Looking for Midwives..CNM vs CPM?

[Earthylove]

Hi everyone. DH and I are ttc soon, and i'm just trying to get an idea of the midwife/birthing options we have in our area. I would like to do a home birth, but i'm not sure what is the difference between a midwife with a CPM credential vs a CNM credential. I mean, i looked up the definitions on google, but what i can't figure out is if one is preferable or someone more reputable? Is it just a matter of personal preference or philosophy?

What do you guys think? Do you have a preference?

 

[MrsG09]

I would say it's likely best to look at the additional credentials for anyone you might be considering...number of years experience, referrals, authorization for continuing care if hospital transfer is required, etc. And then these things will be part of your personal preference on what you are looking for. CNM, of course, will have licensed nursing care within their experience. But if you find a CPM with a long history of successful care, they may end up being just as or nearly as qualified as a CNM with fewer years of experience. Personally I worked at finding a CNM with many years of highly rated care, because having someone with that nursing experience is important to me, but I also like knowing they have some history. I'm also not sure if hospitals grant CPM's permission to provide care alongside a doctor if you were to need transferring, but I know not all hospitals do this with CNM's either. A lot just comes down to deciding what you want in a provider and researching to find someone who meets those desires I believe.

 

[spunky84]

I would recommend finding a CNM. I believe the main difference between the two is the medical background and education/certification requirements. I believe CPMs have less requirements & do not have to attend as many births to earn their certification whereas a CNM has more schooling and clinical hours / births.

Here is a good reference (that I just found) regarding the difference between CNM and CPM: https://www.midwife.org/ACNM/files/ccLibraryFiles/Filename/000000001385/CNM%20CM%20CPM%20ComparisonChart%20082511.pdf

Granted, I'm sure you can find bad CNMs as well as CPMs as well as good of both. As you would with any provider. Regardless of the route you go, I would just make sure you research, look up reviews, interview, etc.

If you're going through insurance, you will likely have more choices with CNM. With a CPM you may be very limited on insurance coverage and may have to pay out of pocket.

ETA: Assuming you're in the states, regulations may vary by state. Some states, if you're thinking of home birth, may require a CNM. I would look into your states regulations of CPMs as well as that might be what makes the decision for you.

You might want to review the MANA and ACNM websites. They can probably provide you with a lot of information. There's definitely a lot of information out there on both types, but it's definitely a lot to sift through.

I'm also not sure if hospitals grant CPM's permission to provide care alongside a doctor if you were to need transferring, but I know not all hospitals do this with CNM's either.

I'm guessing a CPM wouldn't be able to. At most they could transfer care to an MD that has privileges, but I don't think a CPM would be granted privileges at a hospital. It's definitely worth asking a CPM about, but my best educated guess would be no.


OP, it's definitely a lot to consider, but you just have to find what works best for you.

 

[MindUtopia]

The PP described it really well already, but basically CNM's are nurses with midwifery training, so they have a background in clinical training like any nurse would, plus they are trained as midwives. CPM's have trained as midwives, but haven't received any clinical training (like a nursing degree) in addition to that. Basically, I think the difference really is just the extra clinical background, plus it depends on if you will be seeking any reimbursement for your care (if your insurance even will entertain the idea, many won't, but they might pay for some blood testing or scans, etc.). Some CNMs can do certain medical procedures and then third party bill for them. CPMs will likely not be able to and may need to send you to someone else (an OB or your primary care doctor) to have them done. Plus, every state regulates home birth differently, so it would also just depend on the legality of midwifery care in your state too. Really I would interview whoever is local to you, get a sense of their experience, what they will and will not do in terms of your care, and also just what your gut says about whether you connect with them and base your decision off that. All things being equal, I personally would prefer a CNM because they have more clinical training, but I would pick a CPM with 25 years experience who attends lots of home births over a CNM who just started 3 years ago and mostly works at a birth centre with only the occasional home birth.

 

[Earthylove]

wow, thanks everyone! I feel like I am getting a better understanding of the two. I also found a pretty interesting blog post about it too. from what I'm hearing from your replies, experience is an important factor so i've started looking into how much experience the CPM's and CNM's in my area have. from what i've read, it sounds like CPMs have less training/education in certain areas than CNMs because they defer those areas to another professional (the website, "nurturing hearts birth services" dot com was very helpful, if you type in "CNM vs CPM" in the search box, a piece comes up about the author's feelings about the differences. very interesting, as are the comments that follow!)

I am leaning towards CNM at this point, mainly because i would personally feel more comfortable with a CNM if there was an emergency.