“If I were to go and become a nurse just to become a midwife, it feels like a hoop to jump through. This is a much more streamlined way to get good midwives into the community and doing good work without clogging up the RN system, because we also need RNs. So kind of differentiating those things, I think, is valuable.”
Tara Melinkovich is talking about a clearer path to reaching her dream of becoming a certified midwife (CM). She has an extensive healthcare background, including a master’s degree in public health. She wanted to enter the midwifery profession directly – without pursuing a nursing degree first.
She’s able to do that at the University of Colorado Anschutz College of Nursing through its new Master of Science in Midwifery (MSM) program. The program started in June and prepares students to become certified midwives (CMs).
Certified midwives provide the same care as certified nurse-midwives (CNMs), but they don’t have a nursing degree. They both care for women, newborns, and families, focusing on birth and reproductive care. They can work in hospital systems in inpatient and outpatient settings or in community birth settings at birth centers or home birth.
Dr. Shannon Pirrie, specialty director of the midwifery programs, says the college’s nurse-midwifery program has been offered for more than 40 years. In 2022, Colorado passed legislation to regulate certified midwives to practice in the state. In response to the new law, the college began developing a new master’s program to educate and train them.
“We developed this pathway here to add an education option for certified midwifery into our already existing certified nurse-midwifery program,” Pirrie says. “There are some differences in how they're admitted, like different prerequisite course needs and some course differences in the program to ensure health system education, since certified midwife candidates may come to the program without having a healthcare education background.”
The Midwifery program is the first of its kind at the college, and is one of three across the country. Unlike the nurse-midwifery program, it does not require any prior nursing experience or a Bachelor of Science in Nursing (BSN). Students in the college’s nurse-midwife program need a BSN degree to be admitted. The first cohort started in June and is a hybrid program with a mix of online and in-person classes and clinicals.
Pirrie says in the past, nursing has been a stepping stone for people to decide to go into midwifery, but now this program provides a new opportunity for students to enter the field directly.
Midwifery Program vs. Nurse-Midwifery Program
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Midwifery students start their program by taking a physical assessment class with the undergraduate nursing students and a health systems course in the School of Public Health to build their healthcare foundation. From there, they will join nurse-midwifery students in taking the core master's courses, then more specialized classes in caring for childbearing families and practice in the college’s midwifery clinics.
“The goal of the midwifery cohort being added to our school is not to remove nursing, it's to add midwifery,” Pirrie says. “They will be educated with midwives who are nurses, and they're going to be educated with nurses who are becoming nurse practitioners who aren't becoming midwives.”
Pirrie says there is no difference in quality of care between a CM and a CNM. However, not all states have passed laws allowing CMs to practice, so they are more limited in where they can work. CMs can be licensed in 12 states and Washington, D.C., compared to CNMs, who can be licensed in all 50 states.
The Student Experience
The program’s first cohort has five students, each with a similar goal: to ensure quality patient care during the pregnancy and birthing process.
One of these students, Kathryn Schoenecker, says she joined the program to improve birth outcomes.
“I think that midwives have a really unique ability to not only improve birth outcomes but to improve the whole landscape when it comes to birth, prenatal and postpartum care, and women's care in general,” she says.
The program’s accessibility and focus on the local community were two key reasons why Alexa Cleary-Townsend enrolled. “I'm based in Colorado, and I think being able to train in the community in which I envision myself working is really meaningful, but also just having access to a program that encourages more midwives to exist because there aren't as many barriers with the direct entry program was also a very meaningful reason as to why I chose this,” she says.
Melinkovich says in the past, midwives have been an alternative for people having home births, but she says there needs to be more access to midwives across the health care system.
“We should be empowering all birthing people to be able to have a midwife if that's what they want. There are signs that people really do want midwives, that we need more out there, and so to be able to create that access, I think is really important as well.”
Financial Support
To honor the inaugural cohort, Dean Elias Provencio-Vasquez, PhD, RN, FAAN, FAANP, gave each student a $6,000 scholarship. Pirrie says the money is a “thank you” to each student for putting their trust in the college’s newest program.
Receiving a scholarship allowed Melinkovich to fully focus on her education.
“Getting the scholarships was really helpful for me to feel comfortable taking the leap to basically leave my job. I think if we had not gotten those scholarships, I wouldn't have felt as safe,” she says.
Schoenecker says the gift was meaningful in other ways, too.
“It was nice to hear that the school as a whole has an investment in the direct entry midwifery program. I thought that it was really encouraging that the school is seeing the need for midwifery.”
