Planned Home Birth

COMMITTEE ON FETUS AND NEWBORN

doi:10.1542/peds.2013-0575

A statement of reaffirmation for this policy was published at

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Lack of Recognition of CPM Credential
Sharon B Dejoy

Published on: 22 May 2013
Re:Lack of Recognition of CPM Credential
Kristi L Watterberg

Published on: 10 May 2013
Lack of Recognition of CPM Credential
Sharon B Dejoy

Published on: 29 April 2013

Published on: (22 May 2013)

Lack of Recognition of CPM Credential
Sharon B Dejoy, Assistant Professor, Dept. of Health
Dear Committee on Fetus and Newborn:
Thank you for supporting a woman's right to autonomy in pregnancy. That being said, I am discouraged that you did not recognize the Certified Professional Midwife (CPM) credential for midwives. I would like to contribute to the debate via my admittedly personal and anecdotal evidence.
When I decided to become a midwife, I entered a three-year accelerated BSN/MSN pro...
Show More

Dear Committee on Fetus and Newborn:
Thank you for supporting a woman's right to autonomy in pregnancy. That being said, I am discouraged that you did not recognize the Certified Professional Midwife (CPM) credential for midwives. I would like to contribute to the debate via my admittedly personal and anecdotal evidence.
When I decided to become a midwife, I entered a three-year accelerated BSN/MSN program at the Ivy League university where I obtained my bachelor's degree. Had I continued down that path, I would have received a thorough grounding in nursing theory, a six-figure student loan debt, and perhaps some home birth experience. I left for a now-defunct Midwifery Education Accreditation Council(MEAC)-accredited three-year Associate's Degree program in midwifery at a community college, where I received an excellent clinical education at 1/30 of the cost, and was required to demonstrate my competency in managing 50 women and 50 newborns at home.
I have the utmost respect for my CNM colleagues, and do not believe one midwifery credential should be valued over another. However, there is no question in my mind that I was a safer provider of out-of-hospital care as a new graduate of the associate's degree program than I would have been as a new graduate of the Ivy League master's program. I have yet to attend a home birth where I have used my expensive nursing theory, but there have been several where I was grateful for my extensive home birth training.
The United States Department of Education is currently exploring the benefits of competency-based education as an adjunct to, or replacement for, credit hours in the awarding of degrees. The North American Registry of Midwives (NARM) is ahead of its time in this regard, since it awards the CPM credential based on demonstration of clinical competency.
As pediatricians, you know first-hand the consequences of preterm and low birth weight birth. You are aware of the public health crisis in this country regarding the availability of high-quality and accessible prenatal care for underserved women. As the demographics of the United States continue to change, we will need more culturally-competent maternity care providers that can deliver high-quality care at a reasonable cost. I believe CPMs can make an important contribution, but not if we are ignored by the mainstream medical community.
I urge the American Academy of Pediatricians to join with Certified Professional Midwives, public health officials and other interested stakeholders to design a maternity care system that is based on competencies and outcomes, not on arbitrary credentials. This researcher is interested in collaborating with physician colleagues to further explore the processes and outcomes of CPM care, which can be used as evidence in such a process.
Thank you.
Sharon Bernecki DeJoy, PhD, MPH, CPH, CPM
Conflict of Interest:
None declared
Show Less

Competing Interests: None declared.
Published on: (10 May 2013)

Re:Lack of Recognition of CPM Credential
Kristi L Watterberg, Professor of Pediatrics
Other Contributors:
Thank you for your letter regarding our Planned Home Birth statement. We understand your perspective; however, the sentence in our statement regarding midwife certification expressed agreement with the Planned Home Birth statement of the American College of Obstetricians and Gynecologists. Their statement specifies in more detail that, "The recognition and regulation of certified professional midwives and lay midwives v...
Show More

Thank you for your letter regarding our Planned Home Birth statement. We understand your perspective; however, the sentence in our statement regarding midwife certification expressed agreement with the Planned Home Birth statement of the American College of Obstetricians and Gynecologists. Their statement specifies in more detail that, "The recognition and regulation of certified professional midwives and lay midwives varies tremendously from state to state. At this time, for quality and safety reasons, the American College of Obstetricians and Gynecologists does not support the provision of care by lay midwives or other midwives who are not certified by the American Midwifery Certification Board." (1)
As pediatricians, we do not consider that we have expertise in obstetric practice and therefore have no further comment on individual certification standards within the midwifery community, although we certainly support the goal of developing a cohesive maternity care system with standards of education and training that can be agreed upon by the involved health care providers.
1. American College of Obstetricians and Gynecologists, Committee on Obstetric Practice. ACOG Committee Opinion No. 476: planned home birth [erratum in Obstet Gynecol. 2011;117(5):1232]. Obstet Gynecol. 2011;117(2 Pt 1):425-428
Conflict of Interest:
None declared
Show Less

Competing Interests: None declared.
Published on: (29 April 2013)

Lack of Recognition of CPM Credential
Sharon B Dejoy, Assistant Professor, Dept. of Health
Dear Committee on Fetus and Newborn:
Thank you for supporting a woman's right to autonomy in pregnancy. That being said, I am discouraged that you did not recognize the Certified Professional Midwife (CPM) credential for midwives. I would like to contribute to the debate via my admittedly personal and anecdotal evidence.
When I decided to become a midwife, I entered a three-year accelerated BSN/MSN pro...
Show More

Dear Committee on Fetus and Newborn:
Thank you for supporting a woman's right to autonomy in pregnancy. That being said, I am discouraged that you did not recognize the Certified Professional Midwife (CPM) credential for midwives. I would like to contribute to the debate via my admittedly personal and anecdotal evidence.
When I decided to become a midwife, I entered a three-year accelerated BSN/MSN program at the Ivy League university where I obtained my bachelor's degree. Had I continued down that path, I would have received a thorough grounding in nursing theory, a six-figure student loan debt, and perhaps some home birth experience. I left for a now-defunct Midwifery Education Accreditation Council(MEAC)-accredited three-year Associate's Degree program in midwifery at a community college, where I received an excellent clinical education at 1/30 of the cost, and was required to demonstrate my competency in managing 50 women and 50 newborns at home.
I have the utmost respect for my CNM colleagues, and do not believe one midwifery credential should be valued over another. However, there is no question in my mind that I was a safer provider of out-of-hospital care as a new graduate of the associate's degree program than I would have been as a new graduate of the Ivy League master's program. I have yet to attend a home birth where I have used my expensive nursing theory, but there have been several where I was grateful for my extensive home birth training.
The United States Department of Education is currently exploring the benefits of competency-based education as an adjunct to, or replacement for, credit hours in the awarding of degrees. The North American Registry of Midwives (NARM) is ahead of its time in this regard, since it awards the CPM credential based on demonstration of clinical competency.
As pediatricians, you know first-hand the consequences of preterm and low birth weight birth. You are aware of the public health crisis in this country regarding the availability of high-quality and accessible prenatal care for underserved women. As the demographics of the United States continue to change, we will need more culturally-competent maternity care providers that can deliver high-quality care at a reasonable cost. I believe CPMs can make an important contribution, but not if we are ignored by the mainstream medical community.
I urge the American Academy of Pediatricians to join with Certified Professional Midwives, public health officials and other interested stakeholders to design a maternity care system that is based on competencies and outcomes, not on arbitrary credentials. This researcher is interested in collaborating with physician colleagues to further explore the processes and outcomes of CPM care, which can be used as evidence in such a process.
Thank you.
Sharon Bernecki DeJoy, PhD, MPH, CPH, CPM
Conflict of Interest:
None declared
Show Less

Competing Interests: None declared.