CNMs in the United States

Certified Nurse-Midwives (CNMs) in the United States

Certified Nurse-Midwives (CNMs) are advanced practice registered nurses who specialize in midwifery. They provide a range of healthcare services to women, including gynecological exams, family planning advice, prenatal care, labor and delivery support, and postpartum care. CNMs are recognized as primary care providers in the United States and play a crucial role in the healthcare system, particularly in women's health.

Education and Certification

To become a CNM in the United States, a registered nurse (RN) must complete a graduate-level program in nurse-midwifery that is accredited by the Accreditation Commission for Midwifery Education (ACME). These programs typically culminate in a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) degree.

After completing their education, candidates must pass the national certification exam administered by the American Midwifery Certification Board (AMCB) to earn the CNM credential. Certification must be maintained through ongoing education and periodic re-examination.

Scope of Practice

CNMs are licensed to practice in all 50 states, the District of Columbia, and U.S. territories. Their scope of practice includes:

• Prenatal Care: Monitoring the health of the mother and fetus during pregnancy, providing education and counseling, and preparing the mother for childbirth.
• Labor and Delivery: Assisting with childbirth, managing labor, and providing support to the mother during delivery.
• Postpartum Care: Offering care and support to the mother and newborn after birth, including breastfeeding support and family planning.
• Gynecological Services: Conducting annual exams, Pap smears, and providing contraceptive counseling.

CNMs often work in collaboration with obstetricians and other healthcare professionals, especially in cases of high-risk pregnancies or complications.

Legal and Professional Status

The legal status and scope of practice for CNMs can vary by state. Some states allow CNMs to practice independently, while others require a collaborative agreement with a physician. CNMs are recognized as primary care providers under federal law, which allows them to be reimbursed by Medicare and Medicaid for their services.

History of Nurse-Midwifery in the United States

The profession of nurse-midwifery in the United States began in the early 20th century. The first nurse-midwifery education program was established in 1932 at the Maternity Center Association in New York City. The profession has grown significantly since then, with CNMs now attending approximately 10% of all vaginal births in the United States.

Professional Organizations

The American College of Nurse-Midwives (ACNM) is the professional association representing CNMs in the United States. The ACNM provides advocacy, education, and resources for its members and works to advance the practice of midwifery.

Also see

• Midwifery
• Advanced Practice Registered Nurse
• Obstetrics
• American College of Nurse-Midwives
• Accreditation Commission for Midwifery Education