Certified Nurse Midwife Profession (CNM)

History of the profession

Nurse-midwifery in the U.S. dates back to 1925. At that time, Mary Breckenridge developed the Frontier Nursing Service in Kentucky. The program utilized public health registered nurses, who had received additional nurse-midwifery education in England, to staff nursing centers in the Appalachian mountains. The centers offered family health care services in addition to childbearing and delivery care to residents within the region.

The first nurse-midwifery education program in the United States was founded in 1932 at the Maternity Center Association of New York City. The program enrolled public health nurses and awarded a certificate in nurse-midwifery to its graduates.

Today, all nurse-midwifery programs are within institutions of higher education. Approximately 70% of nurse-midwives graduate at the Master's degree level. These programs must be accredited by the American College of Nurse-Midwives (ACNM) in order for graduates to be eligible to take the National Certification Examination. There are 47 ACNM accredited nurse-midwifery programs in the United States. Applicants for nurse-midwife programs must be registered nurses and have at least one to two years of nursing experience. As with the nursing profession in general, most CNMs are women. However, in recent years more male nurses have chosen to become nurse-midwives.

Primary health care services for women within underserved populations have been greatly enhanced through the services of nurse-midwives. The National Institute of Medicine has recommended that more reliance be placed upon nurse-midwives for the delivery of women's health care.

Numerous studies over the past 20 to 30 years have documented the ability of nurse-midwives to independently manage about 80% of all perinatal (including prenatal, delivery, and postpartum) care and up to 85% of the family planning and gynecological needs of women of all ages.

Nurse-midwives work in a collaborative role with OB/GYN physicians and either consult with or refer to other health care providers on cases outside their scope of practice (for example, high-risk pregnancies, women with concurrent chronic disease). See types of health care providers.