Pregnancy & Childbirth

Midwifery Courses: Online, University, and College Courses

May 26, 2013

Midwifery courses are a must for women who want to become a registered or certified midwife.

Midwives help women through pregnancy, labour and childbirth. It is a calling that requires stamina, empathy, great communication skills, and quick decision-making. Midwives are increasingly the first choice for mothers in the developed world who prefer to limit medical interventions that modern medicine often insists on. At the same time, the World Health Organization has targeted the further education of nurses and midwives as essential to decreasing the rates of infant and maternal mortality in third world countries.

Midwives have practiced for centuries without formal training in educational institutions, but that is changing rapidly. Certification and licensing is usually a requirement to practice midwifery, and many countries have a continuing education requirement and midwifery courses to ensure that midwives are up-to-date on new methods and procedures in the field of childbirth. Aspiring and practicing midwives can take midwifery courses online, in class at colleges or universities, or through paper-based distance education programs.

Note: This article is targeted to North American midwives. Please refer to your country’s midwifery association for educational requirements.

Midwifery Courses: Education Requirement

As of March, 2011, the International Confederation of Midwives defines a midwife as “a person who, having been regularly admitted to a midwifery educational programme, duly recognised in the country in which it is located, has successfully completed the prescribed course of studies in midwifery and has acquired the requisite qualifications to be a registered and/or legally licensed to practise midwifery.” This means that if you want to be legally recognized when you become a midwife, you will have to take courses and apply for a license in the area where you wish to practice.

Education for Midwifery in Canada

To practice as a midwife in Canada, individuals must complete a four-year university degree in midwifery.

As of May, 2013, the midwifery degree is offered at Laurentian University, Ryerson University, McMaster University, University of British Columbia, Universitie du Quebec at Trois Rivieres. There is an Aboriginal Midwifery Program offered at University of the North in the Pas, Manitoba.

Prerequisites for the Bachelor of Health Sciences degree in Midwifery in Canada are similar to the requirements for a nursing degree. Students attend classes and work closely with practicing midwives. Once the degree is completed, an aspiring midwife must apply to the college of her province or territory for licensing and registration to practice.

Internationally trained midwives can attend a “Bridging Program” in order to apply for registration to practice midwifery in Canada. They can also apply to their provincial College of Midwives for a Prior Learning and Experience Assessment to be registered to open a midwifery practice.

Continuing Education for Midwives in Canada

In Canada midwives complete continuing education courses in Cardiopulmonary Resuscitation, Obstetrical Emergency Skills, and Neonatal Resuscitation to keep these certifications current. In addition, there are specialized workshops and professional development courses available through the provincial Colleges of Midwives.

Education for Midwifery in the United States

In the U.S., there are two recognized designations of midwife.

Direct-entry midwives enroll in midwifery courses without a prior professional health care designation, and can be awarded the Certified Professional Midwife (CPM) designation.

Certified Nurse Midwives are already Registered Nurses prior to attending midwifery courses and can be awarded the CNM designation.

Many direct-entry programs are offered through local colleges as part-time programs or full-time programs with work placements with practicing midwives. Some students, especially in rural areas, are able to complete midwifery courses online through distance education and meet the practical requirements of their education by working with a local midwife. Education, designation and licensing appears to vary from state to state.

Continuing Education for Midwives in the United States

As of 2010, midwives practicing in the United States must be re-certified every five years. This ensures that as specialized health care professionals midwives remain competent, safe, and up-to-date providers of care to women. Midwives are just one of many advanced health care fields which are moving away from the “lifetime competency” model, where a practitioner receives an initial license or certification and may practice for the rest of their lives without proving competency. Nurses and physical assistants are also moving to this model. As midwifery regulation may differ from state to state within the U.S., please check with your state authority to confirm your continuing education requirements.

Licensing, Certification, Registration

The American Midwifery Certification Board (AMCB) is the governing body in the United States providing the certification, re-certification and disciplinary actions to Certified Midwives (CMs) and Certified Nurse-Midwives (CNMs). The board works closely with the American College of Nurse-Midwives in maintaining and promoting the profession of midwifery.
The AMCB made changes in 2010 effecting the requirements to maintain certification as a CM or CNM.

Midwifery Courses: Useful Links

Becoming a Midwife: Do You Have the Required Skills?

May 25, 2013

Are you interested in becoming a midwife?

Midwifery is a growing career across the world. As more women choose a midwife to assist them throughout their pregnancies, childbirth, and post-partum days, the demand for certified midwives and nurse-midwives is growing.

Some women are drawn to a career in midwifery as an extension of their nursing degrees or jobs. Others come to the profession without prior medical education. If you are interested in becoming a midwife, there are many courses leading to degrees and designations in midwifery. However the most important skills may not be taught in a textbook or through online courses. Communication, empathy with patients, quick decision-making skills, and organization are essential skills for a successful midwifery practice.

Communication Skills

Women who are pregnant often experience hormonal shifts that lead to enormous mood swings. The combination of hormones, morning sickness, and pregnancy brain (the term often used to describe forgetfulness during pregnancy) can make it difficult to focus on new information.

First time mothers and fathers have many questions regarding the medical aspects of what they are experiencing. The ability to answer sometimes difficult questions and explain complicated medical procedures in a clear manner is important.

One of the things midwives are commended for repeatedly by their patients is their willingness to ensure pregnant mothers understand what their bodies are going through.

A midwife must be skilled in assessing the best terminology and manner in which to share information with her patients.

Women of various backgrounds, education levels, and nationalities seek out midwives to birth their babies. Being able to communicate quickly and clearly with patients is an important skill to work on when becoming a midwife.

