The core competencies for basic
midwifery practice describe the fundamental knowledge, skills, and behaviors expected of a new
practitioner. Accordingly, they serve as guidelines for educators, students, health care
professionals, consumers, employers, and policy-makers and constitute the basic requisites for graduates of all
nurse-midwifery and midwifery educationThe core competencies for basic
midwifery practice describe the fundamental knowledge, skills, and behaviors expected of a new
practitioner. Accordingly, they serve as guidelines for educators, students, health care
professionals, consumers, employers, and policy-makers and constitute the basic requisites for graduates of all
nurse-midwifery and midwifery education
programs accredited/preaccredited by the Accreditation Commission for Midwifery Education (ACME) (formerly the American College of Nurse-Midwives (ACNM) Division of Accreditation (DOA).
Midwifery practice is based on the Core Competencies for Basic Midwifery Practice, the Standards for the Practice of Midwifery and the Code of Ethics promulgated by the American College of Nurse-Midwives. Certified nurse-midwives (CNMs) and certified midwives (CMs) who have been certified by the ACNM or the American Midwifery Certification Board (AMCB), formerly the ACNM Certification Council, Inc. (ACC), assume responsibility and accountability for their practice as primary health care providers for women and newborns.
The scope of midwifery practice may be expanded beyond the core competencies to incorporate additional skills and procedures that improve care for women and their families. Following basic midwifery education, midwives may choose to expand their practice following the guidelines outlined in Standard VIII of the Standards for the Practice of Midwifery.
Midwifery education is based on an understanding of health sciences theory and clinical preparation that shapes knowledge, judgment, and skills deemed necessary to provide primary health care management to women and newborns. Midwives provide health care that incorporates appropriate medical consultation, collaborative management, or referral. Each education program is encouraged to develop its own method of addressing health care issues beyond the scope of the current core competencies, and each graduate is responsible for complying with the laws of the jurisdiction where midwifery is practiced and the ACNM Standards for the Practice of Midwifery.
ACNM defines the midwife's role in primary health care based on the Institute of Medicine's report (1996)*, the ACNM philosophy (2004), and the ACNM Position Statement on Certified Nurse-Midwives and Certified Midwives as Primary Health Care Providers/Case Managers (1997). Primary health care is the provision of integrated, accessible health care services by clinicians who are accountable for addressing the majority of health care needs, developing a sustained partnership with patients, and practicing within the context of family and community. As primary health care providers, CNMs and CMs assume responsibility for the provision of, and referral for, appropriate health care services including the prescribing, administering and dispensing of pharmacologic agents. The concepts, skills, and midwifery management process
programs accredited/preaccredited by the Accreditation Commission for Midwifery Education (ACME) (formerly the American College of Nurse-Midwives (ACNM) Division of Accreditation (DOA).
Midwifery practice is based on the Core Competencies for Basic Midwifery Practice, the Standards for the Practice of Midwifery and the Code of Ethics promulgated by the American College of Nurse-Midwives. Certified nurse-midwives (CNMs) and certified midwives (CMs) who have been certified by the ACNM or the American Midwifery Certification Board (AMCB), formerly the ACNM Certification Council, Inc. (ACC), assume responsibility and accountability for their practice as primary health care providers for women and newborns.
The scope of midwifery practice may be expanded beyond the core competencies to incorporate additional skills and procedures that improve care for women and their families. Following basic midwifery education, midwives may choose to expand their practice following the guidelines outlined in Standard VIII of the Standards for the Practice of Midwifery.
Midwifery education is based on an understanding of health sciences theory and clinical preparation that shapes knowledge, judgment, and skills deemed necessary to provide primary health care management to women and newborns. Midwives provide health care that incorporates appropriate medical consultation, collaborative management, or referral. Each education program is encouraged to develop its own method of addressing health care issues beyond the scope of the current core competencies, and each graduate is responsible for complying with the laws of the jurisdiction where midwifery is practiced and the ACNM Standards for the Practice of Midwifery.
