Friday, April 27, 2007

How to become a nurse midwife


It seems that many people have been looking at my blog trying to figure out what are the qualifications, educational requirements, and psychological requirements for being a midwife/nurse practitioner. I am a Certified Nurse Midwife and a Women’s Health Nurse Practitioner. First, I live in the United States so what I say about qualifications only pertains to my country. So here goes…

What education was required? Both CNMs and WHNPs must be registered nurses prior to doing their nurse practitioner training. Currently a Masters degree is required to become a Nurse Midwife. By 2015 it is planned that a Doctorate degree will be the entry level requirement for a midwife or nurse practitioner. Certified nurse-midwives (CNMs) must graduate from an accredited education program and pass a certification exam. CNMs are licensed in all 50 states. Their standards of practice are set by the American College of Nurse-Midwives (ACNM) and by state licensing organizations. Women’s health nurse practitioners (WHNPs) must meet similar educational and certification requirements. Their practice standards and certification exam are set by the National Certification Council (NCC).

What can a CNM do? I provide care for women from adolescences through menopause. I take care of pregnant women from conception through postpartum. I am able to do births in a home, birth center, or hospital. I am able to admit women to the hospital, do normal deliveries, (YES, I can order epidurals), and all postpartum care. I am able to assess and care for newborn babies. I do yearly gynecological exams (pap smears/breast exams), birth control (including IUDs), treatment of menstrual disorders, and provide treatment for peri-menopause and menopause (including hormone replacement therapy). I am able to do primary care (meaning provide basic medical care for routine illnesses, physical exams etc.) As a nurse practitioner and midwife, I have full prescriptive authority in my state. I can write prescriptions for medications including controlled substances (pain medication).

What is the difference between a doctor and a nurse practitioner? I don’t have as extensive education as a doctor and I don’t do any surgical treatments. I have 6+ years of medical training. Doctors usually have 12. I am not meant to replace physicians. I work as a part of a healthcare team. My specialty is recognizing and caring for low-risk women. Physicians are trained to recognize and treat high risk situations. I work closely with a consulting physician. I take care of the low risk problems and consult or transfer higher risk patients over to the physicians care. I appreciate and greatly admire my consulting physicians. I have a great respect for their skills and knowledge. They in turn appreciate me taking care of the low-risk patients so that they have more time for those high risk patients who need their expertise.

What is the difference between physician and nursing philosophy? I am trained to look for normalcy and to support normal body functioning. I look at the person in a holistic manner taking into account the physical, nutritional, psychological, social, and emotional aspects. CNM theory is that birth is a natural and normal process. It is not an illness. Most pregnancies need little medical intervention. What they do need is a lot of education and support. CNMs believe that with proper support, many pregnancy complications can be avoided. Most CNMs will stay with a woman during her entire labor and delivery. Doctors are trained to look for diseases and complications. They approach pregnancy as a risky time that requires medical intervention to avoid or treat complications. I believe there are advantages to both philosophies and skill levels. That is why we make a great healthcare team!



photo from http://www.shopacnm.com/mymomi.html

52 comments:

fbw said...

Every women deserves a midwife- Love your blog

Midlife Midwife said...

I agree with you. Thanks for the compliment.

Timmie said...

I love your blog. Thank You for the information. I just applied to a CNM program and am very excited to startmy path as a CNM.

Midlife Midwife said...

Timmie: Good luck on your journey to be a midwife. I love what I do. I hope you will too. Let me know if I can help.

Brandy said...

I have wanted to be a CNM for a long time. I am in my last year of my BSN and have heard the woes and troubles of other midwives who complain about the schedules and malpractice insurance. What about these are truths and myths? Do you love it so much that those troubles aren't a problem or are they a myth?

Midlife Midwife said...

Brandy: I LOVE being a midwife. Yes, there are problems. Yes, it drives me nuts sometimes. Especially now because my current employer and the local hospitals won't allow a midwife to do deliveries.

As far as hours are concerned, a large midwife practice (like my last employer) makes for easy hours because you can trade off call with more midwives. Solo practice can be brutal because you never know when you will get called to do a delivery so you are on-call "24-7".

