labor nurse has been reborn and shares her experiences as a new nurse-midwife, woman, and blogger

Tuesday, June 3, 2008

A Board

I recently learned that the Commonwealth of Massachusetts has legislation underway that would create a Board of Midwifery. I had no idea that this was something that was in the state legislature, and was happy to hear about it. I have not done much research on it, but from what I understand this Board would regulate all midwives in the state. This includes CNMs, CMs, and CPMs. Currently, only CNMs can practice legally in the state. If this Board legislation goes through, which apparently has made it quite far and it is looking promising, then the creation of CM and CPM licensure would follow. This would allow for women in Massachusetts to "legally" choose the women's health provider of her choice.

As you can imagine, ACOG opposes this Board. They seem to be ok with CNMs practicing under the current nursing regulation as they provide "a valuable service to our (ie, the doc's) patients" but think CMs and CPMs are under qualified to "practice medicine". Which completely boggles my mind given the fact that all midwives, CNMs, CM, and CPMs, practice midwifery. In the Act put out by ACOG, there are some talking points for physicians in Massachusetts to discuss with their local representative. They state that CPMs, also known as lay midwives according to ACOG, only need to do 10 births as an apprentice. Is this true? Again, I have not researched this, but I had thought that CPM apprentices are required to attend 100 births or something like that. That is more than CNM and CM students are required for graduation as the ACNM only requires 20 births. I admit I am completely ignorant to the educational standards of CPMs so any information you can share with me is appreciated.

Regardless, I hope that this bill makes it to law. Establishing a board of midwifery in Massachusetts would open the door to more states doing the same. Perhaps midwives throughout this country could completely cut regulatory bureaucracy that restricts their practice....I hope to see this in my career.


~*Spindelicious Handspun*~ said...

haha! ACOG...always good for a laugh.
Here's the clinical requirements to graduate from the Seattle Midwifery school (where I hope to go):
Participation in 60 births, including at least:
30 births in which the student functions in role of primary midwife under supervision
20 births in which the student is actively involved in the client’s care
10 births in which the student is observing
30 births in an out of hospital setting
25 births in the US or the student’s country of origin
an additional 40 observed births (total of 100 births) for Washington State licensure

Participation in 1,500 hours (the equivalent of 50 credits) of clinical work, including at least:
400 hours of intrapartum care provided by the student
800 hours of clinic time in prenatal, postpartum and gynecological care

Participation in 720 client contacts, including at least:
300 prenatal exams
100 postpartum visits
50 newborn exams
50 follow-up newborn exams
50 gynecological exams

Clinical training for at least one year at a minimum of two clinical sites in the US or the student’s home country. All clinical training is with adjunct clinical faculty who are practicing legally in their region and will incorporate:
at least one preceptorship in which the clinical faculty member is a midwife
one site for at least six months and 15 births in an out of hospital setting
one site for at least three months and 10 births.

As you can see it's much more than 10 births. :)

womantowomancbe said...

Some midwifery sites you can explore for more info include and and This page from NARM says that CPM applicants must attend a minimum of 20 births as an "active participant" (I guess as an apprentice, doula, or monitrice?); and they mast attend a minimum of an additional 20 births functioning in the role of a primary midwife. This is in addition to providing a certain number of prenatal, newborn, and postpartum exams.


Angi said...

Oh I hope this passes! Ohio is a lemming state. (usually not for our betterment) If your bill passes, we can't be far behind!

womantowomancbe said...

I posted something already, but it didn't come through, so I'm trying this again, in case I messed up. :-) (So if this is a duplicate, please delete!)

The number of births an apprentice midwife is required to attend for certification may vary based on the state she is certified in, or based on the curriculum she takes. You can check out the Midwives Alliance of North America; the North American Registry of Midwives, and Citizens for Midwifery for more info (I'm not putting in links in case it makes it go to spam, but you can google these names). What I read yesteray (I think from NARM), is that apprentice midwives have to be involved in 20 births (I guess as a doula or assistant to the midwife), and then be in the role of primary midwife for an additional 20 births, prior to certification. They also have to do a certain number of prenatal, postpartum, and newborn exams. Because of the number of newborn exams (I think it was 75), they are likely to have to attend that many births, unless they show up soon after.

Hope this helps!


I am a Monkey's Mama said...

Once again, a trade union looking out for its own survival...scared to death that someone might actually find out that midwifery care is superior to OB/GYN care for low risk women...gosh, to think that OB/GYN's might one day only deal with surgical patients who really, actually, and truly need surgery.

A girl can dream, right?