The Different Types of Health Care Providers
MidwivesAlthough there are different types of midwives, they all specialize in caring for healthy women anticipating a normal pregnancy and birth. They focus on health and wellness and encourage women and families to join in decision-making. Midwives are trained to identify possible problems in pregnancy, and they work together with physicians when necessary for complicated pregnancies. Mothers "give birth" with midwives in birth centers, at home, and in hospitals.
A certified nurse-midwife (CNM) is a registered nurse who has additional education and certification in midwifery (meaning that she* has taken the required courses and has been licensed by the state in which she practices - all 50 states license midwives). A certified nurse-midwife is trained to provide prenatal care, education, and support; attend birth in a birth center, hospital, or home; and provide follow-up care to mother and newborn after the birth. Most certified nurse-midwives are also licensed to write prescriptions and provide "well-woman" care such as gynecological checkups, pelvic and breast exams, and pap smears, as well as family planning.
Certified midwives (CM) are new professionals in the health care field. Like certified nurse-midwives, CM's are certified by the American College of Nurse Midwives, but come from backgrounds other than nursing (including physician assistants, physical therapists, and other health professionals). The settings in which they practice and the care they provide is comparable to CNM's.
Certified professional midwives (CPM) have passed the certification exam of the North American Registry of Midwives (NARM). NARM certification recognizes multiple routes of entry into midwifery, and most CPM's become midwives without first becoming a nurse. CPM's provide prenatal care, care during labor and birth, and postpartum care of the mother and her baby in the early weeks after birth. Most CPM's attend births in birth centers or at home.
Family PhysiciansFamily physicians focus on the health care needs of the entire family. Not all family physicians include maternity care in their practice. Those that do may work hand-in-hand with an obstetrician if a complication arises during pregnancy, labor, or birth. Some family physicians are trained in surgery and perform cesarean sections. Family physicians primarily attend births in hospitals.
ObstetriciansObstetricians (OB's) may be either medical doctors (MD's) or doctors of osteopathy (DO's). Medical doctors have gone through 4 years of medical school. DO's have completed 4 years of study at a school of osteopathic medicine, which emphasizes the study of the body's muscle and bone structure, in addition to the regular medical school curriculum. Both MD's and DO's must complete an approved 4-year residency program in OB/Gyn to become obstetricians. OB's care for women before, during, and after their pregnancies. They are trained to identify and treat medical problems in pregnancy. They are also trained in surgery and are able to perform cesarean sections. Sometimes obstetricians manage high-risk pregnancies in conjunction with a perinatologist.
PerinatologistsPerinatologists are obstetricians with additional special training in managing high-risk pregnancy and birth. They consult with and accept referrals from other maternity care providers. Perinatologists practice mostly in major medical centers in large cities.
* Throughout Journey to Parenthood, both health care providers and infants are referred to as "she" for the sake of convenience.
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Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
Most recent page update: 9/9/2010