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FREQUENTLY ASKED QUESTIONS
(Click on any question below for answer.)

What is a Certified Nurse Midwife (CNM) in Tennessee?
How many births do Certified Nurse Midwives attend each year in Tennessee?
How is a nurse-midwife licensed in Tennessee?
How is a nurse-midwife different from an obstetrician?
Can a nurse-midwife administer medications in labor for pain relief?
How much training does a nurse-midwife have?
What happens when there is a complication?
What kind of questions should I ask when I'm choosing a nurse-midwife?
How can I become a nurse-midwife?
Where do I find a nurse-midwife?


What is a Certified Nurse Midwife (CNM) in Tennessee?

A Certified Nurse-Midwife is a licensed health care practitioner educated in nursing and midwifery. Among the CNMs approved to practice in Tennessee, the majority hold a Master's degree or higher in nursing education. CNMs provide primary care to women of childbearing age including: prenatal care, labor and delivery care, care after birth, gynecological exams, newborn care, assistance with family planning decisions, preconception care, menopausal management, management of common health illnesses, and counseling in health maintenance and disease prevention.

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How many births do Certified Nurse Midwives attend each year in Tennessee?

According to Birth Certificate Data, CNMs have attended approximately 4,000 births this year. However, this does not include those women who developed complications requiring a physician to attend their birth, i.e. an assisted birth with vacuum or forceps, or a cesarean birth. Where do nurse midwives practice? Midwives attend over 70% of births in the world. In the Netherlands, midwives deliver a majority of the babies. Other countries do not utilize midwives to their fullest potential. In the United States, nurse-midwifery care is available in all 50 states, the District of Columbia and some U.S. territories. Most CNMs are employed by a hospital or a physician practice. While some CNMs attend home births, most of the births they attend occur in hospitals or birth centers. In TN, nurse-midwives practice in rural and urban settings, in private practices and public health systems, in hospitals, birth centers, and at home.

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How is a nurse-midwife licensed in Tennessee?

To be eligible to practice in Tennessee, you must:

-Be licensed as a Registered Nurse in Tennessee
-Graduate from an educational program accredited by the American College of Nurse-Midwives (ACNM)
-Pass a national certification exam administered by the ACNM Certification Council (ACC)
-Hold a Tennessee Advanced Practice Nurse Certificate
-Advanced practice nurses with a Master's degree also hold a certificate to prescribe medications

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How is a nurse-midwife different from an obstetrician?

Nurse-midwives are trained in the care of healthy women, both pregnant and non-pregnant. The model used is a holistic model of care that incorporates physical, mental, and social needs of the entire family. Studies show that this model of behavior results in fewer use of interventions such as medications, cesareans, etc. For more information check out the Philosophy of Nurse Midwives on the American College of Nurse-Midwives website (www.acnm.org).

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Can a nurse-midwife administer medications in labor for pain relief?

Yes, nurse-midwives working in hospital practices can have access to all of the pain medications that physicians do. This includes narcotics and epidurals. Medications tend not to be used as often by nurse-midwives because other techniques like walking, use of tubs or showers, and supportive presence are often used and provide equivalent or better relief. Women who choose to birth at home or in a freestanding birth center would not have access to epidurals or an extensive list of medications.

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How much training does a nurse-midwife have?

Certified Nurse-Midwives have a required standard education requirement by the American College of Nurse-Midwives. Their nurse-midwifery education may have been a certificate program or a Master's degree program. Many CNMs also have other forms of training such as childbirth educator, lactation consultant, massage therapist, family nurse practitioner, or other advanced degrees. The amount of experience will vary between nurse-midwives.

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What happens when there is a complication?

Nurse-midwives have a collaborating physician agreement where the nurse-midwife can consult or refer a woman depending on her health needs at any point in her care. In Tennessee, nurse-midwives can write prescriptions.

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What kind of questions should I ask when I'm choosing a nurse-midwife?

-How long have you been practicing and in what kind of birth setting?
-What is your philosophy of care?
-What are the eligibility requirements for your services?
-What arrangements do you have if complications occur?
-What are your fees and will my insurance cover them?
-Can my family be present during labor and birth?
-What kind of options do I have during labor and birth?
-What is your epidural, cesarean section, episiotomy rate?

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How can I become a nurse-midwife?

In Tennessee, the only educational program available is at Vanderbilt University. Click here for information regarding their program. Other educational programs can be found through the American College of Nurse-Midwives website (www.acnm.org).

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Where do I find a nurse-midwife?

Click here for a listing of nurse-midwives in the state of Tennessee who are members of the Tennessee Chapter. To identify one or more practices in your area, click on the American College of Nurse-Midwives (ACNM) website www.acnm.org

Speak with those in your community familiar with nurse-midwifery; try childbirth educators, health fairs, health food stores, massage therapists, La Leche League, other women, local hospitals, and don't forget the yellow pages. Women and families should find a health care provider that best matches their needs and lifestyle. Keep in mind there are physicians who practice much like CNMs in that they are very non-interventive, and there are nurse-midwives who practice much like physicians. It is important to find from the available providers the best match that suits you and your family.

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