As for malpractice, when I left my last job, the malpractice costs for a midwife ranged from $40,000 - $60,000 a year. (compare that to about $7,000 - $9,000 a year when I am working as a "nurse practitioner" and not doing births) Reimbursement for package care (pregnancy, delivery, and postpartum) was sometimes as low as $1,800. You have to do a lot of births just to cover the insurance. But our malpractice costs are still a lot lower than the doctors.

But, that said, there are still places that you can work a 40 hour week and do deliveries and have a home life too. There are places (like federal or Indian health clinics) where you are covered under federal tort reform laws and don't have to pay malpractice. And there are still birth centers and midwifery practices that allow us to practice independently and to truly give midwifery care without all the medicalization of birth.

In spite of it all, I still love midwifery. I still believe in the notion that birth is a natural process. I still love working with women and I am happiest with a slippery newborn in my hands. I still think I have something special to offer my patients. And in spite of the trials and frustrations, I will continue to be a midwife...and love it.

Brandy said...

Thank you so much for your response! I am so thankful for people like you that are willing to share your thoughts. You are my window to what is ahead.

I can't believe that local hospitals and your employer can take away your ability to deliver babies. THAT IS CRAZY!!!! Can I ask why? I can't imagine training for something like that and having it taken away. Are you considering going to another location? What is one to do in such a situation?

I am a very positive person and truly look at that the bright side of almost anything, so I could be generally happy doing just about anything. I am extremely thankful for living at a time in history and a place in the world where, as a woman, I can do whatever I want. Deep down, helping women through such an amazing moment in their life and helping to bring life into this world is what fills my soul. Also, as I was a confused adolescent woman I have an affinity toward helping young women with just about anything they are going through. I am just worried that the logistics of the midwife career will drain my soul. Like the situation that you are in ... suddenly you can't deliver babies any more .... I am not sure I would handle that very well and it is one of the reasons I am hesitant to become a midwife. Situations like yours feel unstable and scary. Do you have any more thoughts for this young grasshopper?

Midlife Midwife said...

"Young grasshopper": My new employer and the hospitals didn't take away my legal licensure to do deliveries. They just don't allow it in my job description (at work) or allow me to be credentialed (at the hospitals). In order to do deliveries I have to have three things: a license to do deliveries (I have that), a back up physician who will be there if I do deliveries (hence the employer can decide not to provide back up service for deliveries) and credentialing at a hospital that will give me permission to admit patients, write orders, and discharge patients in that hospital. Not all hospitals credential midwives. Many hospitals only credential doctors. That means that other nurse practitioners are not allowed to practice in the hospital either (pediatric nurse practitioners, family practice etc.)

Some states are more "backwards" than others in allowing independent practice. My current state is much more restrictive than my former state.

There are two hospitals that do credential midwives, and there are a couple practices that do allow midwives to do deliveries. I had applied to one of them but just couldn't wait any longer for them to make up their mind to give me an official job offer. It was a tough decision to make to go where I am now.

I do miss doing births. I would jump at a chance to change jobs if I thought I could do births. But for now, I am keeping my skills up and I am learning a lot about GYN stuff. So I am expanding my skills and keeping myself employed. My old employer said they would take me back in heartbeat but my husband loves his new job and we aren't in a position to make another interstate move. I am confident that some day I will get to catch babies again.

I have to remind myself that every woman deserves midwifery care...even ones who go to a large HMO. So I am trying my best to do what I believe in, in less than ideal circumstances.

My ability to be employed has always been high. There isn't a lack of jobs out there. For now I am reminding the doctors at every turn that I can ease their on-call if I could do deliveries. I explain to EVERY pregnant woman that I am capable of doing their deliveries and encourage them to voice their desires to have me do them. I introduce myself as a nurse practitioner AND a certified nurse midwife. I explain to all my GYN patients that a midwife does more than just deliver babies and that I am trained to take care of all women across their lifespan. I hope that someday, that will pay off in being able to practice full-scope midwifery someday. Until then, I am enjoying no nights, weekends, holidays or long 24 hour call days. :-)

k_byvoets said...

