Monday, April 1, 2013

Who's Who in Delivery?

A very important aspect of the birth of your little one is choosing a competent care provider.  Today we are going to go over the difference in care providers to help you in your decision making process.  (Arranged in alphabetical order – of no significance of importance)
Certified Midwife (CM)
A Certified Midwife (CM) is an individual educated in the discipline of midwifery, who possesses evidence of certification according to the requirements of the American College of Nurse-Midwives.
Certified Midwife (CM) is also used in certain states as a designation of certification by the state or midwifery organization.  
International Definition of a Midwife
Adopted by the International Confederation of Midwives 19 July 2005
A midwife is a person who, having been regularly admitted to a midwifery educational program, duly recognized in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery.
The midwife is recognized as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labor and the postpartum period, to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant. This care includes preventive measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical or other appropriate assistance and the carrying out of emergency measures.
The midwife has an important task in health counseling and education, not only for the woman, but also within the family and community. This work should involve antenatal education and preparation for parenthood and may extend to women’s health, sexual or reproductive health and childcare.
A midwife may practice in any setting including in the home, the community, hospitals, clinics or health units.
What is the Midwives Model of Care?
The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes.
The Midwives Model of Care includes:
•Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
•Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
•Minimizing technological interventions
•Identifying and referring women who require obstetrical attention
The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.
Copyright (c) 1996-2008, Midwifery Task Force, Inc., All Rights Reserved. 
Certified Nurse-Midwife (CNM)
A Certified Nurse-Midwife (CNM) is an individual educated in the two disciplines of nursing and midwifery, who possesses evidence of certification according to the requirements of the American College of Nurse-Midwives.  CNMs generally deliver within hospitals, birth centers and homebirths.
Look here to find a CNM near you
American College of Nurse-Midwives (ACNM)
The mission of the American College of Nurse-Midwives (ACNM) is to promote the health and well-being of women and infants within their families and communities through the development and support of the profession of midwifery as practiced by certified nurse-midwives and certified midwives. The philosophy inherent in the profession states that nurse-midwives believe every individual has the right to safe, satisfying health care with respect for human dignity and cultural variations.
American Midwifery Certification Board (AMCB)
The American Midwifery Certification Board (AMCB), formerly ACC is the national certifying body for Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs).
Certified Professional Midwife (CPM)
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.  CPMs generally deliver in homes of their clients or free standing birth centers.
Look here to find CPM State-by-State Legal Status
North American Registry of Midwives (NARM)
The North American Registry of Midwives (NARM) is an international certification agency whose mission is to establish and administer certification for the credential "Certified Professional Midwife" (CPM). CPM certification validates entry-level knowledge, skills, and experience vital to responsible midwifery practice. This international certification process encompasses multiple educational routes of entry including apprenticeship, self-study, private midwifery schools, college- and university-based midwifery programs and nurse-midwifery. Created in 1987 by the Midwives Alliance of North America (MANA), NARM is committed to identifying standards and practices that reflect the excellence and diversity of the independent midwifery community in order to set the standard for North American midwifery.

Direct Entry Midwife (DEM)
A direct-entry midwife is an independent practitioner educated in the discipline of midwifery through self-study, a midwifery school, or a college- or university-based program distinct from the discipline of nursing. Most often they learn in an apprentice/preceptor relationship spanning several years.  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.  DEMs deliver in a homebirth setting.
Family Practitioner (FP)
FPs graduate from medical school, but are not specialized inbirth.  Some FPs do 50-100 births a year, some do much less.  They refer to OB/GYNs and residents at the hospital where they have privileges.  They generally take a more natural outlook on the birth process than OB/GYNs.   Their philosophies often straddle the line between OB and Midwife.  However, that is a generalization and you need to take it upon yourself to inquire about their perspectives and routine procedural care as well as hospital protocol.  FPs only deliver in the hospital (in the US, in other parts of the world they often do homebirths).
Lay Midwife (LM)
The term "Lay Midwife" has been used to designate an uncertified or unlicensed midwife who was educated through informal routes such as self-study or apprenticeship with a preceptor, rather than through a formal program. This term does not necessarily mean a low level of education, just that the midwife either chose not to become certified or licensed, or there was no certification available for her type of education (as was the fact before the Certified Professional Midwife credential was available). Other similar terms to describe uncertified or unlicensed midwives are traditional midwife, traditional birth attendant, granny midwife and independent midwife.  LMs deliver in a homebirth setting.
A person, who instructs, supervises and/or assesses the clinical skills and knowledge of a student throughout the process of meeting the specific knowledge, skills and experience goals required to fulfill professional standards. Preceptor-based education offers the student one-on-one instruction, close supervision of clinical experience and on-the-spot evaluation.States, Provinces or organizations may have specific requirements to qualify as a preceptor.
Obstetrics and gynecology (OB/GYN)
Two surgical–medical specialties dealing with the female reproductive organs in their pregnant and non-pregnant state, respectively, and as such are often combined to form a single medical specialty and postgraduate training program. This combined training prepares the practicing OB/GYN to be adept at the surgical management of the entire scope of clinical pathology involving female reproductive organs, and to provide care for both pregnant and non-pregnant patients. They are intended to manage high risk pregnancies and surgery on the fetus, referred to as perinatology.  In the US, four years in residency are required.  A bachelors degree is the minimum formal education required.  They are accredited by the Accredited Council of Graduate Medical Education (ACGME) and the American Board of Obstetrics and Gynecology (ABOG). To be recognized as a board-certified subspecialist by the American Board of Obstetrics and Gynecology or the American Osteopathic Board of Obstetrics and Gynecology, a practitioner must have completed an ACGME or AOA-accredited residency and obtained a Certificate of Added Qualifications (CAQ) which requires an additional standardized examination.  OB/GYN only delivers in a hospital setting.

   Ashley Turner


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