Empathy Skills

While communication skills are essential to sharing and teaching patients, a midwife must also be empathetic. One of the common complaints made about obstetricians, gynecologists, and other medical professionals are that they lack a good “bedside manner.” This refers to the soft skill of empathy, a crucial skill for anyone interested in becoming a midwife.

You may have mastered the formal training for midwifery, but if you lack empathy for your patient they will know it.

Empathy is “the identification with and understanding of another’s situation, feelings, and motives,” according to The Freeweb Dictionary. People who display empathy are often described as warm, loving, friendly, and/or maternal.

Pregnancy can be a time of anxiety, fragility, and nervousness for new parents, and a midwife’s empathy can go a long way to calming a nervous mother-to-be, especially one who is in labor.

Decision Making Skills

A midwife may be the primary caregiver in a woman’s pregnancy. While everyone hopes for a low-risk, uncomplicated pregnancy and labor requiring little or no intervention, that is not always the case.

Midwives are fully accountable for the well-being of their patients (big and little!), and must be prepared to make important, and sometimes, quick decisions on behalf of others. Typical decisions may include:

referring to a specialist during pregnancy for a pre-existing or new condition affecting the health of the mother and baby
a fast decision during labor to move from home to hospital
when to call an ambulance

A midwife must be confident in her ability to exercise quick decision-making skills based on her medical training and the situation at hand.

Organizational Skills

A midwife’s day can be long and unpredictable. Many midwives in North America operate in private practices, so in addition to seeing their patients and maintaining detailed records of visits, patient histories, and birth plans, midwives are responsible for the business aspect of their practices.

Some midwives work in collectives or with other types of birth attendants such as doulas or registered nurses. In Canada and the United States midwives’ salaries as employees are comparable to nurse-practitioners, while private practice midwives have a wide range of incomes.

Being able to juggle daily appointments, record-keeping, staying up-to-date with continuing education requirements, running a business, and above all, being on-call 24 hours a day for patients means midwives require great time-management skills.

Babies arrive all hours of the day or night, so always being prepared to attend a birth, and re-organize a day’s schedule is an essential skill of a midwife. Some of the continuing education and professional training for midwives include workshops on time management, record-keeping, and business organization skills.

Resources: Becoming a Midwife?

Canadian Association of Midwives

Midwifery Education Programs in Canada

International Conference of Midwives

Midwives Alliance of North America

American College of Nurse-Midwives

What is a Doula?

April 20, 2013

Are you looking for emotional and practical support during pregnancy? Maybe you need a doula.

A doula is a person who provides non-medical support to a mother and father during pregnancy and childbirth, and the period immediately following.

Doula comes from a Greek word meaning female slave. Doulas, sometimes called “birth attendants”, have existed in an informal role through the ages and in many societies and cultures, and are becoming increasingly used in modern Western Society as a resource to new parents in addition to a family doctor, obstetrician, or midwife.

Training and certification requirements for doulas vary greatly from country to country. According to DONA – Doulas of North America, a doula is defined as “a woman who is trained and experienced in childbirth and provides continuous physical, emotional, and informational support to a woman during labor, birth, and the immediate postpartum period.”

What is the Difference Between a Doula and a Midwife?

A doula is a comforting and knowledgeable birth counselor. A midwife is a formally trained medical professional who carries out the medical tests, reports, physical exams and oversees the medical aspects of labour and delivery.

While many midwives may provide the emotional support of a doula, doulas are not licensed to perform births in Canada, the United States, the United Kingdom or Australia.

History of the Doula

Women have been supported by other women through childbearing throughout history. The period of pregnancy, childbirth,and the “laying in” period or initial weeks following the birth of a baby were traditionally the dominion of women, and occurred in the mother’s home with one or more women attending her.

It has only been in the past one hundred years that childbirth in the Western world has moved to the hospitals and become more of a medical experience than a social one.

As more mothers became concerned with the frequency and number of medical interventions (such as cesarean sections) that appeared to be becoming commonplace even in lower-risk pregnancies, birth attendants or doulas began to accompany mothers into hospital in increasing numbers. The term “doula” began appearing in literature in the United States in the mid-1970s.

What Does a Doula Do?

Pregnancy, childbirth, and the care of a newborn can be physically and emotionally draining. Historically new parents could turn to grandparents and other family members for support during this time. Today’s parents often live far from their extended family.

A doula can help fill the role that older female friends and relatives used to provide to pregnant women.
They can support mothers and fathers emotionally, and answer questions and give advice on concerns many new parents have.
Prior to labour and delivery doulas may provide suggestions for pregnancy massage, advice regarding non-medicinal morning sickness remedies, exercise and lifestyle modifications to make pregnancy more comfortable, and they may also help with preparing a birth plan.
During labour and delivery a doula can be a comforting presence to both the labouring mother and an anxious father.
She can help explain what the doctors, midwife, or nurses are doing, provide suggestions for pain relief alternatives to medical intervention, and help coach the mother while the the medical staff carry out their clinical duties.
For mothers who do not have a partner or close female friend, a doula can provide invaluable assurance and support throughout the pregnancy, labour, and childbirth, and assure the labouring mother of her progress.

Where Can I Find a Doula?

You can find a doula by asking your midwife or healthcare professional for a local referral. If that isn’t possible, try your local health unit. There are also doulas listed on the Internet. Breastfeeding.com has an extensive directory of doulas. As of March 2011 there are almost 5,300 doulas listed worldwide. Please satisfy yourself as to the training and credentials of any doula you choose as they are not verified by the site.

How Can I Become a Doula?

Training and certification of doulas varies greatly throughout the world. If you are interested in learning more about becoming a doula, visit the DONA International Site for more information on the CD (Certified Doula) and CPD (Certified Post-Partum Doula) certifications that they offer. There is also more detailed information on the steps required for formal training, doula workshops, continuing education and re-certification courses, doula forums and links to various country and regional offices.