Advanced Practice Corner: Certified Nurse Midwives

August 29, 2019
nurse midwives

Q: Tell us about yourself.

A: I have been a midwife for about 8 years. In 2014, I was hired by Swedish Issaquah to start their midwifery program alongside a small group of peers. Our clinic originally opened with 2 midwives and, today, we have grown to 6 FTE midwives plus several per-diem midwives. As a team, we manage approximately 35-45 births per month including all prenatal, delivery, and postpartum care.

Q: Why did you choose to become a certified nurse midwife?

A: Unlike many CNMs, I did not previously work as a nurse. In fact, I spent 14 years teaching science and health to middle- and high-school students prior to nursing school. I always felt it was my calling to be a nurse midwife so I went back to nursing school at the University of Washington and graduated with my master’s degree at the age of 40.

Q: What is the process and training required to be a certified nurse midwife?

A: All CNMs are nurses first. After completing a Bachelor of Science degree in Nursing (BSN), CNMs complete an advanced degree in nursing practice. This additional education can be either a master’s degree or a Doctorate in Nursing Practice (DNP) and the programs provide a mix of classroom education and hands-on experience. Following graduation, CNMs take a board certification exam and complete any additional requirements to become a licensed CNM in their state of practice.

Q: Tell us a little more about what it’s like to be a certified nurse midwife.

A: It’s interesting because midwifery is the one of the oldest professions. However, it’s often still considered weird, odd, or “hippie” by many patients. In reality, our care is equally as safe for low-risk patients and can sometimes be more effective because we create strong relationships with our patients. Overall, midwives have lower cesarean section rates than obstetricians.

Midwives meet women where they are. Our philosophy is to be women-centered and we spend a lot of time getting to know each patient so they can be in charge of their own care. We have 30 minute appointments (new appointments are longer) so we can spend more time with our patients providing more education and ensuring we can answer their questions.  The midwifery philosophy of pregnancy and birth is that this is a normal, healthy part of life and our team works with each mom to meet their individual goals.

Q: What makes certified nurse midwives unique from other advanced practice nurses?

A: Only CNM/advance practice nurses provide 24 hour, 7 days a week, 365 days a year care. This makes midwifery a very intense and sometimes exhausting job. But caring for families throughout this important time of life is very rewarding. We see our patients 7 to 12 times during the 30 weeks they receive prenatal care, and at least twice more in the following 8 weeks. This allows for very special, and sometimes intense, relationships with our patients. We frequently see repeat clients, either for pregnancy care or for gynecology care in the years that follow.

Another unique aspect of midwifery is that we offer care in a group setting. CenteringPregnancy is an evidence-based model of care that many midwives, including the Swedish Issaquah midwifery group, offer as an option for prenatal care. Centering at Issaquah includes 9 prenatal group sessions where we sit together for 2 hours with a group of soon-to-be mothers and partners. During this time, moms have a quick, 5-minute “belly check” and then the group has 1.5 hours to ask questions and discuss any concerns related to their pregnancies and birth. This format allows me, as the care provider, to answer questions once (rather than during each individual appointment) and allows patients to learn from other patients. Centering is an evidence-based practice that not only creates life-long friendships for new parents, but it better prepares them for what to expect during their birth. It’s also a lot more fun!

Q: What do you enjoy most about being a certified nurse midwife?

A: Centering is one of my favorite parts of my job because it benefits everyone. Hospital nurses love centering because the patients are so well-prepared for their births. Patients love it because they build relationships with peers and feel more educated which makes them better-equipped to handle any situation that may arise at the hospital.  I love it because it's so fulfilling to watch each group grow from strangers to friends while sharing their prenatal care. It's almost a rite of passage in a way that families need as they grow.

Q: What advice would you give to someone interested in becoming a certified nurse midwife?

A: If you have an interest in caring for women, go for it! Midwifery is an incredible, intense, and highly-rewarding job. Just don’t do it for the hours because babies like to come at night J

Q: Is there anything else you would like to share?

A: A common misconception is that midwives are just for pregnant women. However, we are trained as primary care providers (PCP) so we take care of all women, including teens and women nearing menopause. In fact, I recently saw an 85-year old patient because her PCP wasn’t available that day. Even people who aren’t pregnant need a little extra TLC and patients often appreciate our longer visits and individualized approach to their care.