OB-GYN-L Messages for February, 2006: Re: 2/06 ACOG Statement on "Lay" Midwifery

I would really like to see the CPM qualification become the basic level of competency for midwives. I think it is unfortunate that the ACNM (of which I am a member) jumped in and took control of this, but I think that was done in conjuction with MANA (Ina May?). Nurse-midwives were already established and working within the "system," and it seemed logical that non-nurse midwives not completely reinvent the wheel.

In order to facilitate the acceptance of non-nurse midwives, some educational and professional standards need to be in place. If the only way that most of the American medical establishment will feel comfortable collaborating and consulting with us, I don't see why that is a problem. If a physician (or a patient, or an assistant) have no idea of the midwifes basic level of competency, how can anyone just agree to be available when medical management is needed, and TRUST us to know when that is? We need to face that we need MD's more than they need us, and they have the right to establish standards that work for them.

The next step is to get the word "nurse" removed from our title (hence, Certified Midwife). Even for those of us who once were, our practice now is much closer to a physician than a nurse. I could no more work as a nurse than sprout wings and fly. In fact, more nurse midwives train residents than train nursing students.

Then we get the American Midwifery Certification Board (AMCB)to accept the NARM exam as the standard upon which all of our competency is judged (which is at least as stringent in the care of normal and the recognition of abnormal pregnancy, birth, and newborn as the ACNM exam that I took) and get them to accredit programs like the Seattle Midwifery School (the only one of which I am sufficiently familiar to comment). Then we all take the same test, we all use the same initials, and we can stop the turf wars amongst ourselves (midwives). Some os us just took the nursing detour (variety of reasons, most having to do with few other avenues to midwifery when we were starting out).

I see this as the easiest way to have insurance reimbursement, prescriptive authority, and acceptance of midwifery as a profession attained by midwives in general. Then we can drop the ridicuous "P" from CPM (how many MD's need "PMD" to verify their professional status - it is a given). So ACOG has given us, really for the first time, a way for non-nurses to collaborate professionally with them. Thank them, and lets get to work on the AMCB!

Fran Wilson CNM
Kennewick, WA

From: "R. Daniel Braun" <rd.braun@gmail.com>
Reply-To: ob-gyn-l@obgyn.net
To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
Subject: Re: 2/06 ACOG Statement on "Lay" Midwifery
Date: Wed, 22 Feb 2006 13:12:17 -0600

Yeah BUT none of those are what are known as Lay Midwives in most places in the US. Most placces they have to graduate from High School then enter and complete a 1 year program and work with a Mentor for a short period of time. Then they are an "LM"

On 2/22/06, Stmidwife@aol.com <Stmidwife@aol.com> wrote:

LAY MIDWIFERY

The American College of Obstetricians and Gynecologists (ACOG) is the representative organization of physicians who are qualified specialists in providing health services to women. ACOG is committed to facilitating access to women's health care that is both safe and high quality. One method of attaining this goal is to assure that providers of care meet educational and professional standards of a certification process. ACOG recognizes the educational and professional standards currently used by the American Midwifery Certification Board (AMCB)* to evaluate and certify midwives. While ACOG supports women having a choice in determining their providers of care, ACOG does not support the provision of care by lay midwives or other midwives who are not certified by the AMCB.

*The American Midwifery Certification Board (AMCB), formerly known as the ACNM Certification Council (ACC), was incorporated in 1991. The AMCB develops and administers the national certification examination for Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs). CNMs are registered nurses who have graduated from a midwifery education program accredited by the American College of Nurse Midwives Division of Accreditation and have passed a national certification examination administered by AMCB. Certified midwives have also graduated from a midwifery education program accredited by the American College of Nurse Midwives Division of Accreditation, have successfully completed the same requirements, have passed the same AMCB national certification examination as certified nurse-midwives and adhere to the same professional standards as certified nurse-midwives.

Approval by the Executive Board February 2006

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Re: 2/06 ACOG Statement on "Lay" Midwifery - Long response