ACNM defines the midwife's role in primary health care based on the Institute of Medicine's report (1996)*, the ACNM philosophy (2004), and the ACNM Position Statement on Certified Nurse-Midwives and Certified Midwives as Primary Health Care Providers/Case Managers (1997). Primary health care is the provision of integrated, accessible health care services by clinicians who are accountable for addressing the majority of health care needs, developing a sustained partnership with patients, and practicing within the context of family and community. As primary health care providers, CNMs and CMs assume responsibility for the provision of, and referral for, appropriate health care services including the prescribing, administering and dispensing of pharmacologic agents. The concepts, skills, and midwifery management process
identified below comprise the
foundation upon which practice guidelines and educational curricula are built. The core
competencies are reviewed and revised regularly to incorporate changing trends
in midwifery practice. This document must be adhered to in its entirety and applies
to all settings for midwifery care including hospitals, ambulatory care
settings, birth centers and home.
of Midwifery
to the ACNM Philosophy, Standards, and Code of Ethics
A. Independently manages primary
health screening and health promotion of women from the perimenarcheal through the postmenopausal periods
1. Initiation or referral for age/risk appropriate periodic health screening2. Management strategies and therapeutics for alleviating the common discomforts that may accompany the perimenopausal period
B. Management of Common Health Problems
Independently manages infections, self-limited conditions, and mild and/or stable presentations of chronic conditions, utilizing consultation, collaboration, and/or referral to appropriate levels of health care services as indicated.
1. Applies the knowledge of midwifery practice that includes, but is not limited to, the following:
a. Identification of deviations in the following areas:
* Cardiovascular/hematologic
* Dermatologic
* Endocrine* Eye, ear, nose, and throat* Gastrointestinal* Mental health* Musculoskeletal* Neurologic* Respiratory* Renal
b. Management strategies and therapeutics for the treatment of common health problems/deviations of essentially healthy women
VI. Components
of Midwifery Care: The Childbearing Family
A. Care of the Childbearing Woman: Independently manages the care of women during pregnancy, childbirth, and the postpartum period
Applies knowledge of midwifery practice in the antepartum period that includes, but is not limited to, the following:
a. Confirmation of pregnancyb. Genetics, placental physiology, embryology, and fetal developmentc. Epidemiology of maternal and perinatal morbidity and mortalityd. Influence of environmental, cultural and occupational factors, health habits, and maternal behaviors on pregnancy outcomese. Emotional and psychosexual changes during pregnancyf. Health risks, including but not limited to, domestic violence, infections, and substance use/abuseg. Promotion of breastfeedingh. Indicators of normal pregnancy and deviations from normali. Assessment of the progress of pregnancy and fetal well-beingj. Etiology and management of common discomforts of pregnancyk. Management strategies and therapeutics that facilitate healthy pregnancyl. Deviations from normal and appropriate interventions including management of complications and emergenciesm. Anticipatory guidance related to birth, breastfeeding, parenthood, and change in the family constellation
2. Applies knowledge of midwifery practice in the intrapartum period that includes, but is not limited to, the following:
a. Confirmation and assessment of labor and its progressb. Assessment of maternal and fetal status during laborc. Indicators of deviations from normal, including complications and emergenciesd. Measures to support psychosocial needs during labor and deliverye. Management strategies and therapeutics to facilitate physiologic labor progressf. Techniques for (i) administration of local anesthesia (ii), spontaneous vaginal delivery, (iii) third stage management, and (iv) performance and repair of episiotomy and repair of lacerationsg. Techniques for management of emergency complications and abnormal intrapartum events
3. Applies knowledge of midwifery practice in the postpartum period that includes, but is not limited to, the following:
a. Postpartum self-care, newborn care and feeding, contraception, and family relationshipsb. Management strategies and therapeutics to facilitate a healthy puerperiumc. Facilitation of the initiation, establishment, and continuation of lactationd. Deviations from normal and appropriate interventions including management of complications and emergenciese. Management of discomforts of the puerperium
B. Newborn Care: Independently manages the care of the well newborn during the first 28 days of life.
Applies knowledge of midwifery practice to the newborn that includes, but is not limited to, the following:
a. Effect of maternal/fetal risk factors on the newbornb. Bonding and attachment theoryc. Evaluation of the newborn: initial gestational age assessment and initial and ongoing physical and behavioral assessment
d. Methods to facilitate adaptation to extrauterine life: (i) stabilization at birth, (ii) resuscitation, and (iii) emergency management
e. Primary health screening, health promotion and assessment of growth and development up to 28 days of life
f. Facilitation of the initiation, establishment, and continuation of lactation
g. Management strategies to facilitate integration of the newborn into the family
h. Indications of deviation from normal, recognizing which infants should be referred to their pediatric care provider for further evaluation and care
*Committee on the Future of
Primary Care, Institute of Medicine, National Research Council. "Primary Care: America's
Health Care in a New Era". Washington, D.C: National Academy Press, 1996.
Source: Basis Competency
Section, Division of Education
Approved by the ACNM Board of Directors: June 1, 2007
Updated January 15, 2008
(Supersedes ACNM Core Competencies for Basic
Midwifery Practice, May 2002)
