FAQ's: How to Choose Between a Doctor or a Midwife? — The Bump
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FAQ's: How to Choose Between a Doctor or a Midwife?

there are two different types of midwives and that causes a lot of confusion regarding the distinction between the two.  most people think that all midwives are the same and that is usually not the case.

1.  Certified nurse midwife, CNM, is a woman who is an RN first and then goes to midwifery school to specialize.  By the time she graduates she has a master's degree.  She can work in the hospital, in a birth center or in a home birth practice.  She can work in all 50 states and must be under the supervision of a doctor. 

2.  The other type of midwives have different titles depending on which state they are working in.  Some states refer to them as licensed midwives (LM), registered midwives (RM), certified professional midwives (CPM) and other states offer a permit to be a midwife. These women are known collectively as direct entry midwives (DEM) and cannot work in the hospital.  She can work in birth centers and home birth practices, but cannot work in all 50 states. They do NOT need to be under the supervision of a doctor and are independant health care providers.  In some states they can also receive medicaid reimbursement. 

Here is a website that explains the legal status of DEM's: https://mana.org/statechart.html

There will always be exceptions to the rules, but generally speaking CNM's are more medical as they are trained under the medical model of care.  While DEM's are trained in more natural methods under the midwifery model of care. 

I would think that the first step is to determine where you feel most comfortable birthing.  Then interview a few different providers to see how you feel and if you connect with a particular one.  You are looking to assemble a team of people who are going to support you during your pregnancy, labor, birth and the postpartum period.  Talk to other mom's who are like-minded and ask for references. 

ok ladies, what else can you add to this topic? 

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Re: FAQ's: How to Choose Between a Doctor or a Midwife?

  • Thanks for posting this.  I had the hardest time getting my sister to understand that my CPM for my homebirth is completely different than her CNM she had in the hospital.  And when questions are posed on this board about midwives it's very hard to answer questions if the poster doesn't specify the type of midwife/or birth location.
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  • I think your answer is a good explanation of the different types of midwives.  You might add that in states where DEM's cannot work legally, there are still usually midwives working underground.  

    Your answer didn't delve into the difference between doctors and midwives.  Maybe change the title of this one and handle the doctor issue separately so it's not too long?  I think it should mention that FP's also do deliveries since a lot of people don't think about that option.  Also that you really have to consider the individual, not just their title.

    Is there going to be a separate one about questions to ask a potential care provider? 

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  • imageiris427:

    I think your answer is a good explanation of the different types of midwives.  You might add that in states where DEM's cannot work legally, there are still usually midwives working underground.  

    Your answer didn't delve into the difference between doctors and midwives.  Maybe change the title of this one and handle the doctor issue separately so it's not too long?  I think it should mention that FP's also do deliveries since a lot of people don't think about that option.  Also that you really have to consider the individual, not just their title.

    Is there going to be a separate one about questions to ask a potential care provider? 

    well partly i was hoping to just get the topic started and then have others add their experieces and knowledge.  it's too much info for one person, part of the idea is to get a lot of different people's perspectives and advice.  i would love to hear what you have to add specifically about the things mentioned above.  i know that you have a lot of good knowledge to share! 

    i've seen FAQ's that were links to posts, so that way everyone's responses would be heard instead of it just being one person's input.  i was thinking maybe that's what this would be.  wdyt?

    i tried to get into the differences between midwives and doctors and i started to type out a response three different times and keep deleting it.  i found it hard to do without being super long and i figured that most people knew what a dr was, it's the diff kinds of mw's that tend to confuse ppl. 

    there is going to be a separate post about what to ask your provider.  i think that is a lot of info and needs to be on it's own. 

    everyone, please add your info!  i'm just trying to get the threads started...

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  • imageTexas77again:
    imageiris427:

    I think your answer is a good explanation of the different types of midwives.  You might add that in states where DEM's cannot work legally, there are still usually midwives working underground.  

    Your answer didn't delve into the difference between doctors and midwives.  Maybe change the title of this one and handle the doctor issue separately so it's not too long?  I think it should mention that FP's also do deliveries since a lot of people don't think about that option.  Also that you really have to consider the individual, not just their title.

    Is there going to be a separate one about questions to ask a potential care provider? 

    well partly i was hoping to just get the topic started and then have others add their experieces and knowledge.  it's too much info for one person, part of the idea is to get a lot of different people's perspectives and advice.  i would love to hear what you have to add specifically about the things mentioned above.  i know that you have a lot of good knowledge to share! 

    i've seen FAQ's that were links to posts, so that way everyone's responses would be heard instead of it just being one person's input.  i was thinking maybe that's what this would be.  wdyt?

    i tried to get into the differences between midwives and doctors and i started to type out a response three different times and keep deleting it.  i found it hard to do without being super long and i figured that most people knew what a dr was, it's the diff kinds of mw's that tend to confuse ppl. 

    there is going to be a separate post about what to ask your provider.  i think that is a lot of info and needs to be on it's own. 

    everyone, please add your info!  i'm just trying to get the threads started...

    OK, got it.  I'll try to come back and add some info later :) 

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  • You said that. Lol
  • Which type can affect insurance coverage sometimes. I know for our insurance to cover my birth it had to be with a CNM

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  • I'm assuming insurance coverage depends on the legality of midwifes in your area. Because it is legal for DEMs here in Washington state to practice, my insurance provides coverage. When I was in Kentucky prior to arriving here, I don't know of anyone who worked with a DEM there who had coverage- they all had to pay out of pocket- and there are also a few other difficulties as well (such as obtaining birth certificates, referrals for medical care out of the realm of the midwife, etc.), Although some people may only have coverage for a CNM, sometimes the fee of paying out of pocket for a DEM is still less than the expense of delivering at a hospital with insurance coverage..
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