Certified Nurse-Midwife (CNM): Advance Practice Nursing

Certified Nurse-Midwives are described as advanced practice nurses where their roles are expanded but with particular focus on care of women’s, child, and family health.  The American Nurses Association (ANA) contend that CNMs can provide “services to women and their babies in the areas of prenatal care, labor and delivery management, postpartum care, normal newborn care, well-women gynecology, and family planning.”

Nurses with this advanced practice role provide primary care for women, newborn, and infants.  Essential factors of primary care and case management such as assessment, treatment, evaluation and referral as required are incorporated by the CNM as part of being a primary care provider.  CNMs practice is independent, comprehensive management of women’s health care in a variety of settings focusing particularly on childbearing, childbirth, childrearing, postpartum care, family planning, and gynecologic needs of women throughout the life cycle.  While it is independent, CNMs also practice in collaboration with the physician when necessary and this depends primarily on the needs of the individual woman or infant and the practice setting.  As nurses having an expanded roles, CNMs receive an average annual base pay of $90,00 to $100,000 (USD).

Issues abounding the practice of CNMs include the overlapping of functions of registered midwives, registered nurses, and even physicians.  The American College of Nurse –Midwives (ACNM) established in 1955 sets forth the standards for practice and education in the United States while the American Midwifery Certification Board (AMCB) establishes and maintains the certification standards.  Many states required a certification from the AMCB for licensure, and many institutions require an AMCB certification to grant practice privileges.  Although there may be differences in the practice per state specifications, the following are the general functions of Certified Nurse-Midwives:

  • Attend to cases of normal childbirth
  • Refer birthing complications to the physician
  • Assisting childbirth by any artificial, forcible, or mechanical means
  • Dispense medications, except controlled substances
  • Perform episiotomies and repair of lacerations of the perineum
  • Treating STDs
  • Providing Health Education
  • Others, as may be state specific

In the Philippines, nurses who intend to expand their capabilities may opt to comply with the necessary requirements and take the licensure examination for midwives.  Being a Registered Nurse and a Registered Midwife however, does not constitute a professional to become a CNM as there is not a clear-cut certification for this effect.  While a professional holds both licenses (RN, RM), the professional must abide by the practice acts for each and at same time, act only on the scope of practice of the field he or she is employed.

Byron Webb Romero, RN, MSN

Finished BSN at Lyceum of the Philippines University, and Master of Science in Nursing Major in Adult Health Nursing at the University of the East Ramon Magsaysay Memorial Medical Center. Currently working at Manila Doctors College of Nursing as a Team Leader for Level I and II, Lecturer for Professional Nursing Subjects, and also a Clinical Instructor.

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