Licensed Mid-wives - Amazing Babies

The United States faces a deepening crisis in the quality, cost and availability of health care. Maternity care in particular reflects the basic inefficiencies of the current model – on the one hand too many women receive unnecessarily expensive care due to the overuse of technology, while others cannot access even the most basic services. Midwives are poised to address this problematic distribution of care by providing essential health services that result in excellent outcomes at lower cost than typical care. Any plan for health reform should include support for and expansion of midwifery services.

Certified Professional Midwives (CPMs) are a fast-growing segment of the midwifery profession in the United States today. Certified Professional Midwives are trained and credentialed to offer expert care, education, counseling and support to women for pregnancy, birth and the postpartum period. They have particular expertise in out-of- hospital settings. CPMs practice as autonomous health professionals working within a network of relationships with other maternity care professionals who can provide consultation and collaboration when needed.

The purpose of the CPM Issue Brief is to provide information about Certified Professional Midwives: their qualifications, philosophy and scope of practice; the best available evidence regarding the safety and quality of their care; and a brief exploration of how increased utilization of their services will address America’s health care needs.

Click here to download a pdf of the CPM Issue Brief.

What is a Certified Professional Midwife?

A CPM is a direct-entry midwifery practitioner who has met all the certification standards set by the North American Registry of Midwives (NARM). What distinguishes a CPM from other nationally certified midwives is that CPMs primarily attend to out-of-hospital births and are trained via a competency-based model of education. NARM recognizes competency-based education as the optimal model for educating maternity care providers practicing in out-of-hospital settings because it is the only model that requires clinical experience in out-of-hospital settings, continuity of care, and risk assessment skills, which are required to determine when referral, collaboration or consultation with a physician is necessary.

WHAT IS A COMPETENCY-BASED CREDENTIAL?

A competency-based credential is the outcome of a competency-based educational program. The defining characteristics of a Competency Based Education program are:

Competencies to be demonstrated by the student are role-relevant competencies determined through job analysis.
Criteria to be employed in assessing competencies are explicit in stating levels of mastery (standards) under specified conditions.
Competencies are specified to students prior to instruction.
Criterion-referenced measures are used to measure the achievement of competencies.
A system exists for documenting the competencies achieved by each student.

The Certified Professional Midwife (CPM) clearly exhibits all the required characteristics of a competency-based program. Regardless of the educational pathway chosen-apprenticeship, post-secondary education, adult education, at-a-distance education, or a self-paced program-student competency attainment remains the objective. The assessment component of the program provides evidence that successful passage of the national CPM examination ensures that entry-level competence has been attained.

IS THE CPM A RECOGNIZED CREDENTIAL?

Yes... The North American Registry of Midwives (NARM) is an international certification agency whose mission is to establish and administer the credential called the Certified Professional Midwife (CPM). NARM was created in 1987 by the Midwives Alliance of North America (MANA) and is committed to identifying standards and practices that reflect the excellence and diversity of the midwifery community. The guidelines for certification were developed through a series of certification task force meetings and the 1995 Job Analysis of the Role of Direct-entry Midwives, which was based on the MANA Core Competencies. The NARM Written Examination, Skills Assessment, and the CPM credential follow the psychometric guidelines and standards for excellence formulated by the National Organization for Competency Assurance (NOCA). The NARM Written Examination is used as the regulatory examination in twenty-four (24) states that offer direct-entry midwifery regulation.

A BRIEF OVERVIEW OF THE CPM CREDENTIALLING PROCESS:

Students successfully complete an education program accredited by the Midwifery Education Accreditation Council (MEAC); receive certification as a CNM or CM from the American College of Nurse Midwives Certification Council; or, complete the NARM Portfolio Evaluation Process (PEP), a competency-based evaluation process developed to assess an applicant's apprenticeship or self study education.
PEP is designed to validate that a candidate has the necessary knowledge, skills, experience, and ability for entry into the profession of midwifery. MEAC programs, the PEP process and the CPM credential are all based on the MANA Core Competencies and the extensive 1995 Job Analysis, which serves as the psychometric underpinning for the NARM Written Examination and the Skills Assessment.
All candidates must demonstrate successful completion of 1350 contact hours of clinical experience. The clinical component must be at least one year in duration and must include 75 prenatals, 20 intrapartals, 40 postpartals and 20 newborn care by a student midwife acting as a primary midwife under the supervision of one or more perceptions. Ten of the 20 births must occur in out-of-hospital settings, and a minimum of three must be with women for whom the student has provided care during at least four prenatal visits, birth, newborn exam and one postpartum exam.
Students who have chosen to use PEP to evaluate their apprenticeship or self-study education must pass the Skills Assessment.
All CPM candidates must pass the NARM Written Examination
All CPMs must meet re-certification.

The demand for home and birth center births is on the rise.
This is due in part to the increasing number of women and families who want less routine technological intervention and a more cost effective, family oriented birth setting.
The advantages to a home birth or birth center setting include:

more and better opportunities for the care provider to engage in nutritional and basic health education
no exposure to anesthetics that interfere with neonatal neurological development
less exposure to bacteria and viruses that proliferate in a hospital environment
less disruption of bonding for mother, baby and family
elimination of unnecessary hospital expenses for a normal life event

If you would like additional information about becoming a Certified Professional Midwife, please go to www.NARM.org and www.NACPM.org

If you would like information about earning a Midwifery Degree at one of the only California-accredited degree-granting programs, please go to the National College of Midwifery www.midwiferyeducation.org

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