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Certified Nurse Midwife Scope Of Practice

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What Is A Nurse

Certified Nurse-Midwife – Advanced Practice Provider Profiles

If you are looking for a rewarding career that allows you to focus on womens health, from adolescence to menopause, a career as a certified nurse-midwife may be a suitable fit for you.

A CNM is an advanced practice registered nurse who goes through comprehensive training, mainly providing care to pregnant women from labor to delivery to postpartum care. Before you get to this point, becoming a certified nurse-midwife involves several steps, including becoming a registered nurse, applying for an accredited nurse-midwifery program, and, after the program, taking the The American Midwifery Certification Board Nurse-Midwifery/Midwifery examination to earn certification. After earning certification, you must apply for state licensure to practice as a CNM in your state.

The Role And Scope Of Practice Of The Nurse Practitioner

NPs are the providers of choice for millions of patients. Current provider shortages, especially in primary care, are a growing concern, yet the growth of the NP role is addressing that concern head-on. The faith patients have in NP-provided health care is evidenced by the estimated 1.06 billion patient visits made to NPs in 2018.

Joyce Knestrick, AANP President

Why Are Midwives Such An Important Member Of The Patient

Midwives are associated with positive outcomes in part because of their approach, according to Farley. Almost one-third of all births in the United States are cesarean sections,5 twice the World Health Organizations target rate for cesarean sections.6

When you just treat women according to their needs and not according to some hospital policy or convenience of staffing, you get better results, Farley stated.

One study found that when Nurse-Midwives are better integrated into the health care system through regulations, limited restrictions, and increased access to resources, the rate of cesarean sections declines significantly.7

The same study showed a decrease of preterm and low weight births in states that granted midwives a scope of practice that utilizes all their training.

For these reasons, institutions like the National Institute for Care and Excellence, a health advisory body in the United Kingdom, recommend that at least one midwife be present for every birth.8

We have to keep going back to legislation, Farley said, to make sure were at the table for these discussions, are seen as part of the solution, and are allowed to practice to the full extent of our training and expertise.

The following section contains tabular data from the graphics in this post.

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Credentialing And Scope Of Practice For Certified Nurse

The vast majority of midwives in the United States are Certified Nurse-Midwives , with more than 12,655 active CNMs counted as of 2019.

Certified nurse-midwives are advanced practice registered nurses backed by the American College of Nurse-Midwives. To become a CNM, registered nurses must graduate from a masters or higher-level nurse-midwifery education program accredited by the Accreditation Commission for Midwifery Education and pass the national Certified Nurse-Midwife Examination through the American Midwifery Certification Board.

All CNMs must hold state licensure, usually issued through their state board of nursing. They must also meet specific continuing education requirements to maintain state licensure and the CNM designation.

All U.S. states recognize and license CNMs and allow them prescriptive authority. Eighteen states allow CNMs to diagnose and treat without physician supervision, while the remaining states require CNMs to enter into a collaborative practice agreement with a physician. Medicaid reimbursement for CNM care is mandatory in all 50 states, and most states mandate private insurance reimbursement for their services.

What Is A Certified Nurse


A Certified Nurse-Midwife is an advanced practice registered nurse who is qualified to provide obstetrical, gynecological, and nursing care for women of all ages, from adolescence through menopause.

CNMs focus their work on womens health and a womans reproductive health care needs, including managing chronic diseases, such as diabetes and heart disease assisting with gynecological and menopausal issues, such as abnormal bleeding and depression and educating and counseling patients about issues relating to sexual health. CNMs also provide prenatal care during pregnancy and labor, postpartum care, and newborn care.

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Certified Nurse Midwife: Everything You Need To Know

by oaapn | Jun 9, 2020 | |

Certified nurse-midwives are valued and trusted healthcare providers who provide women with a low-tech, high-touch alternative to traditional gynecologic and obstetrical care. CNMs are advanced practice registered nurseswho possess a graduate-level degree in nurse-midwifery and earn national certification as a CNM through the American Midwifery Certification Board .

CNMs are qualified to work in all birth settings, including hospitals, homes, and birth centers, and possess the authority to write prescriptions in all 50 states. While CNMs are most commonly associated with delivering babies, they also provide health care and wellness care to women, which may include family planning, gynecological checkups, and prenatal care.

According to the Ohio Board of Nursing, there are 431 licensed CNMs in Ohio, as of June 2019. Currently, CNMs attend about 8 percent of births in the United States, the majority of which are in a hospital setting. CNMs offer similar care to that of an OB/GYN doctor, but their approach is somewhat different.

Midwifery care involves a trusting relationship between the provider and pregnant person, who share decision-making. While the medical model of care tends to focus on managing problems and complications through the use of routine care and the use of technological interventions, midwives also see pregnancy and labor as normal life processes rather than a condition to be managed. The midwifery model of care focuses on:

Should I Enroll In A Certified Nurse Midwife Program

CNMs are registered nurses who receive graduate-level training through programs accredited by the Accreditation Commission for Midwifery Education . Programs can vary and include nursing and midwifery programs. There are multiple options for completing your degree you could opt for a two-year masters program or a longer four-year doctoral degree.

