NM609 Saddlebag Project-FAQ about Midwifery for Health Care Professionals
Title ideas
What Ob/Gyn’s and other providers should know.
Certified Nurse Midwives (CNM)
Frequently asked question by health care providers. OR
FAQ’s by health care providers.
How are CNM’s educated? Certified Nurse Midwives education follows the Core Competencies set forth by the American College of Nurse Midwives (ACNM). Today’s CNM’s must obtain a graduate level degree from a midwifery education program that is recognized by the Accreditation Commission for Midwifery Education (ACME) . How are CNM’s certified? After the completion of midwifery school, the graduate student must be successful in passing a national examination for certification in order to practice as a CNM. CNM’s must also hold a current RN license. CNM’s are required to participate in a Certificate Maintenance program. Both the initial certification and the maintenance program are managed by the ACME . How are CNM’s licensed? CNM’s are authorized to practice in all 50 states, District of Columbia and territories of the U.S . Each state determines its own licensing requirements for CNM’s and other advanced practice nurses
Practice relationships: Certified Nurse Midwives (CNM) work with a team of professionals to ensure their patients receive the best care. Professional relationships are going to vary based on the state in which the CNM practices; as most states require a CNM to practice with an OB Physician. Most CNM’s will need to form a professional working relationship with an OB Physician, a Dietician, a Child Birth Educator, and a Physical Therapist, as well as specialist. If the CNM works in a practice that does not allow her to spend time with her patients while they labor having a good working relationship with several of the Doula’s in the community could also be of great benefit. Scope of practice: CNM’s are nurses that have obtained additional education and credentialing in order to care for women throughout their life. Nurse Midwives can provide well women care, contraception education and counseling, write prescriptions, and provide all perinatal care including, pregnancy, labor and birth support, and postpartum care. Nurse Midwifes also have perscriptive power in all fifty states, so they can provide any needed perscription. The scope of practice for midwives does vary based on the state they practice in. By contacting your local board of nursing you can find detailed information about the state in which you practice. You can use this website to find out contact information for you state board of nursing https://www.ncsbn.org/contactbon.htm This is a fabulous easy to read medline article that provides basic education about nurse midwives. http://www.nlm.nih.gov/medlineplus/ency/article/002000.htm Liability Risk: In its most basic definition liability means legal responsibility. As CNM's practice under their own lciense there is no vicarious liablity for physicans that colaborate with nurse midwifes. There are several ways in which liability affects CNM’s. The following website has links to several ways for CNM’s to reduce their liability as well as some basic information on liability insurance for CNM’s. http://www.midwife.org/index.asp?sid=14&TextSearchWordList=liability+risk+for+cnm
Isthere research to support midwifery care? Yes, the evidence is there. A recent Cochrane review of 11 clinical trials involving more than 12,000 women found that midwifery care is safe and offers no increased risk of adverse effects for women with low and high risk pregnancies. (Hatem, Sandall, Devane, Soltani, & Gates, 2008) .Women who receive midwifery care may experience fewer fetal losses prior to 24 weeks gestation, lower use of regional anesthesia, and fewer episiotomies and instrumental births, while having a higher incidence of vaginal birth, higher breastfeeding initiation rates, and greater feelings of control during labor and birth. The researchers concluded that midwife-led care confers benefits, is cost effective, shows no adverse outcomes, and should be offered to all pregnant women. Is midwifery care a growing trend in the United States? Yes, more women are choosing midwives every year. Nurse-midwifery in the United States began in the 1920’s in response to the increasing rate of maternal and infant mortality, and by 1963 there were 275 CNMs practicing in the U.S. Today, over 7,000 certified nurse-midwives practice in all 50 states and in many developing countries, and the numbers continue to grow. In 2005, CNMs attended 306,000 deliveries in the United States. This number accounts for almost 8% of total U.S. births, and 11.2% of vaginal births. The American College of Nurse-Midwives (ACNM) is the professional organization for CNMS. ACNM is a politically active organization that is working to advance midwifery practice and improve care to women and infants. One of ACNMs established goals is to add 1000 newly certified midwives by 2015. (mymidwife.org) How prevalent is nurse-midwifery in my state?
