Thinking of Using a Nurse-Midwife?
What is the difference between a nurse-midwife, midwife, and doula?
Certified nurse-midwives (CNMs) are licensed healthcare practitioners educated in the two disciplines of nursing and midwifery. They provide primary healthcare to women of childbearing age including: prenatal care, labor and delivery care, care after birth, gynecological exams, newborn care, assistance with family planning decisions, preconception care, menopausal management and counseling in health maintenance and disease prevention. CNMs attend almost 8 percent of the births in the United States. 96 percent of these births are in hospitals.
A certified midwife (CM) is an individual educated in the discipline of midwifery, who also possesses evidence of certification by the American Midwifery Certification Board. Like CNMs, the CM provides primary healthcare to women of childbearing age including: prenatal care, labor and delivery care, care after birth, gynecological exams, newborn care, assistance with family planning decisions, preconception care, menopausal management and counseling in health maintenance and disease prevention.
The overwhelming majority of midwives are either CNMs or CMs. Still, a variety of titles are used to label midwifery practice so it can be confusing for consumers who want to determine just what qualifications have been met by their midwife. ACNM believes that, in the United States, all midwives should graduate from an accredited midwifery education program that is affiliated with an institution of higher education. All CNMs and CMs have earned at least a bachelor's degree, while over 80 percent hold a master's degree or higher. ACNM also believes that midwives should be licensed to practice and should provide their clients with a safe mechanism for consultation, collaboration and referral if needed. Because standards for the education and practice of midwifery may vary, we urge consumers to carefully evaluate credentials and look for a well-educated provider who allows direct access to medical care if needed.
The doula's role is to provide physical and emotional support to women and their partners during labor and birth. A doula offers information, assistance and advice on topics such as breathing, relaxation, movement and positioning. Perhaps the most crucial role of the doula is to provide continuous emotional reassurance and comfort. Doulas do not perform clinical tasks, such as vaginal exams or fetal heart rate monitoring. Doulas do not diagnose medical conditions or give medical advice. Doulas and midwives often work together as their philosophy and practice is complementary. At times, midwives need help because of the complex course of labor or the competing needs of more than one woman, which makes the doula-midwife team a wonderful option.