This isn't exactly on topic, but your question reminds me of something. Someone asked me the other day what the difference is between CPM and DEM, and I wasn't exactly sure how to answer the question. Is the only difference their education? Rachel, I'd like some clarification if I'm wrong, but I think CPM's and DEM's in our state both have to pass the same state certification requirements (state certification exam), but CPM's have attended midwifery college while DEM's have completed an apprenticeship. Is this accurate?
Here's the response I got from a midwife in our state when I asked a similar question:)
DEM (or "Direct-Entry Midwife") is a general term meaning a midwife who is not a nurse-midwife, that is, one who obtains her midwifery training without being required to first obtain training as a nurse. A DEM may choose (or not) to become a CPM ("Certified Professional Midwife") via one of two routes. The first route is by PEP ("Portfolio Evaluation Process") whereby the DEM studies on her own or via a non-accredited program and completes her clinical requirements by apprenticeship, and then takes the certifying exams (one written and one clinical). The second route is via a MEAC-accredited school, which guides the student through academic courses and either provides clinical experiences or supervises them via local preceptors, and then the student takes the written (not clinical) certifying exam. You can get information about these routes to the CPM at http://www.narm.org/htb.htm.
You must become a CPM to obtain licensure as an LDEM in Utah. In addition, you must meet other qualifications (CPR & NRP certification and completion of an approved pharmacology course) to get the license.
The cheapest way to obtain your CPM (and thus your LDEM license) is to go the PEP route. But I warn you, this only works if you are the type of self-motivated student who will actually do the studying, fill in your own knowledge holes, and impress a preceptor enough to take you on for your clinicals. I know many students who have tried PEP and failed to pull it off. The MEAC-accredited school route works better if you need structure and some prodding to get through the academics, but of course, it is more expensive. The Midwives College of Utah is a MEAC-accredited school and you can get the skinny on them at www.midwifery.edu.
Thank you! This fits what I understood, but explains it much better than I could. I'll pass this along. Also, do the distinctions between CPM and DEM vary state to state?
I'm doing an apprenticeship partly because I can work on it at my own pace and it won't cost me a lot of money to get the education I want, and I have a good group of midwives to study under. Also, this is one area of my life that I feel I can sufficiently motivate myself to achieve my goals. I still haven't decided if I'll do the PEP when the time comes, but I have a few years to decide on that.
NARM states that "The CPM is the only international credential that requires knowledge about and experience in out-of-hospital settings", and that "Completion of this Certification cannot be seen as legal protection, which is determined by territorial governments."
So, the CPM designation is an international credential acquired through NARM, but the ability to practice as such is dependent upon state laws.
My understanding also, is that in some states CPM's are legal, but DEM's are not. So, in those state midwives who have obtained CPM credentials through NARM are allowed to attend home birth, but those who haven't completed the process are not legally allowed to attend births.
(On a personal note, learning more about this is making me feel better about my decision to do an apprenticeship, because ultimately I can still achieve the same certification I could if I were to attend a midwifery college, which is something I was unsure of. I already made my decision, but some things are starting to come together now and make more sense to me.)
I also understand that in some states midwives are prohibited from attending home birth, period. In those cases, women don't have the option of having a midwife if they want a home birth.
I also hear about some women having a CNM attend their home birth. This is very rare in Utah, isn't it? But what about in other states? I'm very curious to hear from women in other states about the laws in their areas.
I think there are a few cnm's that deliver at home here, but it is my understanding that they also are CPM's.(makes the stats even more difficult to unravel:)). So if this is an international credential, then how does that work in other countries I wonder? I may post this on the main board just to see.
Whether or not CNMs can legally attend home births depends on the state laws. For example, in Illinois (where I used to live) CNMs legally can attend home births. However, in Ohio (where I currently live), they cannot. CPMs also cannot legally attend homebirths in Ohio, although I'm not really clear on what the laws actually say about this. But we do have quite a visible group of CPMs here in Columbus who run a very busy homebirth business!
In Texas, the term DEM is synonomous with CPM. Basically any MW that does not have a BS in Nursing is considered a DEM. The designation of CPM comes with the NARM certification and refers to any DEM in Texas that is liscensed to practice Midwifery in this state.
I found this link that gives the laws about midwifery in most states