The Differences in Midwives

 

CPM, DEM, CNM? What Does It All Mean?

 

Certified Professional Midwife(CPM)

Certified Professional Midwives are skilled professional who provide the Midwives Model of Care to women and families in a variety of settings, including birth centers, homes and hospitals. Preparation to become a CPM involves specialized, competency-based education programs and risk assessment training, that requires out-of-hospital clinical experience. A certified Professional Midwife is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the midwifery model of care. The CPM is the only international credential that requires knowledge about and experience in out-of-hospital settings.CPM’s are the only learning experience that require out-of-hospital training. copy right May 1996 Midwifery Task Force

Most CPM’s practice in hombirth or birth center settings. Some Practice in hospitals. Some states (only 8 left) do not allow CPM’s to practice, others grant a state license by using the NARM certification and CPM and even grant privilege to write prescriptions. Other states say once you have the CPM credential that is enough, and no state license is needed. State by state is different. CPM’s practice independently, but will still have a back up physician.

Direct Entry Midwife (DEM)

A Direct Entry Midwife is one who has trained with a more experienced midwife, mastering the skills needed to practice the art of midwifery. A direct-entry midwife is an independent practitioner educated in the discipline of midwifery through self-study, apprenticeship, a midwifery school, or a college-or university-based distinct from the discipline of nursing. A direct-entry midwife is trained to provide the Midwives Model of Care to healthy women and newborns throughout the childbearing cycle primarily in out-of-hospital settings.

Many DEM’s go on to become a CPM. Not all are allowed to practice in all states. Some states grant a license to practice as a DEM.

Certified Nurse Midwife (CNM)

A Certified Nurse Midwife is a midwife who has first become a nurse, learning OB, and all other areas of nursing. They have then finished a program which may or may not require a masters degree in nursing. They attend an educational program accredited by the American College of Nurse Midwives Certification Council (ACC). They most often practice in hospitals and birth centers.

Some do homebirths, and not all have prescriptive authority. All states recognize the CNM but not all do homebirths. They usually do not practice independently from a physician. This means to practice in the homebirth setting they need to have a physician that backs them, not ‘just have back up’. This limits some midwives in some states. This can be due to the back up Doctor or the state that regulates them. Sadly, this is becoming more of a problem with CNM’s working in the homebirth setting. Many have been shut down from homebirth practice. Some have even went on to obtain their CPM in order to practice independently. In some states they are trying to get it so they can practice independently as the CPM does, and just have physician back up as the CPM does. Hopefully for them this change takes place
Lay Midwife

This is a midwife who has not had any formal training, but has been trained by older and more experienced midwifes who could themselves be a lay midwife, or a CNM, CPM, CN or DEM. They are often called ‘granny midwives’, this does not reflect their skills and care. There are still many lay midwives who practice, and provide wonderful care to many women who may other wise not have access to midwifery style of care.