or water therapy. Midwives also usually allow women to eat and drink during labor.

CNMs, like doctors, may use some medical interventions, such as electronic fetal monitoring, labor-inducing drugs, pain medications, epidurals, and episiotomies, if the need arises. Your care will always be discussed and explained in length if any deviations from your birth plan arise.

Midwives of any licensing degree cannot perform cesarean sections. If one were required, an obstetrician would have to perform your delivery. Some midwives have taken special courses to allow them to assist the physician in performing your cesarean section. This allows her to still be a part of you and your significant others birth experience.

Is a Midwife Right for You?

Several studies have shown that midwife-supervised births produce excellent outcomes with fewer medical interventions than average. Midwives' patients use electronic fetal monitoring less often and tend to have a reduced need for epidurals, episiotomies, and C-sections for successful deliveries. To some degree, this stems from the fact that midwives see only low-risk patients with uncomplicated pregnancies. But some researchers attribute the need for a minimum of medical intervention to the midwives' natural approach to the management of labor and delivery, which may reduce a woman's fear, pain and anxiety during birth.

Midwifery is not advisable for women with higher-risk pregnancies. Those expecting twins or multiples and those with prior pregnancy complications, gestational diabetes, high-blood pressure, or chronic health problems of any kind before pregnancy should discuss their options with their primary health care provider or an obstetrician. CNMs who practice in major medical centers and work very closely with obstetricians and perinatologists (specialists in high-risk pregnancy) may take patients with risk factors. But midwives in solo practice or who practice in limited medical facilities generally do not.

A major difference between doctors and midwives is the doctors' ability to intervene surgically when necessary, and to deal with complications that arise. If you feel more comfortable having those options immediately available, a doctor may be the right choice for you.