category one: vocation

i realize that i may not have shared with some of you my change of plans which took place a few months ago while i was in guatemala. i decided not to go to the midwifery school Maternidad La Luz in El Paso. instead i am going to go into Nurse Midwifery.

in case you do not know, there are different classifications of midwives. There are traditional midwives: usually indigenous women practicing the old way of midwifery that is sometimes integrated with some new practices. There are unlicensed midwives: women who are midwives but either live in a state where there is no opportunity to gain licensure (where midwifery and homebirth is outlawed) or women who choose not to get licensed because of the limitations that licensure would put on their practice. There are licensed midwives called Certified Professional Midwives CPMs who have obtained a state specific licensure and can attend homebirths and sometimes work at birth centers. There are also Certified Nurse Midwives CNMs who have a nursing certificate and a masters in Nurse Midwifery. These midwives are usually found working in hospitals and birth centers, but many also attend home births.

now the state-to-state licensure for CPMs does not permit one to deliver babies in the breech position or twins, the regulations don't allow you to serve women who desire to have a vaginal birth after having previously had a cesarean section. There are more standards but these are the main ones that stand out as being quite restrictive. After much thought and reflection I decided that these restrictions would be very difficult for me to deal with. Nurse Midwives have different standards of care. They are given more credit for doing the same work as CPMs but they have a nursing degree which gives them more autonomy. I also made this decision because I would like to be able to work in public health and CPMs are limited as well in this area.

So for the present this means that I am taking a bunch of science classes at the community college and applying to graduate programs in Nurse Midwifery. I am applying to UPENN in Philadelphia as well as UW here in Seattle. I might apply to others but I have not decided yet.