OB, FNP, CPM, CNM- The Alphabet Soup of Providers and Which is Right for You
There are so many decisions to make when we learn we’re expecting our first child- it can easily get overwhelming. Where will baby sleep? Who will watch baby during the day? Who will be up with baby at night? Soft carrier, ring sling, or stroller? Elephants or forest creatures? Hospital or birth center or home?
That last question is possibly one of the most important- where will you have your baby and with whom? There are a lot of options for providers and birth settings in the US, so let’s break them down.
Before we talk about types of providers, let’s start with models of care. There are two primary models of care, and providers tend to fall into one camp or the other. The camp they fall into is based less on their title and more on their education, training, experience and personal beliefs and values.
Midwifery Model of Care (see also, Midwives Model of Care™)
This model of care views pregnancy as a normal, physiological process- something our bodies can do on their own with minimal intervention in most cases. This approach also tends to focus on the relationship between provider and client, takes a holistic approach that considers the emotional and psychological wellbeing of the birthing person in addition to the physical wellbeing.
Medical Model of Care
This model views pregnancy as a series of potential risks and maladies to be overcome or dealt with. Pregnancy is treated as something to fix. The model tends to involve extra monitoring and intervention to control the process of labor and birth and relies more on policy and procedure than individualized attention.
So what kinds of providers are there?
Providers are differentiated based on their training or education and their scope of practice. Each type of provider brings something special to the table, so it’s important to do some homework and meet with several providers to pick the one that feels like the best fit for you.
Midwives
Midwives are experts in normal, physiological birth. They know what a healthy, low-risk pregnancy, labor and birth look like and can intervene or refer to a specialized provider if needed. In all other developed countries, Midwives are the standard provider for all healthy, low-risk pregnant people. Other providers are consulted or referred to when complications arise, which is relatively rare.
CNM- Certified Nurse Midwives began their career as registered nurses, then completed a master’s level degree in midwifery. CNMs can catch babies in hospitals, birth centers, and (in some states) in homes. CNMs are often given prescription writing privileges, which means they can administer antibiotics if you need them during birth, or write you a prescription for birth control once baby is here.
CPM- Certified Professional Midwives are direct-entry midwives, meaning that they did not start their education with a nursing degree (or a nursing degree wasn’t required for entry into their midwifery program). CPMs can study for the exam that grants their license either through a structured apprenticeship process which can take as long as 5 or 10 years of working and studying with a midwife, or by completion of a MEAC-accredited midwifery program. CPMs typically catch babies in client’s homes or free-standing birth centers and do not typically have prescriptive privileges. CPMs have a wide variety of skills and knowledge with which to support birthing people and their families and can be an excellent provider for folks wishing avoid unnecessary intervention.
CM, LM, etc. There are a few other midwifery credentials out there, and these typically relate to where and how the midwife is credentialed.
Non-Midwives
Other providers can care for pregnant people and their families as well, and in the US, non-midwives attend most births (though this trend is changing!).
OB- OBs or Obstetricians are surgeons who specialize in high risk pregnancy and birth. These providers are experts at utilizing technology and interventions to support complicated cases of pregnancy, labor and delivery.
FNP or Family MD - An FNP is a Family Nurse Practitioner, who has undergone training in the support and care of individuals across the lifespan (from babies to elders). FNPs, like Family Medicine Doctors, will often be a primary care provider and continue to care for a client during pregnancy, labor, birth and into the postpartum period. In this case, the provider is known to the birthing person and the continuity of care can be excellent.
Whichever provider you pick, and wherever you choose to have your baby, make sure you ask yourself the following:
Does my provider offer the type of care I want and the level of care I need?
Do I feel comfortable asking questions, and do I feel respected and valued by my provider?
Do I feel safe in the environment in which I’ll give birth?
Have I built up a supportive team of folks to support me through pregnancy, labor, birth and the postpartum period (partner, doula, family, friends, provider)?
Our vision at Birthwise Midwifery School is that every person has access to safe and empowering midwifery care that is representative of them and their community.
Birthwise Midwifery School is a MEAC-accredited school of midwifery that trains skilled and compassionate direct-entry midwives who safeguard physiological birth by providing care that is informed by tradition and scientific evidence.
Learn more about our program here or contact us at info@birthwisemidwifery.edu
Birthwise Midwifery School
24 S. High Street, Bridgton, ME
207-647-5968
