When I began to consider becoming a midwife, I really didn't know where to begin - so I did what anybody else would do - I googled it. "How to become a midwife." The next month of research showed me just how little I knew about midwifery - and I'm not talking about the pregnancy/delivery part - I'm simply referring to the term "midwifery." I'll try to sum up in very basic terms what I learned, just in case any of you are interested.
There are two basic types of midwives: direct entry midwives and nurse midwives.
Let me begin with direct entry midwives. They have many titles depending on their education, licensing agency, and sometimes personal choice. Some of these titles include Certified Professional Midwife (CPM), Licensed Midwife (LM), Direct Entry Midwife (DEM). Occasionally midwives choose to go without licensing, and in some areas direct entry midwifery is actually illegal.
Direct entry midwifery has been going through some dynamic change during the past several years. Traditionally direct entry midwives learned their trade through apprenticeships and self-study. In the past several years, several organizations have begun the process of formalizing the training a midwife receives while still holding onto the valuable hands-on skills she gains from apprenticeships. Now, in order to hold one of the above titles, a midwife must study and apprentice and then pass an exam. Most licensing agencies, including the Texas Department of Health and Human Services, uses the NARM (National Association of Registered Midwives) -http://www.narm.org/ - exam which would be equivalent to passing an all encompassing exam in other professions like law or nursing. In order to be registered with NARM, a midwife must meet several criteria including passing the written exam and a hands-on skills exam and attending 20 births as an active attendant and 20 additional births as a primary under supervision.
A direct entry midwife primarily practices in homes and/or birth centers, but not hospitals. Although, if a client needs to transfer to a hospital a midwife should submit her charts to the attending physician and can possibly stay as the woman's labor assistant. A direct entry midwife does not generally carry malpractice insurance. The availability of such is limited and most direct entry midwives have opted not to carry the insurance because of the prohibitive cost - desiring to keep costs low for their clients. Most direct entry midwives act on the belief that by only assisting low-risk women and by developing a in-depth, personal relationship with a woman and her family, the risk of lawsuits are greatly diminished.
A nurse midwife's training differs considerably. A nurse midwife is first a nurse, having attended and graduated from nursing school and gone on to work as a nurse for a period of time. Following that, she may apply to nurse midwifery school to obtain her master's in midwifery. Upon graduation she is a nurse midwife.
Generally nurse midwives practice in hospitals or birth centers. The lack of malpractice insurance that covers nurse midwives practicing in home birth situations has limited their availability in that arena.
There are lots of opinions about which type of midwife is the best. Studies have shown the safety of both representatives, so my recommendation is to interview a few different midwives, pray about it, and go forward with the person that seems to suit you best. By the way, midwifery needs all the support it can get from the grassroots level to add your voice to the mix, go to the Citizens for Midwifery http://www.cfmidwifery.org/ site.
*Sorry for my links...I couldn't get them to work right, so I just typed the addresses into my post.
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