Certified nurse-midwives (CNMs) provide comprehensive care to women before, during, and after pregnancy. CNMs differentiate themselves from OB/GYN physicians by treating women with uncomplicated pregnancies using non-medical interventions. If a pregnancy does develop complications, the CNM collaborates with an OB/GYN. Certified nurse-midwives are considered valuable members of the OB/GYN team.
It is also important to remember that not all midwives are nurses. Certified midwives (CMs) receive the same midwife training as nurses, but certified nurse-midwives (CNMs) are registered nurses with advanced practice certification who are also trained to be midwives. They provide the benefit of having multiple sources of education and experience.
People often think midwives only deliver babies at home. CNM/CMs attend to approximately 10% of all U.S. births. However, in 89% of those births, CNM/CMs attended to mothers inside a hospital. Less than 10% of those babies were delivered in homes or birthing centers in 2019. Another misconception is that CNM/CMs are only delivery coaches. That is the role of a doula. CNM/CMs coach women, but that is only one of their many roles.
CNMs attend to deliveries the same way OB/GYNs do but with a more holistic approach. They aid women with both their physical and psychosocial needs, assist with alternative pain management during labor, tend to the newborn after birth, and give women breastfeeding guidance.
Certified nurse-midwives also focus on providing women's health outside of prenatal care, labor, delivery, and postpartum care. Some also provide gynecological services, reproductive teaching, and peri and post-menopause care.
Certified nurse-midwives can obtain their advanced practice degree as women's health nurse practitioners (WHNPs) in addition to midwifery training.
Certified nurse-midwives assist women at any stage of pregnancy, during childbirth, and during postpartum care. They also can care for the new infant for the first month. Certified nurse-midwives often meet prospective patients when a woman has found out she is pregnant but may also be introduced to them if there are infertility issues.
General activities may include:
- Perform physical exams, order lab work, and other tests
- Develop a birth plan that includes: tracking fetal growth, mother’s nutrition, pain management options for delivery, and where the delivery is planned to occur.
- Coordinate a plan of care with the OB/GYN team
- Manage the labor of mother and delivery of the infant
- Perform postnatal examinations
- Plan postpartum education for the woman and family that includes breastfeeding, contraception, and newborn care
- Attend to post-menopausal needs such as hormone imbalances and screening for breast cancer and ovarian cancer
Certified nurse-midwives must manage all the care a mother needs during pregnancy. They must be independent thinkers and be patient and compassionate.
They possess skills to:
- Perform pelvic exams
- Administer STD testing and lab work evaluation
- Measure fetal heart rate with monitoring
- Prescribe and administer medications as needed
They essentially care for two patients, the woman, and her infant, at the same time and support other family members in attendance at the birth.