MIDWIFERY SERVICES
Certified Nurse-Midwives (CNMs) are registered nurses with graduate training in midwifery. Upon completion of a university-based educational program, the midwife takes a national exam and is certified by the American College of Nurse-Midwives (ACNM). In Connecticut, the state Department of Public Health then licenses the CNM to practice midwifery. Connecticut CNMs have prescription writing authority and are covered by most insurance plans.
Midwifery education emphasizes personalized, family-centered care. The focus is on patient education, wellness and consumer choice. Midwifery care is attractive to many women and families because of the personalized nature of the relationship and the philosophy that pregnancy, birth and transition through life’s stages are normal events. CNMs schedule more time for each client visit and emphasize education and preventative care. There is more opportunity for the midwife to get to know the woman, her family and their plans for their birth. In labor, CNMs are with the family, often at the bedside, throughout the birthing process. We have the privilege of ensuring that the woman’s experience will be as safe and satisfying as it can be.
Midwives care for women from menarche through menopause. For the gynecologic client, this includes education about nutrition, exercise and lifestyle in addition to routine physical exams, pap smears, birth control and the diagnosis and treatment of minor infections and gynecologic problems.
Certified Nurse-Midwives have been practicing in Connecticut for more than 40 years. The first nurse-midwifery private practice was established in 1975. There are approximately 150 CNMs practicing in a variety of settings including a homebirth practice, birth centers, community health centers, private practices, hospitals and as faculty in nursing and nurse-midwifery educational programs.
For a complete list of midwifery practices and birth sites you may use our search pages.
A BRIEF HISTORY OF NURSE-MIDWIFERY IN THE UNITED STATES
Although midwives have been attending births in America since its colonization, the profession of nurse-midwifery was established in the early 1920’s as a response to the alarming rate of infant and maternal mortality in the U.S.
In Washington, D.C., the Children’s Bureau, the first organization to investigate and report on matters surrounding the welfare of children and child life throughout America, published its first report with appalling statistics: 124 babies per 1,000 were dying, and the maternal mortality rates were equally as devastating. Recognizing the importance of prenatal care, the Bureau outlined a plan to combat the poor pregnancy outcomes that included providing public health nurses for prenatal instruction.
During the same time period, a group of obstetricians, nurses and mothers formed the Maternity Center Association (MCA) in New York City to address the problem of poor pregnancy outcomes and improve the health of mothers and infants. MCA looked to foreign countries with outstanding maternal child health records to serve as models. In these countries, the most prominent figure in the maternity cycle was the nurse-midwife. They believed that these specialty nurses might be the answer to America’s growing maternal and child health problems, but unfortunately no nurse-midwives were working in this country.
Mary Breckinridge, a pioneering nurse who founded the Frontier Nursing Service (FNS) in eastern Kentucky, was the first to bring nurse-midwifery to the United States. Breckinridge established the FNS in the early 1920s to provide family health services to isolated areas in the Appalachian mountains by sending public health nurses to their patients by horseback. After learning about nurse-midwives in Europe, she saw first-hand their contributions to maternity care by traveling to France and England, where she was trained in nurse-midwifery. In 1929, she brought British nurse-midwives to FNS who were the first nurse-midwives in America. They joined the public health nurses in providing quality healthcare to patients in remote areas. Their success was readily apparent. In a study completed by Dr. Louis Dublin of the first 1,000 births attended by nurse-midwives in Eastern Kentucky, he reported that there were no maternal deaths due to pregnancy or birth..
The Maternity Center Association and the Lobenstine Clinic, with encouragement from the Children’s Bureau, set up the first nurse-midwifery school in the U.S. Hattie Hemschemeyer, a Public Health Nurse educator, was named Executive Director of the program. She was also one of the program’s first graduates in 1933. Although no longer in existence, the MCA’s educational program is recognized as one of the nation’s leaders in nurse-midwifery education.
When the future of the Frontier Nursing Service was threatened by World War II, the second nurse-midwifery educational program was established. The British nurse-midwives wanted to return to Britain and serve their fellow countrymen in their time of need, so in November 1939, the Frontier Graduate School of Midwifery opened with two students. Fifty years later the school is still in operation, as Frontier Nursing University, and has graduated more than 500 students. It now stands as both a leader in nurse-midwifery in the United States and a tribute to the accomplishments of Mary Breckinridge and her contemporaries.
Today, more than 7,000 certified nurse-midwives practice in all 50 states, the District of Columbia, and many developing countries.