Becoming a Midwife
Thinking of becoming a midwife? While doula work and midwifery are different in many ways, there are also several similarities. Both doulas and midwives trust in the woman’s ability to birth her child – saving medical interventions for emergency situations. They both realize that some of the best ways to guide a mother through labor is to help her feel of safe and supported, along with permitting her freedom of movement and nourishment during birth.
The big difference between a midwife and a doula? The responsibility. As a doula, you’re number one job is to support and comfort, but as a midwife, you’re key responsibility is safeguarding the health and welfare of the mother and child. How you get trained to take on those responsibilities depends on which kind of midwife you decide to become.
There are two basic kinds of midwives: direct-entry midwives and nurse midwives. A nurse midwife is a nurse with specialized training in obstetrics and gynecology. A Certified Nurse Midwife, or CNM, may work along side a doctor or on her own. While some CNMs attend births in birth centers or homes, most work within the hospital setting. There are undergraduate nurse midwife programs, as well as graduate programs, all of which are accredited by the American College of Nurse-Midwives.
The other kind of midwife, the direct-entry midwife, does require training in general nursing skills. She may get her training through an apprenticeship, self-education, a midwifery school, or a college program. Not every state in America recognizes direct-entry midwives, but for those that do, you can receive a license to practice as a Licensed Midwife. The requirements for this vary greatly from state to state.
There are other ways direct-entry midwives can receive official recognition. The American College of Nurse-Midwives offers accreditation to some direct-entry midwifery programs, whose graduates become Certified Midwives (CM). However, this certification isn’t recognized in many states. Another certification, Certified Professional Midwife, is offered for direct-entry midwives through the North American Registry of Midwives. A really unique and interesting aspect of receiving a CPM certification is that it’s the only international credential that shows you’ve attained experience and knowledge in an out-of-hospital birth setting.
But not every midwife receives or wants certification. A midwife who chooses not to go through an accredited program or apply for licensure is called a lay midwife. This should not be confused with an uneducated or inexperienced midwife, but just reflects a person’s choice to not pursue an official recognition.
How do you decide which route to take? It depends. There are midwives who choose to practice as lay midwives, but their practice goes against their state laws. You may feel ok with this, while another person may not. Others are already nurses and decide to pursue further education to become CNMs.
You’ve got many options in front of you, and the best option is whatever you feel most comfortable with. However you decide to purse midwifery, it’s your heart that will guide you in the end. Education is important, but how you practice your midwifery is what really matters.