I just found your blog while checking out information on being a CNM. I am a 30 year old woman that has been in the Navy for 12 years now. I plan on going to school to become a CNM in about 8 more years. Sure, it may seem a long ways off but who wouldn't want to collect a retirement check at age 38? I have two children of my own and I know how much my doctor and CNM meant to me while I was pregnant. Which is why I want to get into Midwifery in the first place. Is it worth the time and effort to get into nursing at age 40+? I am nervous about starting all over again. The last time I ran out and started something so new I was 18 and bright eyed and bushy tailed. I am concerned about starting all over again at the bottom. I actually don't even know where to begin. Do you have any words of wisdom or good advise for someone who is starting out later in life. Mind you that my military back ground is as an electrician, no medical training other than CPR here.

Midlife Midwife said...

k_byvoets: Yes, yes, yes. It is worth it to change careers if that is what you really want to do. I was an adult reentry student. I got my BSN in my thirties and my CNM in my 40s. You have a lot to offer as an older, more experienced student. I don't regret my years I stayed home with my kids. And I don't regret changing my career path and going back to school when I was older.

Yes, it is hard to go from being the "top of your field" to being the lowly student and making mistakes. It's tough to go school and compete against younger students. But as my husband puts it, "In ten years you will be ten years older. You can be ten years older doing the same thing or you can be ten years older and be living your dreams."

The military is a great place to come from. And a great place to work as a midwife! I worked with a lot of military midwives and they all appreciated the eductation they received in the military.

I guess my words of wisdom would be to have faith in yourself. Don't discount your prior life experiences (an electrician...WOW thats amazing!). In the next eight years, spent as much time as you can reading about midwifery and learning all you can before you start school. Read novels as well as educational books. I have a shelf full of books about midwives that helped me stay motivated to become one during all those long years before I could go back to school. Best of luck to you. :-)

E said...

I have a question. You describe yourself as a Certified Nurse Midwife AND a Nurse Practitioner. Did you train for both? Most of the programs I have seen are CNM OR NP for Women's Health. It seems training for both would mean a lot of overlap, so I'm very curious about how you work as both. I've wanted to become a midwife for a number of years and am just now seriously looking into taking the first steps toward an RN. I already have a bachelor's degree in psychology...so this will be a whole change of direction (though something I've wanted for a very long time).

Thanks for your help! This post was incredibly insightful & helpful!

E said...

Oh...I've also been researching any differences between the NP & CNM...trying to decide if one would be a better choice than the other. I definitely want to be able to "catch babies" as you phrase it. :)

However, I do move periodically and would like flexibility, too. I'm not sure if one offers more than the other...or not.

Thanks again!

Midlife Midwife said...

E: I trained at a program where I could do both certificates. There is a LOT of overlap between the two. I did my midwifery classes and clinicals first. Then in order to become a Women's Health Nurse Practitioner I had to complete a second clinical rotation with an emphasis on GYN. It really only added a couple months onto my total program. I then took my midwifery national board exams and my WHNP national board exams. Both exam were pretty similar.

I do not regret getting them both. It does grant me more flexibility. As a midwife I can do anything a WHNP can do but I can also do births and admit to hospitals. As a WHNP it is a little easier to find a job since more places are familiar with NP's. Some insurance companies actually reimburse at different rates for a WHNP or a CNM. So on some patients I would bill as a CNM. On other patients I would bill as a NP.

I wish you the best on your journey towards catching babies. You will use your psychology training a LOT in midwifery. :-)

E said...

Wow! Thanks so much for this feedback - incredibly helpful! Thanks for the well-wishes, too!

Paul said...

I just found your blog while searching for what I needed to do to become a CNM. This post in particular was very helpful. I'm currently serving in Iraq and plan on going back to school to become a CNM. I plan on going to a hospital nursing school and getting my RN and working for that hospital for two years after passing the NCLEX. I was going to work towards my BSN at the same time and then go to a place like Georgetown or Penn for my CNM. Is this a good plan or should I consider an RN to CNM bridge program? I know from start to finish it can take 6 years or so and I already have two years of previous college I hope will count towards my BSN. Will this plan get me my certification before the doctorate is required in 2015? I'll be getting started on this plan Spring 2010. I thank you for any help in this matter.

Midlife Midwife said...

Paul: First off, my heartfelt thanks for your service in the military. Thank you for putting your life on the line to protect those families there and my family here.

I have known people who have done both directions. Some have done the BSN (bachelors) first and then the MSN (masters). Others have done the ADN (associate degree nursing) first and then done a bridge program from ADN to the MSN. I don't think either one is the ideal for everyone. You have to look at your own life and needs. Your biggest obsticle will be the time line. You have to complete your Masters and pass your boards prior to 2015. Otherwise you will need your doctorate to practice. So you need to look closely at the timelines with both options. But if you can't get it all fit in before 2015, be brave and go for that doctorate!

