The only degree a homebirth midwife needs is a high school diploma? Seriously?

Seriously flat Xsmall

Midwifery Today posted the following query on its Facebook page:

Midwifery Today 3-6-14

In case you can’t make out the text in the image:

I am looking into becoming a CPM soon so I was just curious if you guys had any recommendations on schooling?! I am a stay at home mom located in Oklahoma so I was looking for mainly online courses!

That’s right. She plans to become a homebirth midwife by correspondence course!

If you think that’s bad, consider this: she doesn’t need any midwifery degree at all. Her high school diploma is the only degree she needs to become certified as a homebirth midwife.

Why are the standards so pathetically inadequate?

Simple, American homebirth midwives (CPMs, LMs, DEMs) aren’t real midwives. Unlike midwives in the Netherlands, the UK, Australia and Canada, who are required to have a minimum of a university degree in midwifery, American homebirth midwives aren’t required to have any formal education in midwifery. That’s very different from real midwives in the US, as well. American certified nurse midwives (CNMs) are the best educated midwives in the world with a master’s degree in midwifery.

American homebirth midwives can’t be bothered (or aren’t qualified) to complete a real midwifery degree, but they are “passionate” about birth and want to earn money from their hobby. They created credentials that are nothing more than public relations ploys, designed to convince unsuspecting women that homebirth midwives have the equivalent education and training as midwives from around the world. Nothing could be farther from the truth.

Why did these fake credentials gain a foothold in the first place?

According to Judith Rooks, CNM, MPH and long time homebirth advocate:

The PEP route to becoming a CPM seemed reasonable when it was started, but I thought it would only be used to provide an opportunity for very experienced OOH birth attendants, and that new educational programs along the lines of the Seattle Midwifery School—a direct-entry professional midwifery school based on the curriculum used in The Netherlands, would be started to provide educational opportunities for young women who wanted to start preparing themselves as midwives from scratch…

To my great disappointment, many young women who want to become midwives seem to think it is too much bother, time or money to complete an actual midwifery curriculum and think it is enough to just apprentice themselves to someone for a minimal number of births, study to pass a few tests, and become a CPM that way… (emphasis in the original)

I thought the CPM would be short-term; we have lived with it now for a long time. The data from Oregon, shows that it’s not working. The CPM credential was a stop-gap measure from the next-to-the last decade of the 20th Century. We are now in the 2nd decade of the 21st Century.

On the CPMs themselves:

…[M]any have inadequate knowledgeable, manual skills and clinical judgment. Some DEMs/CPMs say that it is the responsibility of a pregnant pregnant woman to choose her midwife wisely, but that is very hard to do.

I count on the state to not license inadequately trained health care providers. I can’t assess the skills of every professional I use. I would not hire an electrician to change the wiring in my house without someone knowledgeable exercising due diligence to assure me that the person I hire has achieved some minimal level of relevant education and prior experience (an apprenticeship). Attending lectures or reading some books isn’t enough…

Sara Snyder of Safer Midwifery for Michigan gets to the heart of the matter:

The lingering questions then become why are the minimum standards so low, especially in comparison to counterparts around the world? Why is it acceptable for midwives to aim for the cheapest, quickest route instead of striving to be their best? Why are the “certifying” bodies (ie NARM/MANA) keeping the bar so low…as in only requiring a high school diploma as of 2012 instead of requiring a college level education to deliver our babies?

Why are the minimum standards so low? Because the CPM isn’t designed to ensure competence in midwifery; it’s designed to provide a false sense of security to American women, most of whom have no idea that when they hire a CPM they are hiring someone who isn’t a real midwife.

As Rooks points out, it’s long past the time when the CPM should have been abolished. Better late than never, though. The CPM should be abolished as soon as possible.

Will American women continue to hire poorly educated, poorly trained self-proclaimed “midwives”? Some women probably will, but as long as they understand whom they are hiring, they have every right to do so.

In the meantime, anyone contemplating a homebirth needs to understand that at the moment the only degree an American homebirth midwife needs is a high school diploma.


Edited to correct a misattributed quote. The last quote is from Sara Snyder of Safer Midwifery for Michigan, not from Judith Rooks.