by Advance-practice nurses who are specially educated to care for women’s health and in labor are called Certified Nurse-Midwives (CNMs).
The CNMs are mid-level care providers.
Therefore, they are allowed to order diagnostics tests, interpret the results, and prescribe medications.
In some states, CNMS can act as primary care providers.
The job role of CNM includes family planning, postpartum care of the mother and newborn, monitoring pregnancy, and assisting with labor and delivery.
In the USA it is common to choose CNMs to assist during delivery.
In the recent pasts, there are more parents-to-be who choose CNM-assisted birth.
On the other hand, future parents are often concerned about CNM qualifications and the ability to act in critical situations.
CNMs are trained to provide the best care during many labor aspects and identify symptoms of potential combinations.
Moreover, CNMs are aware when complications go beyond their qualifications and when the time is to call an OBGYN MD.
The call OBGYN MD when labor goes without any issue, and then, there is a complication such as a drop in fetal heart rate.
CNMs are educated and trained to call an OBGYN in these risky situations because intervention often goes beyond their scope of practice.
But, what is the procedure when the labor gets complicated and there are certain procedures healthcare workers need to take to deliver a newborn?
For example, CNMs are trained and in some states allowed to perform vacuum-assisted births.
But, they should only perform if they are comfortable doing so.
For a vacuum-assisted delivery, a CNM uses a suction device that will help the baby to go through the birth canal.
It is a medical procedure, and it has a minor risk for scalp injuries, skull injuries, hematomas, or hemorrhage.
On the other hand, the majority of CNMs prefer assisting with labor with as little medical intervention as possible.
Forceps delivery is also risky and injuries such as soft tissue damage, laceration can happen.
Both mother and newborn can get injured during the use of forceps.
The CNMs are also trained to perform a forceps delivery.
Again, the state determines whether a CNM is allowed to perform it or not.
Sometimes the employer sets its policy about who can perform certain medical procedures.
On the other hand, C-sections are more aggressive and have higher risks than vacuum-assisted delivery and forceps delivery.
CNMs are not allowed to perform C-sections.
But, in some states CNMs are allowed to assist during C-section.
Their tasks for that role include applying pressure to remove the baby, suctioning and blotting the blood, suturing.
Sometimes, CNMs do the final step and close the patient.
Even though the state regulations about permissions are different, all CNMs are trained to identify symptoms of complications and can seek OBGYN in risky situations.
OBGYN takes care of women with high-risk pregnancies with collaboration with CNMs.
CNMs can order screening tests and assist, but they cannot take care of high-risk pregnancies independently.
It is beyond their scope of practice.
Nurturing collaboration between OBGYN and CNMS often leads to positive outcomes.
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