As I have said before though. Don't sell yourself short as an adult reentry student. You have a lot going for you. The military has taught you some very important skills like how to work hard, stay on task, stay focused, keep working in spite of a lot of opposition and how to be organized. That will serve you well in school.

Again, look for nontraditional ways to go to school. Look at the prerequisites and see if you can do some by distance learning. Read all you can about midwifery now. Most of all, hang on to your dreams and work at them. Good luck!

demetY said...

Hi there, first of i wana say I LOVED UR PAGE.I dont know how i found ur page but i am glad that i founded (=. Ima Medical Assistant but i wana become a nurse midwife & need some help like what kind of school i spouse to go to?? does it has to a NURSING school??? If u give me some information that will be great. THANK YOU FOR YOUR TIME.

take care.
Demet

Midlife Midwife said...

Demet,
Yes, to be a certified nurse midwife, you have to go to a nursing school. However, some states recognise other midwife providers like certified midwives (similar to a masters degree but without the nursing school first. They can do birth center or home births and in some states can attend hospital births), lay or licensed midwives (apprenticeship programs that don't require any college degree or nursing degree. They mainly do home births and some do birth centers.).

Lesley and Zachary said...

Just found your page when looking up the requirements for becoming a CNM. I just had my first baby in August through the midwife program at Tripler Army Medical Center in Honolulu. The midwives were incredible and I'm so grateful that they were there to help me have a non-medicated birth (of a healthy 9-pound boy!).

I graduated from the US Naval Academy with a BS in Economics, so I'm a little nervous about going back to school in a totally unrelated field. Thanks for getting me started on all my research--I'm getting very excited to start this next chapter in my life!

Gail M said...

I'm curious how you feel about the impending changes in qualification requirements to a doctorate. Doesn't that just increase the gap between birth (for most women) as a healthy, normal life event and the impending doom view of the medical model? To say nothing of the availability of midwives going into free-fall in the opposite direction from what is intensely needed right now - more midwives for normal pregnancies and births...and less involvement by obstetricians. Would like your impressions.

Latterlife Midwife, U.K.
(American RN now living in UK)

Midlife Midwife said...

Gail: (sorry for the late reply) I can see the pro's and con's of both models. Most medical professions have gone to requiring a doctorate as entry level. If nursing wants to still be seen as "professionals" they should follow suit. Nursing is the only medical profession that still has a one year degree as entry level (as an LPN). I do get tired of being told I am "less" than those who have a doctorate degree.

I also see the other side. We already don't have enough midwives and increasing the educational requirements will just exacerbate that.

I think we have to remember it is a NURSING doctorate...not a medical doctorate. So I don't think that a doctorate makes us less as nurses or forces us into the medical model of healthcare. We can still retain our belief in normalcy and holistic healthcare.

I wonder if more hospitals and insurance companies (and doctors) might take us more seriously if we had doctorate degrees. I am frustrated with my current lack of independant practice and inability to get hospital privileges.

I did feel very inadequate as a new NP graduate. There is so much more I needed to know! I do want to go get my doctorate at some point. Not because the initials after my name will make me a better provider. But I do want to learn more. The more I can learn, the more I can offer to my patients.

Right now I am waiting to find a good CLINICAL doctorate program. I want to increase my clinical skills...not just do research (I don't want a PhD for that reason)I want a program that will make me a better practitioner. So maybe one of the programs that offer a residency component.

So for now I am standing on the sidelines and waiting to see what will happen. I was one of the first who was required to have a Master's degree. I think that it is probably inevitable that entry level will be a doctorate at some point, but it may not be by 2015 as is the current proposal.

Andrea said...

i've been looking here to see what midwifery is like in the states.
i'm a midwife in Ireland, but wasliving in Virginia when we were expecting our first baby. I remember there were no midwives there unless I had gone to Maryland. I really missed that!
Was wondering what my options would be if I evermoved back there. In Northern Ireland all pregnant women are looked after by midwives and all babies delivered by midwives unless there are complications.

