Midwives: Certified and Direct-Entry

Midwives have come a long way since the days of "granny ladies" in rural villages. Today, midwives are delivering babies in major metropolitan hospitals, birthing centers, and homes across Texas, combining the instincts of granny with the extensive training required of their profession.

There are two types of midwives: certified nurse midwives and direct-entry midwives. CNMs are trained as registered nurses and then licensed as advanced practice nurses specializing in midwifery. They are supervised by the state Board of Nurse Examiners and generally work with physicians in hospitals -- Austin is the only major city in Texas without midwifery services in any hospital.

Direct-entry midwives, who typically provide professional assistance for at-home births, must pass an extensive training program, an apprenticeship, and an exam. They are regulated by the Texas Midwifery Board; midwives and their advocates successfully fought a legislative effort in the last regular session that would have transferred control of that board from the state Department of Health to a medical board more directly dominated by physicians.

Those who believe there is nothing natural about natural childbirth should talk to women who've had midwife-attended births. The experience made a believer out of Amy Chamberlain, president of the Austin chapter of Texans for Midwifery. "I never expected it to be such a wonderful milestone in my life," she said. Similarly, Gloria Perez-Walker, president of Latina Mamí, a support group for young Hispanic mothers, said her home birth provided her with the experience of a lifetime. "I couldn't believe how calm I was."

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midwives, certified nurse midwives, CNM, direct-entry midwives, Texas Midwifery Board, Department of Health, Amy Chamberlain, Latina Mami, Gloria Perez Walker, Texans for Midwifery

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