• Educated in both nursing and midwifery
• Educated in institutions of higher learning,
• Receive clinical training in clinics, offices, hospitals, birth centers, and homes.
• Registered Nurses with advanced practice-nursing status.
• Must have at least a postgraduate or Masters Degree to practice in Texas.
• Have successfully completed a university-affiliated nurse-midwifery program accredited by the American College of Nurse-Midwives.
• Have successfully passed the national certifying exam administered by the American Midwifery Certification Board. http://www.amcbmidwife.org/
• May legally deliver babies in Texas hospitals, birth centers, and homes.
• May legally provide prescriptive medications in Texas when the requirements of the Texas Board of Nursing are met.

• Provide complete prenatal care to healthy pregnant women.
• Deliver babies and care for women throughout labor & birth.
• Provide complete postpartum care after the birth.
• Newborn care for healthy babies through out the first month of life.
• Provide Well Woman/gynecologic, life cycle, & contraceptive care.
• Identify deviations from normal in any of these areas.

Midwifery Practice by CNMs is the independent management of women’s health care. Midwifery focuses primarily on pregnancy, childbirth, the postpartum period, common primary care issues, family planning, and the gynecologic needs of women, and care of the newborn. CNMs provide for consultation, collaboration or referral as indicated by the health status of the client. CNMs practice in accord with the Standards for the Practice of Midwifery as defined by the American College of Nurse-Midwives (ACNM).

Managing common health problems such as: minor infections, self-limited conditions, stable chronic conditions, common gyn problems & problems during childbearing for women and newborns. CNMs consult, refer or transfer care to the appropriate health care provider or physician as indicated by the status of the woman or newborn.

• Equitable, ethical, accessible, quality health care that promotes healing and health.
• Health care that respects human dignity, individuality, and diversity.
• Complete and accurate information to make informed decisions and the right to self-determination.
• Involvement of a woman’s designated family members, to the extent desired, in all health care experiences.
  

The best model of health care for a woman and her family:

• Promotes a continuous and compassionate partnership and continuity of care.
• Promotes the empowerment of women as partners in health care.
• Acknowledges a person’s life experiences and knowledge
• Includes individualized methods of care and healing guided by the best evidence available.
• Involves therapeutic use of human presence and skillful communication.
• Promotes health, disease prevention, and health education.
• Cares for vulnerable populations.
• Incorporates complementary and alternative therapies in education and practice.

In the normalcy of women’s lifecycle events, we believe in:

• Watchful waiting and non-intervention in normal processes.
• Recognize pregnancy, birth, and life cycle changes as normal physiologic and developmental processes.
• Advocacy of non-intervention in the absence of complications. Appropriate use of interventions and technology for current or potential health problems.
• Consultation, collaboration, and referral with other members of the health care team as needed to provide optimal health care.

CNMs value formal education, lifelong learning, and the development and application of research to guide ethical and competent midwifery practice. These beliefs and values provide the foundation to improve the health of women and their families.
ACNM 2004,2007
http://www.acnm.org/philosophy.cfm
http://www.acnm.org/siteFiles/descriptive/Core_Competencies_6_07_3.pdf

• CPMs/LMs: CPMs obtain certification through the North American Registry of Midwives (NARM) http://www.narm.org/htb.htm. The State Department of State Health Services licenses CPMs in Texas as Licensed Midwife (LM).
• CMs: CMs obtain obtain certification through the American College of Nurse Midwives, but are not nurses. http://www.midwife.org/careers.cfm There currently is no legal status for CMs in Texas. CMs must either become CNMs or CPMs/LMs to practice with a license in Texas.
• Lay Midwives no longer have a legal status in Texas.