Midwifery Licensure and Careers
Get Midwife School, Licensing and Certification Info
Get Midwife School, Licensing and Certification Info
Natural Health Degree Schools | Natural Healers Career Resource Center
| | Midwifery in the United States is regulated by state law and largely influenced by national certification. Laws and regulations vary considerably for both nurse-midwives and direct-entry midwives. Anyone interested in becoming a midwife should become knowledgeable about the laws affecting midwives in any state in which he or she expects to practice. In order to practice as a nurse-midwife, one must be a certified nurse-midwife (CNM). This certification is recognized across the United States. |
Washington state's licensure exam includes two components: the CPM exam, created by the North American Registry of Midwives (NARM), as well as a section specific to Washington state laws, regulations, and standards of practice. Those who pass the exam become LMs and are eligible to complete the NARM certification process to become registered nationally as a CPM without sitting for an additional exam.
State-by-State Requirements for Becoming a Midwife
Direct-entry midwives (LM) are licensed in the following states: Alaska, Arkansas, Arizona, California, Colorado, Florida, Louisiana, Minnesota, Montana, New Hampshire, New Mexico, New York (Certified Midwives certified by ACNM only), Oregon, South Carolina, Tennessee, Texas, Vermont and Washington.
The requirements vary by state, but usually require training by a state-recognized program or apprenticeship, assisting at a minimum number of births in the secondary or primary position, and passing a state approved exam. The North American Registry of Midwives provides a national certification exam for midwives. This exam may not be required for licensure. In a few states, the NARM designation, certified professional midwife (CPM), qualifies a woman to practice as a midwife. It is important to note that some states specifically prohibit the practice of midwifery by anyone who is not a licensed certified nurse-midwife.
Certified nurse-midwives (CNM) are licensed in all fifty states and the District of Columbia and their requirements include certification by the American College of Nurse-Midwifery (ACNM).
In Canada, midwifery is defined on a provincial basis and prospective midwives should check with their provincial authorities for requirements.
Prerequisites for Attending Midwifery School
Prerequisites vary from program to program. For example, Seattle Midwifery School provides training for direct-entry midwives. Prerequisites include the following:
- Earn a high school diploma or its equivalent
- Demonstrate proficiency in the English language
- Complete 45 quarter credits or 27 semester credits of college course work with a cumulative grade point average of 2.8 or better
- Complete an approved Labor Support Course
- Biology: One year of high school or 3 college-level credits
- English: 3 college-level credits
- Human Anatomy and Physiology: 5 college-level credits (preferably a two-quarter course)
- Math: 2 years of high school math (with the past ten years) or 3 credits of college-level math
- Microbiology: 5 college-level credits
- Social Science: 5 college-level credits
Most nurse midwife programs require that students receive a bachelor's degree in nursing and a master's degree in midwifery.
Midwifery Tuition
Independent schools vary greatly, running from $2500 to $5000 per year (most are four year programs). CNM programs are generally located in larger universities and tuition is the equivalent of most master's programs.
Midwifery School Financial Aid
Midwifery Education Accreditation Council (MEAC) is recognized by the U.S. Department of Education, enabling MEAC accredited schools to apply to participate in federal student financial aid programs. See information on accreditation, below.
Organizations That Accredit Midwifery Schools
There are two organizations that accredit direct-entry midwifery schools:
- Midwifery Education Accreditation Council (MEAC) – MEAC adheres to the national standards of direct-entry midwives set forth by the North American Registry of Midwives (NARM) and is recognized by the U.S. Department of Education, enabling MEAC accredited schools to apply to participate in federal student financial aid programs.
- Accrediting Council for Continuing Education and Training (ACCET) – ACCET is recognized by state and federal agencies for vocational training. ACCET-accredited schools are eligible to receive federal financial aid.
You can view a list of MEAC Accredited Schools.
Nurse-midwives receive their training at the university level, usually by completing a bachelor's degree in nursing followed by a master's level midwifery program. The ACNM Certification Council sets the standards for the education and certification of nurse-midwives.
The Value of Attending an Accredited School
Accreditation equals accountability and, in the eyes of some, legitimacy. The accrediting organization sends representatives with backgrounds in finance and education to the midwife aschool, as well as a midwife representative for peer review. The accreditation process includes a thorough review of all school files:
- Educational materials related to the curricula student files (to check for completeness of prerequisites and coursework)
- Faculty files (to ensure the instructors' experience is adequate for their particular subject matter
The school's fiscal records and most recent audit are reviewed to determine that the school is financially solvent. In-depth interviews are conducted with students, faculty, and staff members. Accreditation is granted for a specific amount of time (often about three to five years). After this time has lapsed, the school must apply for re-accreditation.
Students who attend an accredited school can be assured that their learning institution has met the standards of the accrediting organization and shows the promise of growth, solvency, and vitality for the long term.
Length of Study to Become a Midwife
There are a number of routes to the nurse-midwife designation and all are accredited by the ACNM:
- Nurse-midwifery education programs
- BA/BS to RN/CNM-graduate program
- Diploma or associates degree (AD)
- RN to CNM-graduate program master's program (for those that already have a bachelor's degree in nursing)
- Post-master's certificate (for those that have a master's in nursing)
If you hold a BA or BS in a field other than nursing, you may be able to take a master's program that combines the nursing and midwifery. In other words, you don't have to go back and take a four year nursing degree to get into the midwifery program.
Some nurse-midwifery programs are open to AD (associate degree) RN, which also takes less time to complete than the four year nursing bachelor's degree. These programs will allow you to do one of the following:
- Earn a baccalaureate degree and certificate in nurse-midwifery
- Earn a baccalaureate degree and master's degree in nurse-midwifery
- Earn a master's degree in nurse-midwifery.
Length of training and the actual degree earned varies by institution.
Direct-entry midwifery programs can take up to 2 1/2 years to complete, but some programs are much shorter. Several programs are accredited to prepare students to become certified professional midwives (CPMs). Neither of these estimates takes into account the time necessary to complete prerequisites for admission into a particular program.
Advantages to a Nurse-to-Midwife Career Transition
Perhaps the biggest advantage is that the certified nurse-midwife credential (CNM) is recognized nationally and accepted as legitimate in every state. CNMs are welcomed into many hospital systems as maternity care providers, whereas direct-entry midwives often are not.
An aspiring midwife needs to examine all of the differences between nurse-midwifery and direct-entry midwifery before settling on the appropriate route of entry for her or himself. These differences range from the philosophical (working inside or outside of the medical model) to the pragmatic (making a living in a chosen community).
Sources:
Jones, Rosemary. Educational and Career Opportunities in Alternative Medicine. 1999-2007.
Kate McConnell, from the Seattle Midwifery School, 2007.
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