Certified Nurse Midwife profession (CNM)

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SCOPE OF PRACTICE

The nurse-midwife is prepared both academically and clinically to provide a broad range of health care services for women and newborns. CNM functions include diagnostic services (history taking, physical assessment, ordering appropriate laboratory tests and procedures), therapeutic management (outlining care, providing prescriptions, coordinating consultations and referrals), and health promotion and risk-reduction activities.

Although the majority of CNM practice may focus on childbearing, family planning, and gynecological care for well women, CNMs may also assess and manage common illnesses in adults. All services are performed in collaboration with the client.

As with the nurse practitioner profession (NP), CNMs are legally allowed to write prescriptions in some states but not others. Health care management by CNMs includes independent management, consultation or co-management, and referral services.

PRACTICE SETTINGS

Certified nurse-midwives may be found in a variety of settings including private outpatient practices (either by themselves or in collaboration with a physician), health maintenance organizations, hospitals, health departments, and freestanding birthing centers. Traditionally, CNMs have provided care to underserved populations in rural areas or inner-city settings.

REGULATION OF THE PROFESSION

As with many other professions, certified nurse-midwives are regulated at two different levels. Licensure is a process that takes place at the state level in accordance with specific state laws. In contrast, certification is established through a national organization and requirements for minimal professional practice standards are consistent across all states.

Licensure: Much like other advanced practice nurses (such as nurse practitioners), licensure requirements for CNMs may vary somewhat from state to state. The current trend is to require master's degree preparation and national certification.

Certification: National certification is required in some states for CNMs to be licensed to practice. Only graduates of nurse-midwifery programs accredited by the American College of Nurse-Midwives (ACNM) are eligible to take the certification exam administered by the ACNM Certification Council, Inc.

Review Date: 08/08/2005
Reviewed By: Sharon Roseanne Thompson, M.D., M.P.H., Clinical Fellow, Department of Obstetrics & Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.