For many, the term "midwife" calls to mind a time gone by when young nurses were trained for the specialized task of providing prenatal care and delivering babies. But the days of midwifery are far from over and these highly trained individuals actually do a lot more than deliver babies.
Certified Nurse-Midwives (CNMs) are Advanced Practice Registered Nurses who specialize in women's healthcare. In order to qualify as a CNM, nurses must first complete a Bachelor's degree and become a registered nurse, then complete a graduate level work in midwifery. As of 2010, all CNM midwifery schools must confer graduate degrees on their students in the form of a Masters of Science, Masters of Science in Nursing, or Doctor of Nursing Practice. However, those midwives already practicing will not be required to obtain a degree if they have not already.
Contrary to popular belief, the majority of time spent as a midwife is not attending to births, although this is frequently a small part of the job. Rather, midwives attend to female patients in all stages of their lives. Midwives are experts on many different women's healthcare issues including but not limited to reproductive issues and family planning.
In addition to Certified Nurse-Midwife, the credential of Certified Midwife (CM) is available. This career path is appropriate for those with a healthcare background who do not have experience in nursing but still go on to complete an Accreditation Commission of Midwifery Education (ACME) approved midwifery program.
The American Midwifery Certification Board (AMCB) administers the exams required to become either a CNM or a Certified Midwife. Those who pass the examination must recertify every five years in order to continue work. This certification is applicable nationwide and does not vary by state.
In order to train as a Certified Nurse-Midwife, a bachelor's degree is required. Some Certified Nurse-Midwife programs require that incoming students have a Bachelors of Science in Nursing (BSN), but other require only a Bachelors Degree. Because this CNMs are APRNs, incoming students are generally expected to already have experience working as a Registered Nurse (RN). Some programs have a special track that will allow incoming students who are not RNs to complete the required courses and certification to become an RN before proceeding with midwifery classes.
Nurses are not expected to have any formal midwifery experience before entering a CNM program, although a background in women's healthcare is helpful. Since entering students are usually RNs, those that have already assisted in births and other women's health issues do have an easier time being accepted to these programs and performing well once in them.
CNMs are specialists in women's health and as such, there are no official specializations within the field of nurse-midwifery.
Although the specific curricula will vary among different schools, the courses in any nurse midwifery program will have a focus on women's healthcare in addition to clinical requirements. Aspiring nurse-midwives will have to take core classes, which are likely to include:
Each of these basic courses will have a focus on women's health as well as prenatal and perinatal care. Depending on the program, Nurse-Midwife students may also take courses in cultural literacy, nursing issues and trends, and care of specific populations.
Midwifery schools tend to be very intensive because students are expected to learn so much over a short course of time. For this reason, there are not typically many elective courses offered. In some cases, full-time midwifery students will be able to choose relevant electives in areas such as women's studies and professional development.
Instead of sanctioned elective courses, midwifery students find variety in their training by the clinical practicums that they choose to purse. Some midwives prefer to work in hospital settings while others may choose to rotate into birthing centers, community clinics, and other alternative healthcare settings.
Additionally, there are a number of study abroad programs that allow midwifery students to hone their clinical skills in developing countries. This elective course of study can be very rewarding for those students who choose to pursue it.
Certified Nurse-Midwife programs at major universities and nursing schools are likely to receive accreditation from more than one nationally recognized body. The Commission on Collegiate Nursing Education (CCNE) most commonly awards accreditation to nursing schools as a whole. The CCNE awards separate accreditation to baccalaureate and graduate nursing programs and to nursing residency programs.
In order to obtain accreditation from CCNE, schools must first be approved by their state's board of nursing, and must submit to a formal review of their program and facilities. More information on the CCNE standards can be found here.
Although many midwifery programs are part of a larger nursing school, separate midwifery accreditation is necessary for graduates to be eligible to become certified by the American Midwifery Certification Board. For this eligibility, programs must be accredited or in the accreditation process (known as preaccredited) with the Accreditation Commission for Midwifery Education (ACME). ACME offers review and accreditation specifically for nurse-midwifery programs and midwife programs for non-nurses. Complete criteria for ACME accreditation is available here.