Midlife Midwife said...

andrea: why would you want to come here when you can catch babies in Ireland? OK, that's just me being jealous. America is so backwards when it comes to birth. They want healthcare reform, they say they want evidenced based medicine...but then they refuse to let midwives deliver babies even though it has been proven to be safe and cost effective.

There are some states that are more midwife friendly. New Mexico, Washington, Florida to name a few. I just don't live in one of those...sigh.

E said...

Whether or not midwives are allowed to deliver babies (in hospitals) depends on the state. In some states midwives can and do deliver babies in hospitals. In others, they're only allowed to work in birthing centers and home deliveries. If you want change in your own state, you'd probably have to start a grassroots effort to change the system. I imagine there would be many impediments, largest being to overcome the misconceptions of those in the general public as well as the medical community. I do agree with your overall sentiment. We complain about health care, but we're unwilling to make reasonable decisions based on solid data. Decisions which would lower the cost of healthcare across the board.

E said...

Oh...Montana is another state where midwives can deliver in hospitals. :)

Midlife Midwife said...

E: I don't know of any state that midwives can't legally deliver in hospitals. The problem is mainly that hospitals won't grant priviledges. A hospital determines who is allowed to admit patients, write orders, and do procedures. The hospitals my company works with do not credential midwives (give us permission to do deliveries). There are hospitals in this state that do allow midwives but they are very few.

There are three things a certified nurse midwife needs to do deliveries in a hospital: The legal right to be licensed (all states allow that), a hospital who will grant privileges to a midwive. And a doctor who is willing to be a collaborating or backup provider for the midwife. It is the last two that are hard to find.

E said...

Interesting. I was under the belief that it was a state law type thing. However, your explanation makes perfect sense. I know my friends & family members in Texas & Arizona haven't had the freedom in receiving the sort of care they desired due to how "the system" is in their states.

Do you think the third element (getting an MD to back you up) might be tricky because they see midwives as potential competition for patients? My midwife (in Montana) had a wonderful relationship with the OB in her practice. They really had separate practices, but they really collaborated in such a way that resulted in great outcomes for their patients. I really feel like women who aren't involved in this type setup (whether they choose the OB or the midwife) are missing out...it was really wonderful!

I've lived in Montana and now live in New Mexico. Before living in these two states I'm afraid to admit that I had a huge lack of appreciation for midwifery. I just didn't know or understand the differences between the nursing model and the care a patient can expect from an OB. I think if more women understood the differences (and the high level of care they'd receive with the midwife option), most would prefer to have a midwife...and we might see more hospitals jumping on the bandwagon - supply & demand.

Sheri said...

First of all I would like to say that I love your blog. I stumbled upon it while searching how to become a midwife. My girlfriend is 23 and this has been her dream since she was little. I personally knew nothing about midwifing until I read your blog. I've been trying to research to figure out what my girlfriend needs to do to reach her dream. I guess I am still confused about exactly what she needs to do. Where does she need to start? She doesn't have any previous college schooling. Does she need to work towards a masters in nursing? Or LPN then RN? How does it all work?

Thankyou for taking the time to help me!

Jake said...

Thanks a lot for the post. I love to read articles which are about medicine or health related topics. They keep me up to date with the current issues. I hope to read more from you!

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Bri said...

I just found your blog. I am a 24 single mom expecting again. I want to become a L&D nurse. I just want in that field. I have a 5 & 3 yr old now.

Thank you for your information. It helped me. I hope to be able to reach my goal of becoming this.

Future RN said...

Thank you so much for creating such an informative and interesting blog! I am currently obtaining my BSN in hopes of becoming a L&D nurse before obtaining an MSN for Nurse Midwife or Women's Health Nurse practicioner. However, I am confused about the differences between the two. As far as I know, the clinical tasks of both are extremely similar if not the same! So if you don't mind me asking, what is the difference between a Nurse Midwife and a Women's Health Nurse Practicioner?

Midlife Midwife said...

Future RN:
The biggest difference is that a midwife is trained to do deliveries (intrapartum care). Both WHNP and CNM's can do care during the pregnancy and after delivery office visits. Only a midwife is trained to take care of the woman during labor and birth.

