Direct-Entry Midwifery

Direct-entry midwives help women through the childbirth process in non-hospital settings. Explore midwife job duties, education requirements, certification, employment outlook and salary to make an informed career decision.

Is Direct-Entry Midwifery for Me?

Career Overview

Midwives are health professionals that provide medical care to expectant mothers, assist during deliveries and offer postpartum advice for childcare. The direct-entry midwife generally works outside the hospital setting, such as in a client's home or a birthing center. Midwives often provide routine gynecological care for women as well.

Specializations

Many midwives begin as nurses with hospital-based training in the delivery of babies. Upon certification, these midwives are known as Certified Nurse Midwives (CNMs). As a direct-entry midwife, you do not have to attend nursing school, but may become a Certified Professional Midwife (CPM). As a CPM, you'll be qualified in the Midwives Model of Care that encompasses monitoring the social wellbeing of the mother, as well as her physical and psychological wellbeing. This model of care also focuses on individualized counseling, education and prenatal care, as well as assistance during labor, delivery and the postpartum period.

Heavy emphasis is placed on the natural processes of pregnancy and the minimization of technological intervention during childbirth. However, the CPM is also responsible for identifying women who require more advanced care and referring them to an obstetrician if necessary. Most midwives are self-employed and generally provide care at the patient's home or in a private office.

Salary and Employment Outlook

The U.S. Bureau of Labor Statistics (BLS) expects job opportunities for nurse midwives to increase by 29% between 2012 and 2022 (www.bls.gov). The BLS also reported that nursing midwives earned a median income of $92,290 in 2013. This figure did not differentiate between CNMs and CPMs.

How Can I Become a Direct-Entry Midwife?

Education Programs

Direct-entry midwifery does not require that you complete traditional nursing training and is an independent field. Education is obtained through apprenticeships, hospital programs and colleges. Master's and doctoral programs in direct-entry midwifery are available at institutions specifically accredited to distribute graduate degrees. Programs cover a range of subjects, such as patient care, delivery procedures and medical terminology. Clinical experience must take place under the supervision of a preceptor and includes prenatal, intrapartal, postpartal and newborn care.

Licensing and Certification

While there is national certification for midwives, there is no national licensing. Licensing is administered by the state. However, not all states offer licensing, and the legalities vary from state to state. Certification for the CPM is offered through the North American Registry of Midwives (NARM) and is a requirement for licensing in some states (www.narm.org). All nurse midwives must be registered nurses as well.

To be eligible to sit for the CPM exam, you must graduate from a program accredited by the Midwifery Education Accreditation Council (MEAC). A human anatomy and physiology course is a requirement for most programs. Certification demonstrates that you have the competence and skills necessary to practice as a midwife. For CPM certification, at least one year of clinical experience, as well as an apprenticeship is necessary. The average apprenticeship last from three to five years and must be conducted under the supervision of a preceptor.

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