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Certified
Nurse Midwives (CNM)
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Licensed
Midwives (includes the CPM)
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Scope
of Practice
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CNMs independently
manage women's health care services relating to pregnancy, childbirth,
the postpartum period, family planning, and routine gynecological needs.
They may also provide normal newborn care and primary health care for
women.
They consult, collaborate,
or refer to other health professionals for patient care issues outside
of their area of competency.
CNMs may have prescriptive
authority delegated by a collaborating physician if the CNM meets the
requirements of the BNE.
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Licensed Midwives
may independently manage women's health care services relating to pregnancy,
childbirth, and the postpartum period. They also provide normal newborn
care for up to six weeks of age. A licensed midwife with appropriate
training and experience may also provide family planning and routine well-woman
care according to her individual protocols.
They consult, collaborate,
or refer to other health professionals for patient care issues outside
of their area of competency.
Licensed Midwives
have authority to purchase and use oxygen as well as eye ointment for
the newborn.
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Education
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CNMs are registered
nurses that have completed a graduate level program in nurse-midwifery.
CNM educational programs are accredited by the American College of Nurse
Midwives (ACNM) and recognized by the U.S. Department of Education. These
programs must also meet the standards of the Board of Nurse Examiners
for the State of Texas (BNE).
There are two nurse
midwifery educational programs in Texas:
Parkland
School of Nurse Midwifery, Dallas (affiliated with UT Southwestern Medical
Center)
The
U.T. Collaborative Nurse Midwifery Education Program, U.T.M.B., Galveston.
The BNE also has continuing education requirements for advanced practice
nurses.
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Licensed Midwives
are direct-entry midwives. This means they are not required to be nurses.
Their education in Texas is based on the current Core Competencies and
Standards of Practice of the Midwives Alliance of North America (MANA)
and the Texas Midwifery Basic Information and Instructor Manual, which
is created and approved by the Texas Department of Health.
There are currently
three direct-entry midwifery programs approved by the Texas Midwifery
Board:
The
Association of Texas Midwives Midwifery Program, Killeen
Maternidad la
Luz, El Paso
Medical Training
Institute of America Midwifery Program, Dallas
The Midwifery Board
also has continuing education requirements for Licensed Midwives.
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Regulation:
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Certified Nurse-Midwives
are regulated by the BNE. CNMs are licensed as registered nurses authorized
to practice as a category of advanced practice nurse (APN).
Approximately 350
CNMs are authorized by the BNE to practice in Texas.
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Licensed Midwives
in Texas are regulated by The Texas Midwifery Board under the Texas Department
of Health (now the Department of State Health Services) Professional Licensing
and Certification Division.
There are approximately 150 Licensed Midwives in Texas.
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Certification/
Documentation:
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The BNE requires that
nurse midwives be certified, and recognizes the ACNM Certification Council,
Inc. (ACC) as the certification body for CNMs. The ACC develops the certification
exam and sets the requirements for ongoing certification.
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To become licensed
in Texas, a midwife must:
1. Become Certified
by the North American Registry of Midwives (Certified Professional Midwife
or C.P.M.) or
2. Complete midwifery training through a state approved midwifery program
and then pass the North American Registry of Midwives (NARM) exam (This
process also qualifies her to become a CPM).
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Standards
of Practice
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The BNE requires CNMs
to follow the Standards of Practice of Nurse-Midwifery created by the ACNM.
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The Texas Midwifery
Board creates Standards of Practice for Licensed Midwives. These standards
must also be approved by the Texas Board of Health.
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Practice
Settings:
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CNMs work in a wide
variety of settings such as clinics, hospitals, medical offices, and their
own private practices. The majority of CNM assisted births are in hospitals
but they also deliver in birth centers and homes. Licensed Midwives work
in a variety of settings such as clinics, midwifery offices, and their own
private practices.
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Licensed Midwife
assisted births are in birth centers or homes.
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Medicaid
Reimbursement
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In Texas, Medicaid
recognizes CNMs as primary care providers for women. Medicaid reimburses
CNMs at 85% of the rate paid to a physician for the same service.
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In Texas, Medicaid
does not recognize Licensed Midwives as providers and does not reimburse
for their services.
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Professional
Organizations
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Texas:
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Consortium
of Texas Certified Nurse Midwives (CTCNM)
4000 Sunflower
Lane
Belton, TX 75613
gale@infohwy.com
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National:
American College of Nurse Midwives (ACNM)
8403 Colesville Rd, Suite 1550
Silver Spring, MD 20910
Phone 240-485-1800 Fax: 240-485-1818
www.midwife.org
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Texas:
National/International:
The North American Registry of Midwives (NARM)
5257 Rosestone Dr.
Lilburn, GA 30047
Phone: 1-888-842-4784
www.narm.org
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