Other differences is that they are certified by two different agencies. That means that different agencies administer the exams to become certified and maintain records on those who are certified. WHNP are certified by National Certification Corporation (NCC) and Midwives are certified by the American Midwifery Certification Board (AMCB)

Education is similar. In fact I did them both at the same time. For midwifery I had to take more classes and clinicals pertaining to intrapartum care. For WHNP I had to do more GYN clinicals.

Hope that helps!

Jonathan and Telcia said...

By the looks of your attentiveness to your blog-readers, you are a GREAT MIDWIFE!
So I'll keep it short. I found your blog looking for a list of states and their regulations for CNMs. I want to do life-span care for women but have minimum limits as far as delivering babies, prescribing...
Is it necessary to do CNM/WHNP for this? Or is the CNM pretty widely accepted among most of the 50 states.... do you have resources to point me to?
I guess I'm kinda trying to avoid looking up each of the 50 states' regulations.....

awesome blog!

Midlife Midwife said...

Jonathan and Telcia:
ACNM website is a great place to find out about state regulations. They have a page for updates on recent changes and future bills found at http://www.midwife.org/State-Legislative-Developments

CNM's are able to practice in all 50 states. You do not have to be a WHNP as well. Only CNM's are trained and credentialed to do deliveries. It is not a part of the WHNP training.

DarellCarey said...

Such a helpful and well written blog post - your wealth of experience and knowledge has obviously (as the comments show) helped many people understand the role better. I love it when people use their experience to help people - it can really make a difference to those who lack it.

www.acutenursingjobs.com

spiritgirl411 said...

I have a friend who is currently a Physician assistant, but wants to be a midwife. Do you know how much further education it would take to achieve that goal? Any information would help. thanks.

meaganx4 said...

Hi I am wanting to become a cnm&np I did not ever get to finish high school and am now studying for a GED. my first question is can I still have this career path with a ged and also my cnm that I had she was able to do all of my ultrasounds is that part of the training that I will recieve or how does that work. Thanks for having a cool blog like this also!!

StayBless14 said...

Hi i am a soon to be gradute of highschool class of 2014. while i was reading your blog you wrote that "By 2015 it is planned that a Doctorate degree will be the entry level requirement for a midwife or nurse practitioner" i was wondering would that go for me too. Also if you are able to can you please tell me the school requirements of becoming a CNM. thank you in advance.

buffymed said...

HELLO!! I am thrilled to finally see a blog that is positive about Midwives. I have had the dream to become a midwife since I was 18 yrs old in the service working in L&D. I loved my babies and my Moms. I am currently in Nursing school and very sad to see that I have to finish my degree by 2015. No Stress!! Right!?!?. Any suggestions on what to what out for (time wasters) and the " good stuff" to have under my belt?

Midlife Midwife said...

Meagan: yes you can get your degree with a GED. I would suggest starting off at a community college to get some of your prerequisistes. They are less expensive, accept a GED without requiring SAT or ACT scores and are a good place to start off college.

I do ultrasounds but I had to do more training after I graduated as a midwife. It was not a part of my midwife training.

Buffymed: It is still a hotly contested issue about whether a DNP will be required by 2015. But it is always good to have that in mind while you go to school. I am in the middle of working on my DNP. I will be grandfathered in if the DNP requirement passes but I want to stay ahead of the requirements. I am getting older and will need to be able to compete for jobs with the younger, more educated new CNM's. I don't want to be left behind when you new CNM's are becoming the new leaders.

As far as things that are the good stuff? If you are still working on your BSN I would suggest working a year or two before you tackle the CNM degree. Experience is a great teacher!

I've always said I can teach anyone nursing skills. What I can't teach is how to have a compassionate, conscientious, and brave heart. You have to find those qualities within yourself. The skills are important. But the people skills and the ability to love birth are what keeps you in the profession and helps you change lives.

Midlife Midwife said...

Staybless14: Sorry for the late reply. Educational requirement are still currently that you must be a registered nurse and have completed a master's degree. There are "bridge" programs that will take you from an associates degree (community college or 2 year degree) through to your master's degree in one program. I did the traditional route and did my bachelors degree in nursing (4 years) and became a registered nurse. I worked for six years and then went back to do my master's degree (2 more years) and am now working on my clinical doctorate (2 more years) So 8 years total.

Midlife Midwife said...

