logophile
Verbose
- Joined
- Aug 7, 2004
- Posts
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Liar said:
Here in the states, there are two basic kinds of midwives, Certified Nurse Midwives (aka CNMs) and Direct Entry Midwives (aka DEMs).
CNMs obtain a bachelor's (four year) degree in the science of nursing (BSN) and then do a master's (two year) program in Nurse-Midwifery. They are legal to practice in all 50 states, although the laws regarding their practice from state to state. In some places they are required to work under a doctor, in some places they are required to have a collaborative agreement with a doctor and in others they are autonomous practioners. Less than 4% of CNMs attend births out of the hospital setting, say at a birthing center or at home. The other 96% practice a form of midwifery that is close first cousins with traditional western obstetrical care. There are really good, natural minded CNMs, and I know several. But unfortunately, most CNMs are much more medically minded and fear based in their practices.
DEMs enter midwifery directly, meaning that they are not nurses first. They come to midwifery from other paths. They are sometimes referred to as Lay Midwives (a term we really dislike) because they have no formal training until they start their midwifery studies. Most DEMs are apprentice-trained, like me. I studied under an experienced midwife (known as my sr midwife) for five years. I attended all of her prenatal exams, births, postpartum exams for that period of time. She taught the practical aspects of this craft to me everyday we were together. I began catching babies (we also dislike the term "delivering babies") after about two years of my apprenticeship, under her watchful eye. In addition to my apprenticeship, I have had years of self and guided study, classes, workshops, study groups, etc. Some DEMs go to midwifery school. There are a few throughout the country, ranging from one to three, but the biggest emphasis in the schools is still apprenticeship. There are no schools here, and so I chose the other route. All DEMs provide out of hospital births for their clients, at home and in birth centers.
There are other major philosophical and practical differences between CNMs and DEMs, but those seem to be the basic things that interest people.
The bill that passed yesterday was to license DEMs in the state of Wisconsin. We've been practicing here with no problems from the state for years. We have a friendly relationship with all the important departments (health and human services, vital records, etc) and have no need to hide. However, we weren't technically legal. We just weren't defined by law, in either direction. In other states where this has been the status quo, we're seeing lots of midwives suddenly being prosecuted for practicing medicine without a license, or practicing nursing without a license. Those are both felony offenses and carry huge penalties. We wanted to get legislated before the trend caught on here in WI. It seems were just in time, too. A midwife from the area recently had a baby die at home and the investigations into her and other area midwives started immediately. It was looking really scary for a while, but we just cranked up the heat on our bill and got it through as quickly as possible.
Hope that wasn't more than you wanted to know...
again