Depending on what institution you choose, nurse-midwife programs, for example, can be completed on a full- or part-time basis. Depending on whether you pursue a masters or a doctorate, on average, the number of credits needed to graduate can range from 30 to almost 80.

Regardless of the program, those training to be certified nurse-midwives will complete coursework in antepartum care, advanced primary care, intrapartum and postpartum care and newborn care. They also complete clinical rotations in professional settings. Generally and this might vary from program-to-program students in these programs will complete more than 500 hours of working in a clinical setting. This could be in a large hospital, OB/GYN clinics or private practices, among other locations.

After successful completion of an accredited program, certified nurse-midwives are certified by the AMCB. You must hold a graduate degree and have a valid RN license to sit for the certified nurse-midwife examination.

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What Can Midwives Do For Patients

One of many childbirth options in the United States, the midwifery model of care focuses on providing low-intervention births, forming strong relationships, and helping expectant mothers be full participants in their health care.

Not all midwives can legally operate to the full extent of their education and training, as federal and state regulations determine the scope with which Nurse-Midwives practice.

Certified Nurse-Midwives are registered nurses who receive masters level training in midwifery and who are qualified to attend deliveries in settings ranging from the home to the hospital. Certified Midwives also earn a graduate degree but do not have to be a registered nurse prior to entering a program of study. While CNMs are authorized to practice in all 50 states, the CM license is recognized in just five states.

According to the American College of Nurse-Midwives, the midwife cares for babies up to four weeks old and offers care to pregnant women before, when, and after the child is delivered. CNMs are also trained to lead care beyond just labor and delivery. Farley said that Nurse-Midwives work throughout a womans life span and can facilitate annual exams, treatments for common infections, and hormone treatments

Highest Paying States For Nurse

Helen Isaak, DNP, CNM – Certified Nurse Midwife

The salary earned by a Nurse-Midwife can vary significantly by location, with some CNMs earning substantially more than others with the same job description in a different state. For example, Nurse-Midwives in California earn $159,590 annually on average, whereas CNMs in Florida earn just $67,530 per year. The states listed below represent the five highest-paying states for Nurse-Midwives in 2020.


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What Is A Certified Nurse Midwife

A Certified nurse midwife an Advanced Practice Registered Nurses that specializes in prenatal care, labor and birth, and postpartum care. The Certified nurse midwife may also care for the neonate in the immediate postpartum period.

The CNM often works in an independent practice and may prescribe medications, order labs and x-rays, make medical diagnoses, and prescribe treatments. In addition to working with pregnant women, the Certified nurse midwife often works with the womans partner to educate about reproduction and sexual issues.

How Can I Become A Nurse Midwife

Certification to become a certified nurse midwife is regulated by the American Midwifery Certification Board and is recognized in all 50 states. The CMN continues to practice under the regulations set in each state and each hiring institution may also have additional requirements that a nurse must meet in order to practice. An unencumbered registered nursing license is required to be eligible for this advanced degree. In order to earn the CNM, you must earn a masters degree from an accredited program. Typically, this means that you must have a bachelors degree in nursing first however, if you have a bachelors degree in another health science, there are NP programs that will allow you to prepare for RN licensure at the same time you are studying for a masters degree in nursing. If you are a full-time student in a masters program, you can expect to spend two to three years earning the masters degree that will prepare you to take the American Midwifery Certification Board exam.

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Certified Nurse Midwife Roles And Responsibilities

Certified nurse-midwife roles and responsibilities involve aspects of womens health and gynecologic healthcare. Nurse-midwife duties involve aiding women throughout their pregnancy, including prenatal and postpartum treatment. Nurse-midwives care for a woman giving birth by providing her with woman-centered support that emphasizes the normalcy of birth. This extends to the postpartum period as well. They can care for newborns at birth and in those first few months of life.

While mostly associated with care around pregnancy, CNM roles include more general healthcare for women as well. This means that certified nurse-midwives can assess and manage contraceptive and birth control methods, offer general gynecological care, and preventive care. They prescribe medications, medical devices, and treatments. Think of a certified nurse-midwife as a healthcare guide for female patients from adolescence through menopause.

You can find certified nurse-midwives working nationwide from major hospitals to private practices and health and birthing centers. Certified nurse-midwives also attend and assist with home births.

Examination Licensure And Certification

Advanced Practice Registered Nurses (APRN)

After completing graduate or post-graduate education with a focus in midwifery, candidates can apply and test for certification. The American Midwifery Certification Board outlines the requirements for testing/certification such as:

  • Submitting proof of licensure as an RN or NP
  • Completion of a graduate program accredited by the Accreditation Commission for Midwifery Education
  • Verification by the director of the NM program confirming all program requirements were met, along with the date of completion
  • Attestation by the director of the NM program that the applicant performs at a safe, competent beginner level

Applicants can attempt the exam four times, but all attempts must be within 24 months of program completion. Certification is valid for five years, and the AMCB offers re-certification options.

