Midwifery Education and Certification
in the United States
Definitions
ACC—The ACNM Certification Council, Inc. is a national certifying body which developed and administers the certification exam for CNMs and CMs. ACC is responsible for writing and administering the national nurse-midwifery board exam and awards nurse-midwifery certification to eligible candidates.
ACNM—The American College of Nurse-Midwives is the national professional membership association representing certified nurse-midwives, certified midwives, student nurse-midwives and student midwives.
CM—Certified Midwife, certified by the ACNM Certification Council, Inc. This is the ACNM version of a DEM. New in the mid-1990s. They take the same certifying exam as CNMs.
CNM—An individual educated in the two disciplines of nursing and midwifery who possesses evidence of certification according to the requirements of the ACNM. The majority of CNMs specialize in and provide in-hospital maternity care.
CPM—A Certified Professional Midwife is an independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the Midwifery Model of Care. The CPM is the only international credential that requires knowledge about and experience in out-of-hospital settings. A CNM may also be a CPM.
DEM—Direct-entry midwife; a midwife who is not a certified nurse-midwife: includes CMs and CPMs. Legality of their practice varies from state to state, ranging from legal and regulated, alegal to clearly prohibited. Most provide out-of-hospital maternity care and view birth as a non-medical event. Also may be known as a "lay", "traditional" or "licensed" midwife.
MANA—The Midwives Alliance of North America is a membership organization open to all types of midwives in the United States, Canada and Mexico.
NARM—North American Registry of Midwives is an international certification agency whose mission is to establish and administer certification for the credential "Certified Professional Midwife" (CPM). The certification process encompasses multiple education routes including apprenticeship, self-study, private midwifery schools, and college/university midwifery education.
Nurse-Midwifery and Direct Entry Midwifery
Although CNMs, CMs and DEMs have different backgrounds, different levels of experience and legal standing, all groups statistically have excellent outcomes. For a low-risk pregnancy, it is as safe, or safer, for mother and baby to give birth with a nurse-midwife or a direct-entry midwife in any environment than with a physician in a hospital. Despite research-based reassurance, many people would like to see certification or licensure of midwives to ensure public safety. This is the main thrust behind the movement of DEMs to become CPMs.
CPM Education/Certification
- Most DEM/CPMs value
the apprenticeship model of midwifery education.
- CPMs may get their
education through apprenticeship, self-study, private midwifery schools,
and/or college/university midwifery education.
- CPM education and experience
focus on out-of-hospital birth and continuity of care.
- NARM recognizes that the education of a Certified Professional Midwife (CPM) is composed of didactic and clinical experience. The clinical component of the educational process is at least one year in duration, and includes a minimum of 1350 clinical contact hours under the supervision of one or more preceptors.
ACNM and Nurse-Midwifery Education
In order to be certified by the ACNM Certification Council, Inc., a person must successfully complete the national certification examination. The eligibility requirements for application to take the national certification examination as defined by ACC are:
- Licensure (active when applied) as Registered Nurse in one of the 50 states, the District of Columbia, or U.S. territories.
- Satisfactory completion of a program in nurse-midwifery (or in a Master's Program, satisfactory completion of all basic nurse-midwifery theoretical and clinical requirements of the nurse-midwifery component) accredited by or with pre-accreditation status from the Division of Accreditation of the American College of Nurse-Midwives.
- Signature by the director of the nurse-midwifery educational program on test application form attesting that the candidate has satisfactorily completed the nurse-midwifery component of the program.