Today’s Midwife: Not your Grandma’s Neighbor Anymore!
Nationally Certified, State Licensed, Educated and Equipped, a new breed of home birth midwives have emerged onto the scene. They would never dare to cast aspersions on the faithful women of ages past who did so much with so little in providing care in pregnancy and birth to their friends, their family, and the poor. However, that ancient picture of the midwife is not how they want to be known, because it is no longer a complete picture of who they are!
With the advent of the Certified Professional Midwife Program, of the North American Registry of Midwives (NARM), (which is accredited by the National Organization for Competency Assurance, NOCA) there has come into being a way to verify both the applicable knowledge and level of clinical skill of your local midwifery professional. This stringent National Certification process takes (on average) three years to complete. It requires that a midwife be tested through written exam and assessment of proper performance of multiple clinical skills. Candidates must also have a documented number of experiential hours working under another care provider who monitors, trains, and teaches them.
Once certified, continuing education is required to maintain certification.
Before a midwife can be considered as a Certified Professional Midwife (CPM), she must provide proof of certification in Adult CPR and either Infant or Neonatal Resuscitation. Many midwives carry oxygen tanks and much of the same resuscitation equipment that is available at a hospital to each home birth.
Mary Anne is not only certified as a midwife. In addition she is a Registered Nurse (RN) and an EMT-IV (emergency medical technician who has additional training).
Recognizing the new midwife as a valuable community resource, several states are now providing a licensure process that not only affords home birth midwives legal status but also gives them the ability to bill some insurance plans. States see this as an effective cost reduction measure for birth services, since a typical home birth usually costs about half that of a hospital delivery.
Here in Tennessee, midwives are licensed under the Health Department. The designation that proves a midwife is licensed to practice midwifery here is “CPM-TN.” This means the midwife is nationally certified and licensed by our state. It also means she has certain legal requirements placed upon her to provide a minimum standard of care that supports overall safety in birth.
In the past, a criticism of the Midwifery Certification Process has been lack of education. Now, quite a number of midwifery schools are accredited by the Midwifery Education Accreditation Council (MEAC). This ensures the quality and continuity of the classroom type information provided to each midwifery candidate who attends an accredited school. It also ensures adequate preparation for the eight-hour exam that is a part of the certification process. Several of these schools offer Accredited Associates or Bachelors Degrees in Midwifery. Some are considered Title IV trade schools for which Federal Financial Aide is granted to students.
At this time, independent study for the exam (which encompasses the contents of approximately 25 obstetric, midwifery, or other medical texts) is still an option, provided the necessary clinical hours of training can be obtained. Regardless of which training route a midwife takes, each candidate must complete the requirements (including general knowledge, passing the test, appropriate performance of clinical skill, and training hours under a skilled professional) before certification is granted.