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15 Questions To Ask Before Choosing a Midwifery Path and Program

Posted by Midwives Alliance on July 21st, 2015

What midwifery credential should I choose? How can I tell if a midwifery school is right for me? As a practicing midwife, I am asked these questions by potential students as they decide between becoming a certified nurse midwife or certified professional midwife and when trying to choose a midwifery program.

I have gathered together the 15 questions I often ask potential students to consider as they make their decisions. Give yourself a few minutes, jot down your answers, and don't think too hard about any one question! You might be surprised at some of your answers. I hope these help you find the path that is right for you.

Choosing a path

Where do you want to practice? Consider both the place of birth - home, hospital or birth center - and the state or states you want to practice in. Research the license/credential requirements for the state and place of birth you'd prefer.

Who do you want to serve? Teen mothers, low income families, a small rural community, a big city busy practice with other midwives - who do you dream of serving?

What are the laws concerning midwifery (and student midwifery) in your community? Is it legal for a CNM to attend home birth? Can CPMs practice legally? Where? Do you need to register with anyone? Do you need to be enrolled in a school program to attend births as a student midwife? Can CNM student midwives have an internship with an out of hospital midwife?

Do you want to be able to move about the country and work in a wide variety of settings? Nurse midwifery may be more flexible when moving a lot, and also has the advantage of being able to work as a nurse as well.

Choosing a program

Are you interested in a Nurse Midwifery program? a Certified Professional Midwife program? Portfolio Evaluation Process? or a MEAC (Midwifery Education Accreditation Council) approved program?

Are you able to relocate to go to midwifery school? Do you have the resources to move and attend a midwifery school in another community? Is there an at-distance or online alternative?

Are you able to organize yourself and learn independently? Would a program that offers few "extras" and where you would need to work independently be a good fit? Would you be more comfortable with a structured program, that includes a clear plan for success? Do you want to work with your local midwifery community to learn in an apprenticeship model? Do the programs you are looking at have "perks" - support groups, libraries, database search engines, writing labs, or other extras?

Do you enjoy group learning activities? Do the programs you are looking at offer an opportunity to build community with other student midwives?

Does the program you are interested in offer clinical internships in your own community? Is your local community large enough for you to find a midwife preceptor who can help you finish your clinical requirements? Do your local hospitals offer Nurse Midwife internships? Does your program help you find a preceptor?

Do you need to complete any portion of your academic program before beginning your clinical training? Some programs, and some mentor midwives require that you complete up to a year of academics before starting clinicals.

How many of the students who start the program or apprenticeship you are considering finish, and go on to pass the credential and/or licensing exams?

Finding your resources

What are your financial, emotional, spiritual resources? What is your community support like? Does your family support your chosen work? Can they manage living "on call" with you? Are they concerned about liability issues?

Do you need a midwifery program that has federal financial aid? Nurse Midwifery and some MEAC approved programs offer Federal Financial Aid. Some MEAC approved programs do not offer aid but are much less expensive than those that do.

Do you have the time necessary to commit to midwifery training? Do you have time in your life for rigorous academic and hands-on demands? Can you be on call? Part time or full time? How much flexibility do you need?

Will you need to work while you are in midwifery training? Is it realistic? What is the expectation of the midwife you are working with or the program you will be attending?


I hope these questions have helped you to become clearer about how to choose a midwifery path that is right for you. Becoming a midwife is often a winding path, challenging at times, but rewarding! Good luck to you all!


About the author

Treesa McLean, LM, is a homebirth and birth center midwife and has been involved in the birth community as a consumer, an advocate, and a birth professional for more than 30 years. She teaches a workshop "Becoming a California Licensed Midwife" and has been the preceptor for a number of student midwives.

Update from the States: Delaware CPM Legislation Passes House and Senate

Posted by Midwives Alliance on June 1st, 2015


New legislation will make it possible for CPMs to practice in Delaware

House Bill 70 was introduced and passed through both the Delaware House and Senate which will allow for Certified Professional Midwives and Certified Midwives to practice legally in Delaware without a written collaborative agreement beginning June 30, 2016. Since 1984 to present, CPMs needed a physician alliance and written collaborative agreement. This has prevented practice by all but one CPM who currently practices legally and has a written collaborative agreement. That practice currently is limited to serve only the Amish and Mennonite communities per the physician agreement.

Over the past 10 years, there has been continued education and community support for changes to be initiated in the current restrictions toward legal practice of CPMs. Through the many committee meetings with members of the medical community, State Board of Health, and legislators, discussion and education regarding the credentialing process of CPMs has become more clearly understood and accepted. Documents were submitted from numerous states where Certified Professional Midwives are working and valued as a safe option for out-of-hospital birth. Much discussion and work towards safe standards of care has been in process over the past year and now can start to be implemented once the Midwifery Council is designed and in operation. The Midwifery Council will draw up both standards of practice and scope of practice in the state which will then go to the Delaware Board of Medical Practice for approval.

Many thanks to the many members of the medical community, legislators, state board of health and families who were instrumental in helping this goal become realized. Also a special thanks to Shannon Burdeshaw, retired CPM and Karen Webster, CPM for all the time, energy and expertise in assisting the legislative process. Their prior legislative experience in other states served as a great asset to having Delaware join the many other states whose laws recognize and regulate Certified Professional Midwives as primary maternity care providers.


About the author

Pat Gallagher, CPM, has been a practicing midwife for 31 years in Delaware. She has been the only CPM legal up to this time due to the need for written collaborative agreement. She has had a physician alliance since 1984 with a practice limited to Amish & Mennonite families per physician back up. 

Pat is a Certified Childbirth Educator (ACHI). She designed and implemented a state wide paramedic refresher class in emergency childbirth and taught a workshop at MANA regional conference on breech & shoulder dystocia. Pat has been active in the legislative process to license CPMs & CMs and on the new legislation.

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