Skilled midwifery can reduce the need for high-tech interventions for most women in labor, though midwives are also trained in the latest scientific procedures to assist in normal deliveries. CNM-attended births account for 10% of all spontaneous vaginal births in the US and 7% of all US births in total. Of these deliveries, 97% occur in hospitals, 1.8% in freestanding birth centers, and 1% at home.
Today’s midwives come from all walks of life. Some earned their midwifery degree immediately after graduating from college, but others are former teachers, writers, missionaries, general practice nurses - mirroring our modern world: rich in diversity. All of them share a deep commitment to bettering maternal and child health, not only in this country but throughout the world.
Almost all programs require applicants to hold a bachelor’s degree. The majority also require that applicants be a registered nurse (RN), although there are a growing number of programs geared toward students who hold non-nursing bachelor’s degrees. Some, but not all, require that entering RNs hold a bachelor’s degree in nursing (BSN).
If a degree is not in nursing (BA/BS), a student will become a Certified Midwife (CM). If a degree is in nursing (BSN), a student will be a Certified Nurse-Midwife (NM). In most cases, non-bachelor’s-level RNs are required to complete a bachelor’s degree before attending a CNM program. Some programs offer a flexible option that enables associate degree-level nurses to complete their bachelor’s studies in the course of the CNM program. All of the midwives at Cape Cod Hospital are Certified Nurse Midwives (CNM).
Certified Nurse-Midwives in Massachusetts
- Certified Nurse-Midwives (CNMs) have been practicing in Massachusetts since 1977.
- The first CNM assisted delivery took place in Cambridge after CNM legislation passed, enabling CNMs to practice.
- CNMs in Massachusetts practice in a variety of settings including hospitals, health maintenance organizations (HMOs), private health clinics, birth centers, and private practices.
- There are approximately 453 CNMs in Massachusetts.
- CNMs practice in cities and rural areas throughout the state including Hyannis on Cape Cod, the Greater Boston area, greater Springfield, Worcester, Pittsfield, Northampton, Amherst, Greenfield, Cambridge, Holyoke, Fitchburg, Quincy, and Great Barrington.
- There are 342 nurse-midwifery practice sites in Massachusetts.
- In 2004, CNMs attended 10,434 births or 19.3% of all births in Massachusetts. Most of those births occurred in hospitals while the rest were in a birth center or at home.
- There are currently 43 accredited education programs in the United States offering post-baccalaureate certificate and masters degree programs in nurse-midwifery and midwifery. A number of these programs have distance learning education options.
- There is a post-baccalaureate certificate program in midwifery and nurse-midwifery at Baystate Medical Center in Springfield.
- For more information, visit http://www.midwife.org/map.cfm
Practice and Reimbursement Issues
- Nurse-midwifery practice in Massachusetts is regulated by the Board of Registration in Nursing under the Nurse Practice Act.
- Massachusetts CNMs have had prescription writing authority since 1991.
- Massachusetts CNMs have mandatory third-party reimbursement for their services.
- This information was provided by the midwives in Massachusetts - Updated 8/08
This information was provided by the midwives in Massachusetts - Updated 8/08
History of the Certified Nurse-Midwife Profession
- Nurse-midwifery dates back to 1925 in the United States. At that time, Mary Breckenridge developed the Frontier Nursing Service in Kentucky. The program used public health registered nurses, who had been educated in England, to staff nursing centers in the Appalachian mountains. The centers offered family health care services, as well as childbearing and delivery care, to residents in the area.
- The first nurse-midwifery education program in the U.S. began in 1932 at the Maternity Center Association of New York City. The program enrolled public health nurses, and awarded its graduates a certificate in nurse-midwifery.
- Today, all nurse-midwifery programs are in colleges and universities. Most nurse-midwives graduate at the Master's degree level. These programs must be accredited by the American College of Nurse-Midwives (ACNM) in order for graduates to take the National Certification Examination.
- There are almost 40 ACNM accredited nurse-midwifery programs in the U.S. Applicants for nurse-midwife programs usually must be registered nurses and have at least 1-2 years of nursing experience. As with the nursing profession in general, most certified nurse-midwives (CNMs) are women. However, in recent years more male nurses have chosen to become nurse-midwives.
- Nurse-midwives have improved primary health care services for women in rural and inner-city areas. The National Institute of Medicine has recommended that nurse-midwives be given more responsibility for delivering women's health care.
- Many studies over the past 20 - 30 years have shown that nurse-midwives can manage most perinatal (including prenatal, delivery, and postpartum) care, and most of the family planning and gynecological needs of women of all ages.
- Nurse-midwives work together with OB/GYN doctors. They either consult with or refer to other health care providers in cases that are outside of their experience (for example, high-risk pregnancies and pregnant women who also have a chronic illness).