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I want to be a Midwife. I’m interested in working in birthing centers. I don’t want to become a Nurse though. I was thinking about going into a Physician’s Assistant’s program. Can anyone give me advice as to whether I could be a PA, with a CPM degree and work in a birthing center?

I’m currently loving my Microbiology class. I have a big passion for women of the birthing community. I want to deliver babies! I love the natural side of birthing and would want to encourage my patients to have water births. #career-paths #medicine #midwife

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Mary Jane’s Answer

There are PAs who specialize in OB/GYN and care for mothers during labor and childbirth. Whether or not the PA degree would be desirable for the type of maternity care setting you are envisioning probably depends on your geographic location. States vary in whether they allow free-standing birth centers and the types of providers they allow to care for women there. As I understand the CPM certification, you would need to complete a midwifery program and an apprenticeship before you could be certified as a CPM. It might make more sense to complete a PA degree and do a residency for additional training.

I think the bigger issue for you to explore is the difference in mindset between PAs and CNMs. Physician Assistants are trained in the medical model while CNMs are trained in the nursing and midwifery model. Like physicians, a PA is more likely to view pregnancy as a medical condition to be managed versus a CNM who is going to place more emphasis on the psychosocial factors impacting the course of a pregnancy. Based on the interests I hear you expressing, it sounds like the PA philosophy might clash with your own personal goals and beliefs. I recommend you try to find some OB/GYN PAs and some CNMs to interview and shadow. One thing you should ask is what they think the biggest difference between the professions. You might also reach out to people who work in/manage free-standing birth centers to explore what types of practitioners they use on staff.

Mary Jane recommends the following next steps:

Research the nursing model and the medical model. Here's a link to get you started: https://www.kevinmd.com/blog/2013/05/medical-model-nursing-model-difference-philosophy.html
Shadow (or do informational interviews) with OB/GYN PAs, CNMs, and birth center staff.
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Raquel’s Answer

Hello Lexi,
Becoming a midwife is an excellent goal, as is wanting to work in a birthing center and promote natural births. Like Mary Jane said you can work in the world of labor and delivery as a PA, a nurse midwife, or also a physician. So you could certainly become a PA. You would be able to work in a birthing center with either degree, how you practice will largely be up to you and the institution you work for, not based off which degree you hold. I do want to ask though, why don’t you want to be a nurse? I would suggest thoroughly researching both options to see which fits best for you, there is no wrong answer. Another topic I would like to briefly touch on is your statement of wanting to encourage patients to have water births. Encouraging women to have a natural birth is an excellent mindset, however water births are not for everyone. It is important to keep an open mind to each persons experience and individual needs. There are lots of great options for having a successful and positive birthing experience. You will learn a lot about this in school, but don’t go into it with a closed mind and thinking the only right way is to have a water birth.
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Laura’s Answer

Hi Lexi,

I am a Certified Nurse Midwife and have been working in the hospital setting for over 10 years. If you want to provide women's health in the clinic then a PA would be a great choice. If you want to catch babies on Labor and Delivery then you need to be a Certified Nurse Midwife or an OB/GYN. I'm not aware of any PAs who deliver babies, but we certainly have many PAs who work in the clinic and provide excellent patient care.
As a Certified Nurse Midwife I am an ARNP who can see people independtly from a doctor and can prescribe medications if/when needed. I'm a nurse, but I don't work under anyone.

We take care of a lot of women who desire an unmedicated birth but there are absolutely situations where women may need or want an epidural. It's a Midwife's job to go over risks and benefits of options for someone's healthcare, but it is their choice ultimately.
But as a Midwife I get to provide lots of labor support to help families achieve their goals. :-) I hope this helps!!

Laura recommends the following next steps:

www.acnm.org
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