Specifically, what they're taking issue with is that the CPM credential does not require a graduation from an accredited institution - even though the C in CPM obviously means they've been certified, and that certification is recognized by the same national organization that oversees all certifications, including CNMs. But this isn't enough for ACNM:
Until the CPM community has developed a uniform process to ensure that all CPMs have graduated from an accredited educational institution, Congress should not recognize this class of provider in its entirety.This would invalidate a huge number of existing CPMs, to say nothing of closing off that door for many student and prospective CPMs, as it leaves out midwives who have done their hands-on training through an apprenticeship. I know, for example, of some midwifery trainings that are done as distance learning, along with an extensive apprenticeship. Let me emphasize, again, that these apprentice midwives will still pass the crucial certification in order to become CPMs, therefore holding up a strong and consistent standard. There are only 11 accredited midwifery programs in the country! Simply by pure location, this shuts out any prospective midwife who isn't lucky enough to live in one of those 11 areas.
ACNM's letter goes further than the accreditation issue, also critiquing NARM's requirements for CPM preceptors, talking specifically about minimum requirements for clinical experience. I'll be really interested in hearing what the group Big Push for Midwives will have to say about all this, active as they have been in promoting the education of more CPMs.
I know there has always been tension between these two groups. Hell, there can be tension within each of these groups! And I think it's important to not stereotype either side. As Joyce Roberts, a past president of ACNM, put it, "CNMs think DEMs have copped out, and DEMs think CNMs have sold out." On the one side we have 'medwives', and on the other we have 'madwives'. Personally, I've liked and disliked members of each, would feel comfortable with some of each group and uncomfortable with others, and every woman has to choose the individual who's the right fit for her.
So, is it just me, or does this all really come off as a slap in the face from ACNM? Or do they have a point? I'm willing to consider that more rigorous education may be needed, as programs can vary in quality. But does it have to be as drastic as this?
"One group needs to tighten up, and the other group needs to lighten up!"
-- Katherine Comancho Carr, President of the American College of Nurse-Midwives, 2005
Can't we all just get along?