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Natural Birth
Non clicky poll: Is your out of hospital midwife a CNM or a CPM?
I just read the anti home birth article that was posted in a prior thread.
https://ideas.time.com/2011/11/07/what-ricki-lake-doesnt-tell-you-about-homebirth/
Along with several other generalizations the article claims that the majority of home births are done by CPMs not CNMs. I found this odd as all of the midwives in at my free standing birth center, as well as the other center in the county, are CNMs.
Which type of midwife are you using and did the credentials play a role in your choice? Perhaps there are state regulations preventing CNMs from attending out of hospital births.
It is annoying that the author assumes home birthers are not intelligent enough to ensure they have checked the background of their selected provider.
This discussion has been closed.
Re: Non clicky poll: Is your out of hospital midwife a CNM or a CPM?
Actually, both! Credentials didn't play a big role in my choice-though I just switched yesterday to my widwifery team. Two of the midwives are both CNM&CPM as well as state certified. They are assisted by a CNM who is getting both her state certification and her CPM and midwife student getting her CNM.
I made my choice by how.comfortable I was talking with them and how confortable my husband is with them.
Our midwifery team consists of 1 CPM and 1CNM. Before deciding on them we met with several other midwive groups and I found a good balance of both. I think we interview 3 other teams and 1 other was a CNM/CPM team, 1 was both CNM's and the last was just 1 CPM.
My baby is two!!! Baby girl 9/17/09
My other baby is still a baby! Baby Boy 11-30-11
All of the MWs at the Birth Center I used were CNMs and they did birth center, hospital and home births depending on the mother's preference and risk factors.
ETA: Also credentials didn't really play a role. The birth center was one of two in the area and came recommended. There weren't any CPMs in the area that I am aware of, so it was more a matter of what was available.
All 4 midwives at the birthing center I go to are CNMs. They can deliver babies at their birth center or the local hospital where they have privileges. As far as I know, they don't do home births.
DH and I chose their practice because we're both comfortable with getting health care from nurse practitioners, nurse midwives -- basically, nurses with advanced educations and certifications.
And I trust the American College of Nurse-Midwives.
My midwife practice is all CNMs, some of them with degrees from Ivy League schools. I also thought that was a rather weak, ignorant point, especially considering she labeled it #1. CPMs are legally allowed to attend home births in my state but my insurance doesn't cover them.
i previously used a midwifery practice with all CNMs who attended births at their birth center or at the mother's home. they do not have hospital privileges.
for my second birth, i preferred a more intimate relationship with one MW, with whom i could develop a deep level of trust. i chose a CPM. her credentials were less important to me than her level of experience (especially with vbac moms), her deep knowledge and my connection with her.
First of all, I roll my eyes at almost everything "Dr. Amy" writes. She is the same author of the "skeptical OB" blog and "hurt by homebirth". She occasional writes informative, well researched posts, but the majority consist of her making fun of those who support natural childbirth. She also actively searches out posts made by mothers on sites like mothering.com, twists their words, and then bashes them.
Getting back on point. I don't know the statistics on CPMs vs CNMs so I can't weight in on that, but anecdotally I have seen that birth centers tend to be staffed by CNMs. I (personally) would never feel comfortable with a CPM because of the lack of credentialing. I should also add that I wouldn't be comfortable with a CPM because they are unable to legally administer medication. I would be very happy if the United States put a system into place like those in the UK or in the Netherlands.
CNM are not allowed to attend homebirths or work out of free standing birthing centers in MA. Most homebirth MWs in my state are either trained at an midwifery school, but some gain all of their training through apprenticeship.
My MW is a CPM, however my last MW was a direct entry MW who had no plans to go for her CPM. I personally don't think the CMP OR the fact that some MWs are also nurses makes them inherently better than others. My former MW (now retired) was excellent, knowledgeable and in high demand. She had the proper training and experience and a very good reputation and that was good enough for me.
I can safely say that from her (and my current MW) I have received far better care than I did with the CNM I was with before switching to a homebirth with my first. ::shrugs::
Yes, Dr. Amy tends to be far more sensational than the people she is tries to label as such.
Those stats seemed odd but I can only go off of what is available in my area. In this county the only hospitals that allow midwives are Kaiser. The other hospitals kicked all of the midwives out. Of course that was politically and economically motivated but it means that the CNMs at the local birth centers, for the most part, also have logged considerable time in hospital settings.
My midwives are CPMs. In California, CPMs are licensed to perform homebirths.
I have no problem with this.
Dr. Amy can kick rocks.
It's crazy to me that CNMs cannot do home births in some states.
I do think lack of credentials and oversight is an issue with our current system. I would like to see CPM credentials uniform across all 50 states, and them to be legal and regulated just like doctors and nurses are. I'm pro-HB obviously but I do think there are mothers and babies being hurt by poorly trained midwives.
I was not comfortable with the idea of an underground midwife. I had the rare and wonderful opportunity to have my home birth with an awesome ob/gyn.
There is a big push in Ohio right now to license CPMs. I personally would feel safer knowing that my MW was licensed.
With that said, I felt safe with my CPM based on her record and 20+ years of experience. I had a DEM there, but I wouldn't have felt safe it would have only been her there.
Breastfeeding and pregnant!
There is a push here in NC too. But I know some midwives actually oppose it. They don't want to be regulated. But I think women have the right to a midwife who won't have to hide in the closet if something major goes wrong.
Of course there are great, responsible CPMs out there--I certainly don't want to imply otherwise. But when you are in a line of work where lives literally depend on you, there should be someone holding you accountable.
mine is a CPM (I used her for my first homebirth as well)
She went to school and has a lot of experience. I wanted her above a LM which is the other type that do HB's in AZ
Similarly to others, CNM cannot perform home births in my state either. Honestly I could care less if I had a CPM or CNM, but since we wanted a HB we went with a CPM, which is not covered by my insurance.
Just a clarification: At least in my state, CPMs are able to legally administer certain types of medication. For example, my midwife can adminster Pitocin to aid with postpartum hemorrhaging. She could not, however, test for or prescribe the progesterone supplements that I'm currently on.
Anyway, if it's not obvious, I'm using a CPM
I am concerned about the lack of credentialing in general. With a CNM, you know she has a base level of knowledge, but that's not the case with a CPM. Heck, here in Texas, a CPM doesn't even have to have a high school diploma.
That said, I know the credentials of my specific CPM and I'm totally comfortable with them -- which is the important thing. To say, "I'd never use a CPM because of the lack of credentialing" is like saying, "I'd never use an OB because they don't teach natural birth at med school." To do that would mean excluding a lot of wonderful OBs who may not have learned natural birth at med school, but have picked it up along the way.
FWIW, CNMs and CPMs can both attend homebirths here in Texas. I saw a group of hospital-based CNMs for most of my pregnancy with DS, but they don't attend homebirths. When I decided to switch to homebirth, I did have some CNM options, but I was far more comfortable with my CPM.
Mommy to DD1 (June 2007), DS (January 2010), DD2 (July 2012), and The Next One (EDD 3/31/2015)
In my state, CPMs are certified through the medical board. They do not have to be overseen by a physician, and, frankly, I don't think, with all the rigorous training they go through, that they need to be.
My midwife can Rx meds, send me to ultrasounds and also send me for labs. She also carries pitocin for extreme blood loss and oxygen.