Spiritgirl411: I am so sorry to all of you for being so late getting comments up. Life gets in the way. I know that Frontier University (where I graduated) had a program for people who graduated with degrees in other medical related fields. But to be a certified nurse midwife, you have to be a nurse first. However, if you look on the ACNM webpage you will see the requirements to become a Certified midwife and that does not require being a nurse first. Check it out.

Smooth operator said...

Hey I love your blog! I am graduating from nursing school this may and I want to be a midwife sometime down the road. I was wondering where the best areas to work in to get good overall experience. I was thinking of starting out in the ER because you get to see a whole lot of everything. I was also thinking about the women's ICU and of course L&D. I was sure if I should start out in L&D because I don't want to limit my experiences.

Midlife Midwife said...

SmoothOperator: Definitely L&D if you can. But I started out in high risk antepartum and postpartum and that gave me a lot of experience. ER and ICU would be good as second choices. But most midwifery programs want some L&D or women's health care experience.

Liz said...

I'm just a freshman in college and I want to become a nurse midwife. I want to know what should i major in?

Midlife Midwife said...

Liz: That's easy...nursing. You have to be a nurse first before you can be a certified nurse midwife.

Liz said...

Thank you. How many years did it take you to be where you are now?

Midlife Midwife said...

It took me over 40 years of my life to get to where I am now. I had a few side tracks along the way. To answer the question I think you are asking: I spent four years getting my bachelors degree to be a registered nurse. Then I took 2 more years to get my masters degree as a certified nurse midwife. I am currently working on getting my clinical doctorate. It will take me another two years.

Liz said...

Were you ever distracted or felt that you couldn't go on w/ that career?

Midlife Midwife said...

Liz,
Yes I got distracted by life lots of times. I have actually spent many extra years in college because I kept stopping college to do things like raise my family. When I went back to school I had to retake classes. I got discouraged lots of times, especially when I was in my 20's and it seemed like I would never be able to fulfill my dreams of an education.

Yes, sometimes I wonder if I should give up on this career. It's hard to keep fighting for the right to work to the fullest extent of my education. But I love what I do. Just when I think I am ready to give up I meet a patient who reminds me why I went into this career in the first place. Women are amazing and working with them is a privilege.

shanna92 said...

Hi, I just found your blog and I love it! I was wondering if you would have any advice for me.

I've been so confused trying to make a career choice, but I've recently decided that I would love to be a midwife. My confusion has caused me to be a bit ambitious. I am now officially a JUNIOR at the University of Maryland, but for the past 3 years I have been pursuing my BS in physics. My sophomore year I started to double in education, I began pursuing a certificate in women's studies, AND I've been keeping up with pre-med requirements.

Initially my goal was to go to medical school and become an obstetrician, but after reading the differences I found that I prefer the more natural and holistic approach of a midwife. I will be crushed if I have to start from scratch after all I've done. Education is expensive! I don't know where to go from here.

I would like to finish what I started. I felt like teaching would be a steady way to slow down a bit after all the fast paced years in medicine. But, maybe I should transfer what I can to a nursing school. OR, I'm not 100% but I think I read about a second degree "bridge" program for people who already have a BS in a different field but are looking for a BSN?

As you can probably tell I'm driving myself crazy. PLEASE, I need your wisdom! lol Thank you in advance for any help.

Midlife Midwife said...

Dear Shanna92: I am so sorry for the late posting of your comment and my reply. As you may have figured out, I stopped blogging a couple years ago. So I don't check the blog email very often.

My best advice to you would be to see if you can tag along for a day or so with someone who does what you are thinking of doing. For instance, follow a midwife, a physician, a teacher, a physicist (my husband the physicist would say this is the career you should go into...but he is biased LOL) or any other job you are considering. Ask them about what they love and what they hate about their jobs.

Talk to someone in the nursing department and find out just how many of your pre-med and women's studies classes might transfer into a BSN.

I changed my career path many times in the course of my life. You may think your chances are fading fast now that you are a junior but I promise you, you have lots of time to explore multiple careers in your lifetime.

I love being a midwife, but I have a lot of limitations that physicians don't have. I love being a midwife, but I know I can't keep up this pace until I retire and so may change careers again and teach at a university. I'm not sure I am the best one to go to for advice as I am still trying to figure out what I want to be when I grow up! Follow your heart but realize you have to pay attention to your pocket book too. Go for what feels the best to you and that gets you out of school and into a job.