While nurses who work in labor and delivery might deliver a baby if the doctor doesn't make it into the room fast enough, the only nurses specifically trained and legally allowed to deliver babies are certified nurse-midwives, also known as CNMs. Certified nurse-midwives assist at around 8 percent of all deliveries in the United States, according to the American college of Nurse-Midwives. Certified nurse-midwives advocate for client-driven birth choices with minimal medical intervention.
Certified nurse-midwives require additional years of post-graduate training in addition to a bachelor degree. Certified nurse-midwives must also pass the boards for certification as a registered nurse before starting CNM education. Many CNMs work in labor and delivery or another woman-centered field before going back to school for their master's degree to become a certified nurse-midwife. A master's degree became the standard for entry into CNM practice in 2010. After graduation, passing the American Midwifery Certification Board examination grants the practitioner the title of certified nurse-midwife.
Most CNMs work either in a hospital or birthing center, although some do home deliveries in states where home deliveries are legal. Around 96 percent of all CNM births occur in a hospital, with 2 percent occurring in free-standing birth centers and 1.8 percent occurring at home, according to the American College of Nurse-Midwives.
Certified nurse-midwives don't spend all day in a birthing room. Most work in group practices where they divide their time between seeing patients in the office and being on-call for the hospital or birthing center. Certified nurse-midwives also do well-woman check ups, performing Pap tests, breast exams and other routine gynecological care. Certified nurse-midwives can write prescriptions in all 50 states. Around 33 percent of CNMs state that primary care is the main focus of their practices, the American College of Nurse-Midwives reports.
Certified nurse-midwives can't perform major surgery such as Cesarean deliveries. If a client needs a Cesarean, the CNM must transfer care to a physician. A CNM can do minor surgical procedures, such as repairing a vaginal tear or episiotomy after birth. Because CNMs specialize in caring for low-risk pregnancies, women with high-risk pregnancies might need the care of a physician.
A registered nurse with more than 25 years of experience in oncology, labor/delivery, neonatal intensive care, infertility and ophthalmology, Sharon Perkins has also coauthored and edited numerous health books for the Wiley "Dummies" series. Perkins also has extensive experience working in home health with medically fragile pediatric patients.