I found this thread of posts a couple weeks ago and it brought me to tears. To read about the CNMs who take alternative paths and don't just work in hospitals and support their bottom lines was very reassuring. These threads let me rest easy for a while but now there is some indecision rearing its ugly head again. I live in Massachusetts. There is an amazing CPM school in Maine (you've probably heard of it: Birthwise) that I would love to go to. My first BA is in photojournalism & magazine writing and I've studied documentary, so my background is pretty left brained and artsy. I've been working as a birth, and occasionally postpartum doula, for a little over a year. CPM is much more "me": I've always worked for myself, and am very independent. I don't really like hospitals and I'm not so keen on having to be watched under an OB. But I'm pulled to the CNM route so:
1) I can eat and have a house.
2) I can make a change in how birth happens in this country (USA). I am playing by these CNM rules so I can affect change from the inside out but I fear I will have sacrificed a bit of who I am to make that happen. To me, it feels like being a painter and trading in your oils and canvas for a computer. Or, more aptly, working in the darkroom and then switching to photoshop (been there, done that, no likey).
My heart wants to be in the trenches with the CPMS, learning all the skills I need AND tuning my intution for birth. For the CNM route, I will do it but am not psyched about on moving to a new place for some big fancy ivy league program (which, it seems most of the CNM programs are--Yale, Columbia, Vanderbuilt, Georgetown) and papering up just so I can help moms and babies. I don't care about being an RN, I just want to be a midwife.
I noticed the last post is from sometime in 2010. Anyone new out there having this same dilemma still? Or, anyone who chose to pursue the CNM in a program and want to share about their experience?
Sweet mama: Other than the first statement, I was not directing this comment at you or at anyone else on this forum. I appreciate and respect all of women interested or working in this field. I just found this page and was surprised by some of the comments and wanted to say a few things. I'm not saying I know more or what's best. I admit that my experiences have let me biased. But, I also think I have a perspective that might be valuable for someone out there...
There are accredited CNM programs all over the place! And 2 of those states are North Carolina and Tennessee. Don't know of too many fancy Ivy Leagues in those parts.. I planned to become a CNM for many years and looked into all kinds of CNM programs available for BSNs. I know I had at least 20 choices... Although I can't recall a single Ivy League from the list... Columbia, I guess... Anyway, I definately have a huge passion for birth. I know the tragic history of midwifery and empathize heavily with women who fear a sterilized, prepackaged, unhealthy birth experience without anyone to tell them it could be different.. But I don't understand why I can't have those ideals AND have an accredited, formal educational experience.... I'm planned to become an L&D nurse for a few years, than continue on to become a midewife. I'm still deciding what I want to do. My focus on birth has not changed. I've just seen and experienced a lot in the NICU. Watching those tiny paper caskets go out and holding devastated, wailing women has changed me. But all is not lost. I'm able to provide comfort, love, encouragement and individualized care to my patients even though I have a degree and work in a hospital. I have seen so many things go wrong during births. Most of the time, no one could have seen these problems in advanced. Sometimes though, it will be a doctor that missed something. Sometimes a CNM will have missed something. Sometimes a CPM will be the one who missed that little detail that could have saved a life, or prevented a permanent debilitating condition. No one is perfect. I know some if you will hate me for saying this, but most often, the ones that miss the BIG details are CPMs. And the ugliest tragedies are the ones that could have been prevented with simple cerclage at 15 weeks or access to a piece of simple piece of equipment that was unavailable at a home birth or a c-section that would have taken less time than it took for the ambulance to get tote home birth location. Now, I know that there are lots of CPMs who are great and I haven't had the privilege of seeing those beautiful births. And they haven't seen my reality of paper coffins and ruined lives. I'm not saying that all CPMs suck or all (or even most) doctors are amazing (although there are some really incredible ones). I'm saying that birth is important and needs attention and love, even in the form of "accredidations" and government regulations. I have 3 very close friends that are CPMs. (I run with a crunchy crowd.) 1 in AMAZING, the other 2 are just not. The felt they were too artsy to take Chemistry and Stats. I am very left brained, have major ADHD, and took retard math in HS. If I can do it, anyone can. I'm always shocked by the things that come out of my less competent CPM friend's mouths. You really do learn things in nursing school that are incredibly important, in certain situations. When it comes to birth, you are taking womens/children's/families lives into your hands. There is no room for laziness. If you are not passionate enough about birth to take a Chemistry class, you shouldn't be a midwife. I am not saying that this applies to all CPMs are lazy. I'm not against home births. I'm all for women being able to choose what they want for their birth experience and I'm all for midwives finding their own personal route to becoming the best midwives they can be. I know those routes can be different for different women. But I also know that some CPMs take that route due to a lack of confidence and due to laziness. To those women, I would say that losing a child is not an experience you can comprehend until you've lost one. I know this personally, unfortunately. It's not something that a mother can ever recover from. I've done a lot in my last 3.5 years, but I'm still stuck in the day I saw my first paper casket, where my beautiful daughter was placed 12 hours after she was born. I had a CNM who overlooked something that an OB would have seen. Did see, but it was too late. It wasn't a home birth. I had access to every medication and machine... But it was too late. No one is perfect. But, if you get into this field, you should try to be perfect. You should do everything you can to be ready for every possible, improbable situation. Even if you hand 999 smiling women 999 sweet little ones, missing something you could have seen and letting one little baby die before she ever lived will feel like you lost all 1000. That baby that never played outside, fell in love, kissed her mother... Who left a family in pieces, a family that will never experience joy without heaviness and tears because someone is missing who should be there... That baby, not the other 999, will be the one who shows you how precious life is and constantly remind you that 99.9% in not acceptable. Be 100%. Let my little girl be that baby and do everything you possibly can to do you best, know the most and never accept giving care that is less than miraculous. Every little miracle desearves nothing less.