With the introduction of Indiana’s first nurse-midwifery practice in the 1970s, nurse-midwifery has grown. Approximately 84 CNMs reside in Indiana, with 70 sites offering nurse-midwifery services throughout the state. Nurse-midwives in Indiana attended 3,712 births in 2004, which is 5.9% of state births. CNM births were attended mainly in hospitals, with a lesser percentage of births taking place in birth centers and private homes. CNMs in Indiana have prescriptive authority and are reimbursed by Medicaid and many private insurance plans. (mymidwife.org)
Where do Certified Nurse Midwives attend deliveries?
Though the majority of CNM attended deliveries are in the hospital setting, they can also attend deliveries in the client’s home and in birth centers. What is a birth center, what are the benefits?
Birth centers are usually free-standing, but can be attached to a hospital or clinic. Birth centers are an alternative place for healthy mothers to deliver healthy babies with little medical intervention. They are generally home-like settings that provide a comfortable place for family centered care during pregnancy and childbirth. Emphasis is the comfort and privacy of the mother and the support of normal childbirth.
Evidence has shown reduced rates of perineal lacerations, episiotomies, and cesarean sections as well as increased rates of breastfeeding within birth centers when compared to hospital births (Walsh et all, 2004). Are birth centers safe? How are they regulated?
The emphasis in birth centers is on low technological intervention, but all birth centers are prepared with emergency equipment and a plan for transfer to a medical facility should the need arise for mother or baby.
Birth centers in the United States are regulated and licensed by the American Association of Birth Centers, or AABC. This governing body provides guidelines for quality assurance, safety, policy and procedure. Additionally, 76% of states have additional regulations in place for birth centers. Accreditation by the AABC is required for insurance reimbursement in the majority of cases. Currently, there are 107 accredited birth centers in the United States. To find a birth center near you and for more information please visit the AABC website at http://www.birthcenters.org/.
Walsh, D., & Downe, S. M. (2004). Outcomes of Free-Standing, Midwife-Led Birth Centers: A Structured Review.Birth: Issues in Perinatal Care, 31(3), 222-229. doi:10.1111/j.0730-7659.2004.00309.x
NM609 Saddlebag Project-FAQ about Midwifery for Health Care Professionals
Title ideas
What Ob/Gyn’s and other providers should know.
Certified Nurse Midwives (CNM)
Frequently asked question by health care providers. OR
FAQ’s by health care providers.
How are CNM’s educated?Certified Nurse Midwives education follows the Core Competencies set forth by the American College of Nurse Midwives (ACNM). Today’s CNM’s must obtain a graduate level degree from a midwifery education program that is recognized by the Accreditation Commission for Midwifery Education (ACME) .
How are CNM’s certified?
After the completion of midwifery school, the graduate student must be successful in passing a national examination for certification in order to practice as a CNM. CNM’s must also hold a current RN license. CNM’s are required to participate in a Certificate Maintenance program. Both the initial certification and the maintenance program are managed by the ACME .
How are CNM’s licensed?
CNM’s are authorized to practice in all 50 states, District of Columbia and territories of the U.S . Each state determines its own licensing requirements for CNM’s and other advanced practice nurses
Websites to list
American Midwifery Certification Board http://www.amcbmidwife.org/index.php
American College of Nurse-Midwives http://www.midwife.org/
Mymidwife.org
Reference
Practice relationships:
Certified Nurse Midwives (CNM) work with a team of professionals to ensure their patients receive the best care. Professional relationships are going to vary based on the state in which the CNM practices; as most states require a CNM to practice with an OB Physician. Most CNM’s will need to form a professional working relationship with an OB Physician, a Dietician, a Child Birth Educator, and a Physical Therapist, as well as specialist. If the CNM works in a practice that does not allow her to spend time with her patients while they labor having a good working relationship with several of the Doula’s in the community could also be of great benefit.
Scope of practice:
CNM’s are nurses that have obtained additional education and credentialing in order to care for women throughout their life. Nurse Midwives can provide well women care, contraception education and counseling, write prescriptions, and provide all perinatal care including, pregnancy, labor and birth support, and postpartum care. Nurse Midwifes also have perscriptive power in all fifty states, so they can provide any needed perscription.
The scope of practice for midwives does vary based on the state they practice in. By contacting your local board of nursing you can find detailed information about the state in which you practice.
