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.
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