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Looking at licensing, regulation and discipline within the midwife profession, P.1

For any expecting mother, planning for labor and delivery is important not only to calm anxieties about the birth process but also to ensure everything goes as smoothly as possible with the medical professionals who will be assisting her. Most women, of course, choose to deliver in hospital settings, but there is a small percentage that chooses to deliver at home with the help of a midwife.

As a recent New York Times op-ed pointed out, not every midwife receives the same degree of training and has the same certification. One basic distinction is between certified nurse midwives (C.N.M.s) and certified professional midwives (C.P.M.s). Certified professional midwives receive significantly less training to obtain their certification than certified nurse midwives, and yet they are most often the midwives assisting those who choose to have home births. The argument is that this is why home birth is generally more risky. 

Some advocate the abolishment of the C.P.M. designation and moving toward a system where all midwives in the United States meet international standards. As it is, different states have different rules regarding midwife regulation and licensing. New York State, for example, requires all practicing midwives to be licensed and has uniform standards for licensing. C.P.M.s can be licensed as midwives in that state, but only after meeting established standards.

Minnesota specifically regulates two types of midwives: certified nurse midwives and licensed traditional midwives. According to the Minnesota Midwives Guild, midwife licensure is voluntary in Minnesota. Midwives may therefore choose to be licensed, but may still practice legally without pursuing licensure. A midwife who is not licensed still has legal responsibilities, particularly with respect to scope of practice, and is regulated by the Minnesota Nursing Board. Midwives who choose to be licensed, on the other hand, practice under the supervision of the Board of Medical Practitioners.

In our next post, we’ll continue looking at this topic, particularly with respect to discipline within the midwifery profession.

Source: The New York Times, “Why Is American Home Birth So Dangerous?,” Amy Tuteur, April 30, 2016.

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