How to Become a Midwife

Jezzybelle asked me this question on my previous entry, and I've gotta elaborate on it - because actually quite a few people have asked me this.

There are a couple of different types of training for midwives, and a few different kinds of certification. Some are legal in every state, others are illegal in some states, and some states take an alegal stance - there simply are NO laws that apply. So....

1. Nurse-midwife (NM): This is the one that is most likely best known, and the one that is legal to practice in a hospital in all states. Some states prohibit NM's from attending home births, others don't.  Even here, you have a couple of different options based on what school you go to. There are several schools that offer an excellerated BS to Master's in Nursing program that takes three years. Other schools want you to be an RN first, then enroll in the Master in Nurse Midwifery program.  The excellerated course usually takes 3 years, the full RN/MN course normally takes 5 to 7.  Obviously, considering formal schooling is involved, this is the most expensive route - but since you are able to work in hospitals, it's also the route that can insure the largest return.


2. Certified Professional Midwife (CPM) : This is the one that tends to be legal in some states, and alegal in the rest.  Usually it means that the woman has gone through some sort of training program, including an apprenticeship, and then has gotten certified through NARM (North American Registry of Midwives). Usually, these women attend only homebirths, as most hospitals won't give them priveledges. Becoming a midwife through this path requires a lot more initiative and work on the students part, as there aren't many 'preset' programs, and a lot of independant study is required. One of the best distance learning programs is AAMI - Ancient Art of Midwifery Institure.


3. Liscened Midwives (LM): this is a state by state thing - some states offer licensing, others don't. The path is generally the same as the CPM's - with a different final legal status. Once again, there is a lot of independant work, and an appreticeship period.


4. Direct Entry Midwives (DEM): This role tends to be either illegal or alegal in most states, but it's the traditional path of midwifery - where you apprentice for several years to another midwife, learning, on the job, so to speak. What state you live in, and who you apprentice with mainly determines what you learn. This is the cheapest way - but also the longest, because you are learning through hands-on experience, and regretfully, most midwives in most states AREN'T dealing with anything more than 30 - 50 births a years (and that's a serioiusly break neck schedule - roughly a birth a week).

A great resource for learning about the legal/alegal/illegal statuses of each of these types of midwives (as well as whether NM's are allowed to attened homebirths) can be at MANA - Midwives Alliance of North America.

Soo.... I think that about covers it as far as midwives go. Training to be a Doula is much more straightfoward (and faster, and cheaper) because no clinical skills are taught. Most doulas are NOT clinicians, and they are prohibited (either by their certifying authority or by states laws) from performing clinical skills such as vaginal exams, fetal heartrates,  blood pressure checks, and all the rest of that jazz. A doulas main skill is in her hands and her voice to support the mom, the family, and the practioner - whether it be an OB, or a midwife.

Feel free to ask me ANYTHING else you like - this is one subject I can talk about for HOURS.