Understanding the Differences Between CPMs, CNMs, and OBGYNs

three women standing next to each other smiling at the camera

No woman forgets the moment when they first found out they were pregnant. As you stare down at all those little test sticks, it’s easy to be flooded with many emotions, from exuberance to fear. But, whether it was planned or unplanned, your pregnancy is a life-changing and beautiful moment in your life!

Once your pregnancy is confirmed, there will be many decisions to make. For first-time moms, this can feel a little overwhelming, especially when it comes to choosing your care team. Will you give birth at the hospital? Should you hire a midwife? What’s the difference between an OBGYN and a Certified Nurse Midwife? These are all common questions for new mothers navigating our healthcare system.

While the majority of American women in today’s world choose a hospital birth, that’s not the only option. In fact, the practice of midwifery for safe home births has been around for thousands of years. These days, women can make a birth plan that is safe, informed, and aligns with their goals and values whether or not birth is given at the hospital. It’s all about choosing the practitioner who feels most comfortable for you. 

In order to do so, we first have to address the differences between midwives (along with the different certifications they can hold), doulas, and OBGYNs.

So, what’s a Midwife?

woman catching a baby being born

Although an ancient profession, today we recognize a midwife as someone who has successfully completed a midwifery education program that is based on the International Confederation of Midwives (ICM) Essential Competencies for Basic Midwife Practice. 

The midwife is recognized as a responsible and accountable professional who works in partnership with women to give the necessary support, care, and advice during pregnancy, labor, and the postpartum period. They also conduct births on the midwife’s own responsibility and provide care for the newborn and the infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance, and the carrying out of emergency measures. 

What types of Midwives are there?

There are various titles for midwives across the United States, but the main ones we will focus on are Certified Professional Midwives (CPMs) and Certified Nurse-Midwives (CNMs). These are the two main paths a midwife can take to begin their professional career.

Certified Professional Midwife (CPM)

A Certified Professional Midwife is a specialist who has demonstrated competency in midwifery through an apprenticeship and has been certified by the North American Registry of Midwives (NARM). Licensure for CPMs differs in every state and is not offered in all states, in spite of the national CPM designation while CNMs can have licenses in every state. Check out birthservices.net for CPM view on licensure.

The certification for CPM does not require an academic degree, but NARM requires the educational process to be at least two years in duration and include a minimum of 55 births across three distinct categories. CPMs educational options include apprenticeship as well as formal schools.

The clinical education must be supervised by a nationally certified, legally recognized midwife who has practiced for at least three years and attended 50 out-of-hospital births post-certification.

CPMs can provide initial and ongoing comprehensive assessment, diagnosis, and treatment. They are trained to recognize abnormal or dangerous conditions requiring consultations with other healthcare professionals. They also conduct physical exams, administer medications, use devices as allowed by state law, and order and interpret laboratory diagnostic tests.

The majority of CPMs attend births in homes and birth centers.

Certified Nurse-Midwife (CNM)

certified nurse midwife measuring pregnant woman's belly

A Certified Nurse-Midwife is a registered nurse (RN) who has a master’s or doctorate degree in nursing along with the attainment of knowledge, skills, and professional behaviors identified by the American College of Nurse-Midwives. They receive their certification from the American Midwifery Certification Board, and their clinical education must be under the supervision of an AMCB-certified CNM who has preparation for clinical teaching, clinical expertise, and didactic knowledge.

Midwifery practiced by CNMs encompasses a full range of primary health care services for women from adolescence to menopause. This includes pre-conception care, care during pregnancy, childbirth, the postpartum period, newborn care, gynecologic care, and family planning services. CNMs can perform physical examinations, prescribe medications (including controlled substances and contraceptive methods), and order and interpret laboratory and diagnostic tests.

The majority of CNMs attend births in hospitals but also in homes, birth centers, and offices.

What is a Doula?

pregnant woman laying on the floor

A doula may also be involved in a woman’s birth plan, but one main difference is that doulas are not medical professionals. They do not deliver babies or provide medical care. A certified doula has taken a training program and passed an exam on how to best assist pregnant women and their families through childbirth and beyond.

If you work with a doula, they will most likely help you prepare for labor with relaxation and breathing techniques, answer any questions you have, help you understand the labor and delivery procedures, and help you during the first few weeks after birth. 

Doulas offer invaluable emotional care and support for first-time mothers, single mothers, or those who just want more guidance and assistance in the process.

How does an OBGYN differ from the above?

Hospital sign reading 'obgyn'

An OBGYN (short for obstetrician-gynecologist) is a medical doctor who specializes in women’s reproductive health, pregnancy, and birth. They have completed four years of medical school along with 3-7 years of residency and/or fellowship programs. An OBGYN is also surgically trained and can perform C-sections when necessary. 

OBGYNs almost always deliver babies in hospitals. They are the ones to manage high-risk pregnancies and any complications that might arise during delivery. A pregnancy is considered high-risk when the mother has a pre-existing medical condition like diabetes or high blood pressure, or if a woman is expecting twins, triplets, or other multiples.

How to Choose

Only the mother can decide what birth plan and birth team will be right for her. Before taking the leap, it’s important to identify what is covered under your health insurance plan. There are many insurances that do cover CPMs, depending on the state. For instance, Medicaid covers care with CPMs in the state of Alaska. Home births are typically not covered, and not all hospitals are covered under all plans. Contact your insurance and speak with member services to identify what is covered and where before you begin making any appointments. 

How the West Wing Can Help You

three women standing next to each other smiling at the camera

The West Wing is a team of Certified Nurse-Midwives (CNMs) who provide comprehensive prenatal care throughout pregnancy, as well as a full array of women’s services. Our team of Certified Nurse-Midwives are Nurses with a Master’s or Doctorate in midwifery. We are licensed as Advanced Nurse Practitioners and have full prescriptive authority. 

Our team has experience in a wide range of births using both holistic and medical approaches. We believe in supporting women through education and empowering them to make the best choices for themselves. We also offer childbirth classes and help women with vaginal birth after a cesarean. Whatever your situation, the West Wing is here to support your journey through womanhood. 

Why not make an appointment to meet with one of our Certified Nurse Midwives today? We’d love to be part of your journey!

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