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Certified nurse-midwife

Alternative Names:

Nurse midwife; CNM



Information:

HISTORY OF THE PROFESSION

Nurse-midwifery dates back to 1925 in the United States. The first program used public health registered nurses who had been educated in England. These nurses provided family health services, as well as childbearing and delivery care, at nursing centers in the Appalachian mountains. The first nurse-midwifery education program in the United States began in 1932.

Today, all nurse-midwifery programs are at 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. Applicants for nurse-midwife programs usually must be registered nurses and have at least 1 to 2 years of nursing experience.

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 a larger role in delivering women's health care.

Many studies over the past 20 to 30 years have shown that nurse-midwives can manage most perinatal (including prenatal, delivery, and postpartum) care. They are also qualified to deliver most family planning and gynecological needs of women of all ages. Some may check and manage common adult illnesses, as well.

Nurse-midwives work with OB/GYN doctors. They either consult with or refer to other health care providers in cases beyond their experience. These cases may include high-risk pregnancies and care for pregnant women who also have a chronic illness.

SCOPE OF PRACTICE

The nurse-midwife is educated and trained to provide a broad range of health care services for women and newborns. Certified nurse-midwife (CNM) functions include:

  • Taking a medical history, and doing a physical exam
  • Ordering laboratory tests and procedures
  • Managing therapy
  • Conducting activities that promote women's health and reduce health risks

CNMs are legally allowed to write prescriptions in some states, but not in others.

PRACTICE SETTINGS

CNMs work in a variety of settings. These may include private practices, health maintenance organizations (HMOs), hospitals, health departments, and birthing centers. CNMs often provide care to underserved populations in rural areas or inner-city settings.

REGULATION OF THE PROFESSION

Certified nurse-midwives are regulated at 2 different levels. Licensing occurs at the state level and falls under specific state laws. As with other advanced practice nurses, license requirements for CNMs can vary from state to state.

Certification is done through a national organization and all states have the same requirements for professional practice standards. Only graduates of nurse-midwifery programs accredited by the ACNM are eligible to take the certification exam given by the ACNM Certification Council, Inc.



References:

ACNM Position Statement - Midwifery Certification in the United States. American College of Nurse-Midwives. 2009. Available at: elephantcircle.net/wp-content/uploads/2011/10/MidwiferyCertification_in_the_United_States_3_31_09.pdf . Accessed October 19, 2015.

Avery MD, Howe C. The DNP and entry into midwifery practice: an analysis. J Midwifery Womens Health. 2007;52(1):14-22. PMID: 17207746 www.ncbi.nlm.nih.gov/pubmed/17207746 .

Gregory KD, Niebyl JR, Johnson TRB. Preconception and prenatal care: part of the continuum. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 6.




Review Date: 9/26/2015
Reviewed By: Daniel N. Sacks MD, FACOG, obstetrics & gynecology in private practice, West Palm Beach, FL. Review Provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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Goryeb Children's Hospital
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Atlantic Medical Group
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Morristown Medical Center

100 Madison Avenue
Morristown, NJ 07960
973-971-5000

Overlook Medical Center

99 Beauvoir Avenue
Summit, NJ 07901
908-522-2000

Newton Medical Center

175 High Street
Newton, NJ 07860
973-383-2121

Chilton Medical Center

97 West Parkway
Pompton Plains, NJ 07444
973-831-5000

Hackettstown Medical Center

651 Willow Grove Street
Hackettstown, NJ 07840
908-852-5100

Goryeb Children's Hospital

100 Madison Avenue
Morristown, NJ 07960
973-971-5000

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Atlantic Medical Group

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