Frequently Asked Questions

How is a nurse-midwife licensed in North Carolina?

Actually, nurse-midwives are licensed as nurses in NC and approved to practice as CNMs. It is not a separate license. Applications are available through the NC Board of Nursing. Approval is granted by The Midwifery Joint Committee, which is composed of CNMs, MDs who do Obstetrics, and Representatives from both the Board of Nursing and Board of Medicine. CNMs in NC are required to practice in collaboration with a physician who also does obstetrics including obstetricians and family physicians. For more information, contact the NC Board of Nursing at http://www.ncbon.org/.

How many births do Certified Nurse Midwives attend each year in NC?

In 2003, the NC State Center for Health Statistics reports there were 11,513 resident deliveries attended by CNMs in NC, representing 9.7% of all resident births. This does not include, however, women who developed complications requiring a physician to attend their birth, i.e. an assisted birth with vacuum or forceps, or a cesarean birth.

Where do nurse midwives practice in NC, and who are their patients?

Nurse midwives practice all over NC, in rural and urban settings, in private practices, health departments, and at home. Please check out the recent survey by the NC Center for Nursing for more detailed information about CNMs practicing in NC.

Who are Certified Nurse Midwives (CNMs) in North Carolina?

Certified Nurse midwives are RNs with advanced education in women's health, prenatal care, labor and delivery, postpartum, and newborn care. Among the CNMs approved to practice in North Carolina, 75% hold a Master's degree or higher in nursing education. In addition to pregnancy related care, most nurse midwives also provide primary care services such as nutrition counseling, family planning care, gynecological services, and management of common illnesses for their female clients.

In order to practice in North Carolina, nurse midwives must be certified through the American College of Nurse Midwives and hold a current license as a registered nurse in order to obtain an approval to practice and have prescriptive authority. As of July 1, 2005 there were 190 certified nurse midwives (CNMs) with active approvals to practice in North Carolina.

To read more about Certified Nurse Midwives in NC, please visit the following:

The North Carolina Center for Nursing surveyed each of these CNMs during 1999, and this report is available at http://www.nursenc.org/research/midwives.pdf.
Running the Numbers
A Periodic Feature to Inform North Carolina Healthcare Professionals About Current Topics in Health Statistics
From the State Center for Health Statistics, North Carolina Department of Health and Human Services 2002 North Carolina Live Births Attended by Certified Nurse Midwives
http://www.ncmedicaljournal.com/mar-apr-04/running.pdf
Trends in the Supply and Distribution of Obstetric Care in North Carolina, 1998
Cecil G. Sheps Center for Health Services Research
The University of North Carolina at Chapel Hill
http://www.shepscenter.unc.edu/data/nchpds/obtrends.pdf

How is a nurse-midwife different from a doctor?

Nurse-midwives are trained in the care of primarily healthy women, both pregnant and non-pregnant. The model used is a holistic model of care that incorporates physical, mental, and social needs of the entire family. Studies show that this model of behavior results in fewer use of interventions such as medications, cesareans, etc.

Can a nurse-midwife administer medications in labor for pain relief?

Yes, nurse midwives working in hospitals have access to all of the pain medications that physicians do, including narcotics and epidurals. However, nurse midwives use a variety of nonpharmacological techniques for laboring women including position changes, hydrotherapy, and other techniques. Evidence has shown that many of these techniques offer equal and in some cases, improved pain relief and are well received by laboring women. Midwives in NC can also prescribe medications including methods of contraception and treatment for common health problems.

Women who choose to birth at home or in a freestanding birth center would not have access to epidurals or an extensive list of medications, but do have the opportunity to use the nonpharmacological techniques discussed above.

How much training does a nurse-midwife have?

Midwives in NC must have a nursing background and then attend a one-year certificate program in midwifery or a two-year masters program in nursing and midwifery. Upon completion of their education, they must pass a national certification exam. Certified Midwives are not yet legal in NC. They have a degree in a scientific field and then attend a midwifery program. Many CNMs also have other forms of training such as childbirth educator, lactation consultant, massage therapist, family nurse practitioner, or other advanced degrees. For more information on why to choose a CNM/CM, please visit the ACNM page Why should you choose a certified nurse-midwife (CNM)
or certified midwife (CM)?

CPM’s are Certified Professional Midwives who are not licensed in NC. They are certified through The North American Registry of Midwives (NARM). NARM is an international certification agency whose mission is to establish and administer certification for the credential "Certified Professional Midwife" (CPM). To read more about a recent study of home births by CPMs, please visit the British Medical Journal site at http://bmj.bmjjournals.com/cgi/reprint/330/7505/1416.

If I go to a nurse-midwife, do I need a doula or labor assistant?

These are two different issues. A nurse-midwife does provide labor support but the decision for a doula is something you should discuss with your midwife. Some women with special needs find that they need both professionals while others are comfortable with a nurse midwife alone.

Nurse midwives and doulas are a perfect team for women giving birth, but the decision on who will attend a birth is a personal decision that can only be answered by mothers, their midwives, partners, and family.

Can a nurse-midwife take care of my baby?

Nurse-midwives are trained to take care of newborns as part of their basic education. If you choose to deliver your baby at home or in a birth center, your nurse-midwife will be responsible for the care of your baby at birth and up to a month thereafter. If you deliver in a hospital, the nurse-midwife is less likely to take care of your baby unless she/he works with a family physician. You would be asked to identify a provider for your baby. That could be a family physician, pediatrician, or other health care provider.

How can I find a midwife?

ACNM hosts a database of around 4,000 midwifery practices. For more information, or to find a midwife, please visit the ACNM Find a Midwife page.