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Re-entry Guidelines for Certified Nurse-Midwives and Certified Midwives

The following provides guidelines for certified nurse‐midwives/certified midwives (CNMs®/CMs®) re‐entering the midwifery workforce after a period of time of either not working as a midwife or not working In at least one area of full‐scope practice. However, the needs of each re‐entering midwife must be individually evaluated and a plan for re‐entry developed on a case‐by‐case basis.

I. CNMs/CMs who have maintained AMCB certification, but have not worked as a midwife for the following periods of time, have three routes to re‐entry, based on years out of clinical practice.
A. Less than 2 years without clinical practice: orientation should be determined by the midwifery practice this CNM/CM will be joining. A more structured or a longer than usual orientation may be needed.
B. 2‐5 years without clinical practice: a full‐scope precepted clinical experience should be arranged with a clinical preceptor or preceptors, utilizing continuing education modules or didactic education through a midwifery education program as needed.
C. More than 5 years without clinical practice: didactic knowledge equivalency to a safe, beginning practitioner should be demonstrated through an accredited midwifery educational program as well as a precepted clinical experience

II. Upon completion of the re‐entry plan, the precepting CNM/CM or the sponsoring education program must be able to verify that the re‐entry midwife is at a safe, beginning practitioner level.

III.The precepting CNM/CM or CNMs/CMs may be:
A. At the practice that will be hiring the CNM/CM;
B. At a practice that the midwife contracts to work with;
C. At a practice that has a contract with the midwifery educational program that is providing the didactic component of the re‐entry requirement .
D. CNMs or CMs who have had experience as clinical teachers or are recognized as expert midwives by the clinical practice the midwife will join.

IV. If the re‐entry CNM/CM has maintained practice in some areas (and has only one or several areas in which she is not current), then the re‐entry plan will only need to be targeted to those areas of practice in which the CNM/CM is not current.

V. CNMs/CMs who have not maintained their AMCB certification will need to comply with AMCB requirements for re‐certification as well as these guidelines for re‐entry.

VI. CNMs/CMs must check with their state licensing boards for any additional requirements. State requirements supersede these guidelines.

VII. CNMs/CMs must check institutional requirements for credentialing and privileging. These requirements also supersede these guidelines if the midwife wishes employment at that institution.

VIII.The attached self assessment tool and evaluation may be used by the re‐entry candidate or the precepting site to assist with development of the re‐entry plan.


Re‐Entry Guidelines

Years out of clinical practiceLess than 2 years
2-5 years
Greater than 5 years
Clinical Requirements When Full Scope Re‐entry Practice is Needed
Orientation in a clinical practice.

May need to be more structured or longer than usual.
Full‐scope, precepted clinical experience with a validated clinical preceptor.
Full‐scope, precepted clinical experience through an accredited midwifery education program. The program may utilize challenge mechanisms for didactic and/or clinical competency assessment.
Clinical Requirement when Limited Re‐entry Practice is Needed
Orientation in a clinical practice.

May need to be more structured or longer than usual.
Precepted clinical experience in the area(s) of need with a validated clinical preceptor.
Precepted clinical experience in the area(s) of need with a validated clinical preceptor.
Didactic Requirement

Utilize continuing education modules as needed.
May need to participate in certain didactic content from a midwifery education program. The program may utilize challenge mechanisms for didactic and/or clinical competency assessment.
Should demonstrate knowledge equivalency through an accredited midwifery education program. The program may utilize challenge mechanisms for didactic and/or competency assessment.
Fees/Cost
Fees will be determined by the practice
Fees will be determined by the practice and/or the educational program
Fees will be determined by the practice and/or the educational program
Certificate
None
Preceptor may provide letter of completion delineating the area or areas in which the CNM/CM gained experience and her level of proficiency.
Programs might give a post‐MS certificate, enroll students in a MS completion program, or allow non‐matriculated students. Program may provide a transcript or delineate the area or areas in which the CNM/CM gained experience and her level of proficiency. Program or preceptor may provide letter of completion when degree or certificate is not granted
Liability Insurance
May be provided by the practice or purchased by the individual CNM/CM.
May be provided by the practice or purchased by the individual CNM/CM.
May be provided by the practice, the educational program, or purchased by the individual CNM/CM.

Reentry Guidelines for Certified Nurse‐Midwives/Certified Midwives 4
© American College of Nurse‐Midwives, December 2010

 
       






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