You can use this website to find out contact information for you state board of nursing
https://www.ncsbn.org/contactbon.htm
This is a fabulous easy to read medline article that provides basic education about nurse midwives.
http://www.nlm.nih.gov/medlineplus/ency/article/002000.htm
Liability Risk:
In its most basic definition liability means legal responsibility. As CNM's practice under their own lciense there is no vicarious liablity for physicans that colaborate with nurse midwifes. There are several ways in which liability affects CNM’s. The following website has links to several ways for CNM’s to reduce their liability as well as some basic information on liability insurance for CNM’s.
http://www.midwife.org/index.asp?sid=14&TextSearchWordList=liability+risk+for+cnm
Is there research to support midwifery care?
Yes, the evidence is there. A recent Cochrane review of 11 clinical trials involving more than 12,000 women found that midwifery care is safe and offers no increased risk of adverse effects for women with low and high risk pregnancies. (Hatem, Sandall, Devane, Soltani, & Gates, 2008) .Women who receive midwifery care may experience fewer fetal losses prior to 24 weeks gestation, lower use of regional anesthesia, and fewer episiotomies and instrumental births, while having a higher incidence of vaginal birth, higher breastfeeding initiation rates, and greater feelings of control during labor and birth. The researchers concluded that midwife-led care confers benefits, is cost effective, shows no adverse outcomes, and should be offered to all pregnant women.
Is midwifery care a growing trend in the United States?
Yes, more women are choosing midwives every year. Nurse-midwifery in the United States began in the 1920’s in response to the increasing rate of maternal and infant mortality, and by 1963 there were 275 CNMs practicing in the U.S. Today, over 7,000 certified nurse-midwives practice in all 50 states and in many developing countries, and the numbers continue to grow. In 2005, CNMs attended 306,000 deliveries in the United States. This number accounts for almost 8% of total U.S. births, and 11.2% of vaginal births. The American College of Nurse-Midwives (ACNM) is the professional organization for CNMS. ACNM is a politically active organization that is working to advance midwifery practice and improve care to women and infants. One of ACNMs established goals is to add 1000 newly certified midwives by 2015. (mymidwife.org)
How prevalent is nurse-midwifery in my state?
With the introduction of Indiana’s first nurse-midwifery practice in the 1970s, nurse-midwifery has grown. Approximately 84 CNMs reside in Indiana, with 70 sites offering nurse-midwifery services throughout the state. Nurse-midwives in Indiana attended 3,712 births in 2004, which is 5.9% of state births. CNM births were attended mainly in hospitals, with a lesser percentage of births taking place in birth centers and private homes. CNMs in Indiana have prescriptive authority and are reimbursed by Medicaid and many private insurance plans. (mymidwife.org)
Where do Certified Nurse Midwives attend deliveries?
Though the majority of CNM attended deliveries are in the hospital setting, they can also attend deliveries in the client’s home and in birth centers.
What is a birth center, what are the benefits?
Birth centers are usually free-standing, but can be attached to a hospital or clinic. Birth centers are an alternative place for healthy mothers to deliver healthy babies with little medical intervention. They are generally home-like settings that provide a comfortable place for family centered care during pregnancy and childbirth. Emphasis is the comfort and privacy of the mother and the support of normal childbirth.
Evidence has shown reduced rates of perineal lacerations, episiotomies, and cesarean sections as well as increased rates of breastfeeding within birth centers when compared to hospital births (Walsh et all, 2004).
Are birth centers safe? How are they regulated?
The emphasis in birth centers is on low technological intervention, but all birth centers are prepared with emergency equipment and a plan for transfer to a medical facility should the need arise for mother or baby.
Birth centers in the United States are regulated and licensed by the American Association of Birth Centers, or AABC. This governing body provides guidelines for quality assurance, safety, policy and procedure. Additionally, 76% of states have additional regulations in place for birth centers. Accreditation by the AABC is required for insurance reimbursement in the majority of cases. Currently, there are 107 accredited birth centers in the United States. To find a birth center near you and for more information please visit the AABC website at http://www.birthcenters.org/.
Walsh, D., & Downe, S. M. (2004). Outcomes of Free-Standing, Midwife-Led Birth Centers: A Structured Review. Birth: Issues in Perinatal Care, 31(3), 222-229. doi:10.1111/j.0730-7659.2004.00309.x