AWHONN opposes the licensing of DEMs due to inadequate education and trainingDoctors have long opposed the licensing of direct entry midwives. They are not alone. Certified nurse midwives, obstetric nurses, and neonatal nurses also oppose DEM licensing.
AWHONN (Association of Women's Health, Obstetric and Neonatal Nurses) has registered their strong opposition to the licensing of direct entry midwives. According to their current newsletter:
Certain associations representing midwives have been vigorously pursuing the enactment of legislation that would codify for licensure purposes, the "professional" status of Certified Professional (Lay) Midwives... [T]his unfortunate trend ... would contribute to placing patients at serious risk in the face of delivery complications...The bottom line is that all healthcare providers who care for pregnant women and newborn babies, doctors, CNMs, obstetric nurses and neonatal nurses, oppose the licensing of DEMs because of inadequate education and clinical training. Indeed the only people who appear to favor DEM licensing are the DEMs themselves. In other words, anyone who has more education and experience than direct entry midwives understands that DEMs lack the educational background and the clinical experience to provide safe care.
AWHONN strongly supports the practice of midwifery by a Certified Nurse Midwife (CNM), who is a registered nurse with an advanced degree and broad range of training in areas including pharmacology, and formally collaborates with other health care professionals as an expectation of their licensure to provide safe, holistic care.
Certified Professional (Lay) Midwives (CPMs), in contrast, have a far more limited apprenticeship and are not required to have relevant college degree, pharmacology training, or collaborative practice agreement with an obstetrician or hospital in case of complications.
Given the disparities in education, preparedness and professional back-up, AWHONN is concerned that state licensure of CPMs with have a significantly negative implications for women and their newborns.
The term "Certified Professional Midwife" is misleading to the public about the breadth of education and training that the lay midwife may to have, and AWHONN fears that licensing these lay practitioners will serve to foster this misunderstanding and place consumers and patients at unnecessary risk...
... AWHONN ... is against licensure that could mislead the public and cause harm when services are rendered by those who would be licensed as "professionals, " but do not posses the training or clinical affiliations typically required for licensure of trained health professionals.