The Practice of Nurse-midwifery in the United States


Book Description

The use of nurse-midwives for the maternity care of mothers has been very limited in the United States as compared to other countries. However, during recent years, interest in the nurse-midwife has increased as her potential for helping to extend and improve the quality of maternity care has been recognized. The purpose of the study presented here was to look closely at the extent of midwifery practice in the United States and, at the same time, to describe its nature and scope.







Clinical Practice Guidelines for Midwifery & Women's Health


Book Description

Clinical Practice Guidelines for Midwifery & Women's Health, Sixth Edition is an accessible and easy-to-use quick reference guide for midwives and women’s healthcare providers. Completely updated and revised to reflect the changing clinical environment, it offers current evidence-based practice, updated approaches, and opportunities for midwifery leadership in every practice setting. Also included are integrative, alternative, and complementary therapies.




Careers in Midwifery


Book Description

SOME SAY MIDWIFERY IS THE world's oldest profession. You likely know what midwives do: they deliver babies. They have been doing that since the beginning of human history. Throughout the millenniums, midwifery knowledge and skills were passed down from one generation of women to the next. By contrast, today's midwives are highly trained and licensed healthcare professionals with the expertise to help women stay healthy before, during, and after pregnancy. They share a holistic philosophy of care that encourages a more natural approach to childbirth, free of medications, incisions, and other invasive procedures. There are two basic categories for American midwives: certified nurse midwives (CNMs) and direct-entry midwives (DMs). The main difference is the level and type of training. CNMs are registered nurses (RNs) who have earned a graduate level degree in midwifery. Their nursing training allows them to provide a broad range of services. A CNM can be a primary caregiver, managing a woman's health throughout her lifespan from adolescence through menopause. In fact, CNMs only spend about 10 percent of their work time on dealing with childbirth. DMs are also highly trained, but they are not nurses. They are limited by what they can do and therefore, focus solely on the childbearing process. The vast majority of midwives are CNMs. Though the requirements and procedures vary, every state licenses CNMs. Most work in hospitals and that is also where most babies delivered by midwives are born. By contrast, DMs account for only 10 percent of midwives. A number of states prohibit their practice and they rarely work in hospitals. They largely work in settings outside of formal medical care facilities, including women's homes. In many areas of the country, they are welcomed because their services are badly needed.Both CNMs and DMs are in demand and the future looks exceptionally good. Women of all backgrounds are rejecting the outdated notion that childbirth is a pathology that requires medical intervention. The result is a projected increase of over 30 percent in jobs for midwives in the coming years, which is four times greater than the average job growth rate for all occupations combined. Demand will be higher in inner cities and rural areas, but opportunities are everywhere. The level of salaries typically follows the level of demand and midwifery is no exception. American midwives earn a comfortable living with a median annual income of $100,000. Individual earnings vary by location, training, work setting, and other factors. The salary range of the majority is between $80,000 and $120,000. Midwifery is an ancient practice that combines old wisdom and current scientific research. It is a messy business that can be exhausting and stressful at times. Bringing beautiful new babies into the world is a vocation that offers unique rewards to those who answer the call.




Nurse Midwifery


Book Description




State Regulation of Practice and the Utilization of Certified Nurse-midwives for Medicaid-funded Prenatal Care


Book Description

In response to the continuing high percents of low birth weight and premature birth in the United States, one of the goals of Healthy People 2010 is for 90% of pregnant women are to receive prenatal care beginning in their first trimester of pregnancy. The aims of this descriptive correlational design health policy study utilizing multiple secondary data sets were to: (1) describe any association between a state's CNM Scope Index score and the proportion of Medicaid funded services delivered by CNMs in each of the fifty states of the United States; (2) describe any association between a state's CNM Scope Index score and the proportion of Medicaid-funded prenatal care delivered by CNMs in exemplar states representing the extremes on the Scope of Practice Index; (3) describe the category of regulation of practice (legal status, reimbursement policies, or prescriptive privileges) within the index that has the greatest association with the proportion of Medicaid-funded services delivered by CNMs; and (4)describe which of the factors within the most influential category had the greatest association with the proportion of Medicaid-funded services delivered by CNMs. The four key findings were: (1) there is a paucity of data related to individual and specific Medicaid funded services provided by nurse-midwives; (2) states with the fewest barriers to practice have the greatest proportion of CNM births; (3) states with the most restrictive practice regulation also have the highest proportion of vulnerable populations (minority and populations in poverty) and higher percents of adverse perinatal outcomes (low birth weight, premature birth, and neonatal mortality); and (4) states with the greatest autonomy in three areas: professionalism (legal status), business practices (reimbursement), and clinical practice (prescriptive authority) may have the greatest access to care for vulnerable populations. Future studies should focus on improving research methodologies in the areas of state regulation and outcomes of nurse-midwifery practice, specifically those related to data collection. Health policy implications fall into three categories: organizational policy related to research and nurse-midwifery practice, regulation of nurse-midwifery practice, and access to nurse-midwifery care for vulnerable populations of women.










Education for Nurse-midwifery


Book Description