Monday, May 20, 2013

American Midwife Certification Board (AMCB)

ACOG and the AAP recently issued statements regarding planned home birth recommendations.  Among them was the recommendation that midwives attending home births be AMCB certified.  We couldn't agree more and thought we'd share with you what exactly this means. 

What is the American Midwifery Certification Board (AMCB)?
"Our mission: To protect and serve the public by leading the certification standards in midwifery" ~ American Midwifery Certification Board

The AMCB provides certification opportunities for Certified Nurse Midwives (CNMs) and Certified Midwives (CMs), the only two credentials for midwives in the US that require graduate school level education. 
"The American Midwifery Certification Board (AMCB) is the national certifying body for candidates in nurse-midwifery and midwifery who have received their graduate level education in programs accredited by the Accreditation Commission for Midwifery Education (ACME). Certification by the AMCB is considered the gold-standard in midwifery certification and is recognized in all 50 states." 

What midwives qualify to take AMCB's certification exam?
Midwives with a graduate level, university degree may take the AMCB certification exam.  This includes Certified Nurse Midwives (CNMs), and Certified Midwives (CMs).  Regardless of educational pathway, both CNMs and CMs take the exact same certification exam to become certified by AMCB, and must continue education according to standards set forth by AMCB to retain their certification status, every 5 years. 

What is the Scope of Practice for AMCB certified midwives?
 Scope of practice is somewhat determined by state laws that license AMCB certified midwives (CNMs and CMs).  It is important to note that CNMs and CMs have an identical scope of practice, both able to attend births in and out of hospitals according to state laws. 

Why does AMCB certification matter? 
Certification protects the public by ensuring that certified individuals have met predetermined criteria for safety in practice.   While state licensure provides the legal basis for practice, most states require AMCB certification for licensure, and many institutions require AMCB certification to grant practice privileges."

Consistently reliable, high standards for education and practice protect the people.  Why would we accept anything less, whether in or out of the hospital?  Midwives practicing without AMCB certification have not met the educational or practice standards set forth by AMCB, nor do they come close.    

What makes AMCB certified midwives different than CPMs, DEMs, and other midwives & why does it matter?   

I must explicitly point out that a Certified Midwife is very different from a Certified Professional Midwife or CPM.  CPMs are not eligible for certification through AMCB.  Their educational and clinical requirements are vastly different.  

This link: "Why AMCB Certification?" offers a thorough comparison between different types of midwives, their education and certifying bodies.  

We have recently posted a series on the Education of Midwives around the world here on the Safer Midwifery for Michigan blog.  It's important to note that AMCB certified midwives are on par with highly educated midwives serving women around the world.  CPMs would not however, be qualified to practice in any other first world country by current educational and practice standards.  I would encourage any reader wondering about the differences in credentials to visit these posts to learn more. 

Education of Midwives Around the World: Part I
Education of Midwives Around the World: Part II
Education of Midwives Around the World: Part III

The educational background and training of midwives is directly related to outcomes and safety.  One of the most important factors in fostering positive out-of-hospital outcomes is the component of hiring a highly educated midwife. 

Which Michigan midwives are certified by AMCB? 
All CNMs, whether practicing in hospitals or outside hospitals are certified by AMCB, and licensed through the State of Michigan.  If we had CMs in our state, they too would be certified through AMCB, but we currently don't know of any practicing here.  This is likely because our state does not currently license CMs. 

All other out-of-hospital midwives, (CPMs, DEMs, and other midwives) are not certified through AMCB.  These are the majority of midwives serving MI families outside hospitals.  (Majority meaning all but two in the entire state.)  If you're considering out-0f-hospital or home birth in the state of MI, you deserve to know that your midwife is likely not AMCB certified, university educated, licensed, or functioning within the high standards for practice described for AMCB midwives.  

The implication?  Explicitly stated, MI OOH midwives are not in line with ACOG and AAP recommendations for safe home birth.  They are not highly educated as a collective group, nor do they meet this critical component that contributes to positive outcomes.  

The statements issued by ACOG, and AAP directly support the notion that home birth outcomes improve dramatically when attended by highly educated and trained midwives. This is just one important factor in providing for the best out-of-hospital care.  Please be sure to read about the other critical factors here if you are contemplating out-of-hospital birth or home birth. 

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