Certified nurse midwives also must register with their state’s Board of Nursing. Some states offer certification simply by applying, if the graduate program meets the state’s educational standards. Otherwise, nurses can submit certification obtained through the AMCB. Nurses are encouraged to check their state Board of Nursing to identify specific requirements.

Learn more about midwifery schools and post master’s midwifery graduate certificate programs.

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Whats The Difference Between A Cnm And A Cm

It is important to note that a certified nurse-midwife is different than a certified midwife . A CNM is a registered nurse who graduates from a nurse-midwifery program, while a certified midwife is not a registered nurse. Instead, CMs have a healthcare-related degree or educational background and they graduate from a midwifery program. Both CNMs and CMs take the same certification exam to practice but their professional designations are different.

Update Compact Registered Nurse License For Certified Nurse Midwife

Fee Information: There is no fee for this process

This application is for the Certified Nurse Midwife to change the Registered Nurse information in the North Carolina Board of Nursing’s records for another Compact State license. Once the application is submitted, we will verify the information with the Compact State.

If your email address is listed with the North Carolina Board of Nursing, you will receive a confirmation via email verifying receipt of your online application.

Upon successful completion of the online application, you may check your application status via Nurse Gateway. Licensure information can be verified on the Board’s website. The Board of Nursings electronic database serves the primary source of licensure information for nurses in North Carolina.

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Role Of The Nurse Practitioner

The Nurse Practitioner is a vital component in delivering healthcare to people across their lifespan. Millions of people visit NPs annually in both the inpatient and outpatient settings. Their unique characteristic of approaching the patient as a whole and focusing on the health and well-being of the entire patient may be a contributing factor.

The role of the NP includes evaluating, diagnosing, and treating the patient along with delivering education and counseling to their patients to help guide them on a healthier path. The assessment, diagnosis, and treatment are completed by a thorough assessment, ordering diagnostic tests including laboratory and radiologic tests, interpreting the tests, and diagnosing the patient. The NP then initiates treatment through non-pharmacological or pharmacologic measures or consults with another provider or specialty to ensure the patient receives the necessary care. The NP advocates for interprofessional care, which includes consulting physical therapy, occupational therapy, palliative care, or other services as needed to meet the patients healthcare needs.

For more information about the role of the NP, click here.

Important Differences From The New Nurse Practitioner Law

Jill Kocher, CNM – Certified Nurse Midwife

This year was a busy one for expanding the scope of practice for advanced practice registered nurses in California. In AB 890, which we analyzed here, nurse practitioners have been granted a defined scope of practice for the first time in California. However, certain regulations from the Board of Registered Nursing seem to be required before an NP can practice under that expanded scope, and the roll-out of an independent scope of practice will take additional time. In contrast, the revised CNM laws are not dependent on new regulations, and the new scope of practice and all the related obligations regarding informed consent and reporting will therefore be effective January 1, 2021.

Another difference between AB 890 and SB 1237 is that AB 890 added NPs to the list of licentiates under Section 805, meaning peer review bodies will be required to report to the licensing agency certain actions taken against an NPs membership, privileges, or employment. Under SB 1237 CNMs have not been added to the definition of licentiate under Section 805, and therefore peer review bodies will not have to report actions taken against CNMs.

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Existing Law Provides Some Independent Scope Of Practice

Under existing law, in addition to the basic registered nurse scope of practice, CNMs have a supplementary scope of practice that includes care related to childbirth and family planning. This includes, under physician supervision, attending cases of normal childbirth and providing prenatal, intrapartum, and postpartum care, including family-planning care, for the mother, and immediate care for the newborn. When performing functions that are outside the CNM scope of practice and would otherwise be considered the practice of medicine, the CNM must function under “standardized procedures” that include the level of physician supervision required for the particular function. Standardized procedures are required for CNMs to furnish or order drugs or devices under current law.

Certified Nurse Midwives In Oklahoma

Welcome to the Home Page for the Oklahoma Nurse-Midwives!

Your Oklahoma midwives would like to welcome you to our site! Our mission is to help you understand what it is midwives do for you and your family, and the incredible enjoyment you can recieve from choosing midwifery care for your needs as a woman – whether in Menopause, early teens, pregnant, in between babies, or just wanting a female provider who is trained in being “with women”.

Here are some facts regarding nurse-midwives in Oklahoma:

Nurse-midwives have been practicing in Oklahoma since 1980. The first nurse-midwifery practice was at an Indian Health Services Hospital.

There are currently 68 midwives practicing in many parts of our great state. Most are providing full-scope care, which means they will care for you during pregnancy, do your birth, take care of you Post-Partum, then follow you through the years of birth control, into Menopause, and into your older years. Midwives care for patients from early teen through advanced age. They are specially trained for, and are considered Primary Care Providers.

Midwives in Oklahoma practice in a variety of settings including hospitals, clinics, health maintenance organizations, private practices, birth canters, private homes, public health departments and colleges of nursing and medicine.


Practice and Reimbursement issues:

Medicaid reimbursement was approved in 1988. Reimbursement is at 100% of the Physician Rate.

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