ACNM-accredited Programs: Programs accredited by ACNM are situated in institutions of higher education (universities) or are affiliated with such institutions, and lead to academic degrees (predominantly a master's degree in either nursing or public health). Midwives who graduate from these programs have a broad scope of practice which includes some well-woman gynecology and primary care as well as midwifery. They usually practice in hospital-based settings, although a small percentage of CNMs and CMs work in birth centers and/or do home births.

Most nurse-midwifery education programs (and there are about fifty at the present time) require entering students to be registered nurses; some require a bachelor's degree as well. However, there are nurse-midwifery education programs that take students who are not registered nurses; during the course of their program, they become nurses as well as midwives. Examples are the midwifery education programs at Yale University, Columbia University, and the University of Pennsylvania. These programs confer a master's degree on their graduates as well as the right to sit for the nursing boards (usually at an intermediate point in the program) and the midwifery certification exam offered by the ACNM Certification Council, receiving the credential "certified nurse-midwife." In addition, there is one direct-entry midwifery program, at the State University of New York at Downstate, which does not lead to a nursing degree but only to a degree in midwifery. Graduates of this program also take the ACC exam and receive the credential "certified midwife."

All programs accredited by the ACNM require the students to have a bachelor's degree when they finish the program. That is, they must either enter with a bachelor's degree or receive that degree as part of their education. There are five programs which grant a certificate in nurse-midwifery without a degree; candidates must have a bachelor's degree to enter these program. However, the majority of ACNM-accredited programs lead to a master's degree, usually in nursing or in public health. Most of these programs are two years in length and comprise both didactic and intensive clinical training. The clinical training is largely in the hospital setting, as well as in ambulatory care settings where prenatal and gyn care are offered. In addition to the traditional programs, the ACC accredits several distance-learning programs. The best known of these is the Community Based Nurse-Midwifery Education Program (CNEP), which has enabled hundreds of nurses to stay in their own communities and complete their education as midwives.

MEAC-accredited Programs Most programs accredited by MEAC are free-standing educational programs and lead to a certificate in midwifery studies; there is a stronger focus on midwifery without extra requirements in nursing or other fields. Midwives who graduate from these programs have a more limited scope of practice but more experience in certain areas, particularly home birth. They usually provide home births, although they may also practice in birth centers.

There are also educational programs, using an apprenticeship model, that have chosen not to be accredited, but set and maintain their own standards. The Ancient Art Midwifery Institute, which provides distance-learning for midwives wishing to take the apprenticeship route to a home-birth practice, is an established and well-known program. To read more about their philosophy or to apply to their program; visit their website.

All this information about all these paths to midwifery is confusing, no doubt. Ah, just wait.... It gets more so! I would suggest finding practicing midwives and midwifery educators and asking them what they think. Did they make the right decision about education? Would they do it the same way again? What did they gain by taking the route they took? What did they lose? Most midwives are convinced that their path was the correct one, and will try to convince you to follow them down it. After you get many opinions, you will need to make your decision.

To find specific educational programs, click on the links above this text. To find out more about a program, contact the faculty directly or go to the ACNM or MEAC sites.