An Overview of the Midwifery Program

Group ImageImagine yourself as a student midwife at Nizhoni Institute, an accredited post secondary school.

This is what you’ll do in your journey to becoming a midwife.

Nizhoni Institute of Midwifery prepares midwifery students to provide excellent care to healthy pregnant women and their newborns, including the ready identification of complications requiring consultation or referral.

Does that sound like a mouthful? Hold on—it gets better.

Your class sessions will be relaxed and informal, with questions, answers, and practical skills (health assessments, histories, vitals checks) demonstrated and then practiced on one another. Classrooms have comfortable furniture, or you may sit on the floor, but school room desks are not the way we do things at Nizhoni. (Forget about dozing off in lectures because you’ll be active and involved.) In lab sessions, you’ll work with up-to-date models and materials. In preceptorships, you’ll observe and participate in labor and delivery—the very thing you’ve set your long-term goals on!

If you’ve ever played a musical instrument, you know that it takes both knowledge (theory by instruction) and physical skills (practice and performance) to be a musician. With Nizhoni’s program, you’ll develop the analytical skills and critical thinking pathways that provide the foundation for clinical problem-solving.

The program meets course objectives through guided study, discussion, clinical skills practice, multi-media materials, computer-based education, and clinical preceptorship (skills acquisition). Learning activities are evidence-based and oriented toward the midwifery practice.

Though you’ll learn in a relaxed setting, you’ll obtain a formal midwifery education while preserving the advantages of the “Midwifery Preceptorship” model. By combining independent and group study, online discussion, and classroom training with supervised clinical experience, you’ll develop the necessary knowledge and skills essential for entry-level midwifery practice. The format allows you to integrate midwifery theory with practice.

The didactic (teaching) portion of the program is three years in length and consists of 888 hours of didactic study. Students are encouraged to obtain clinical experience with two preceptors whenever possible. Preceptorship usually begins after approximately a year in the didactic program. Clinical experience requires 2,000 hours of supervised practice with credentialed midwife mentors until all clinical competencies have been satisfactorily completed in accordance with the requirements of Nizhoni Institute of Midwifery and the North American Registry of Midwives. Classroom plus clinical completion will result in your proud graduation from Nizhoni Institute of Midwifery.

Graduates are prepared for the scope of practice outlined by the Midwives’ Alliance of North America (MANA) Core Competencies, the North American Registry of Midwives (NARM) certification requirements for Certified Professional Midwives, and the joint mission statement of the Midwives Alliance of North America and the American College of Nurse-Midwives (ACNM).

Licensed Midwife

In some states, such as California, Florida and Washington, direct-entry midwives are licensed by the state with strict requirements for state-approved formal education or approved equivalency options. (These three states presently extend licensure reciprocity.) In several other states, direct-entry midwifery is licensed or otherwise regulated and educational requirements involve alternate routes and/or the demonstration of didactic and clinical competency. And in other states midwifery practice is either legal but unregulated or illegal. In these situations, midwifery training is typically obtained by a combination of preceptorship and independent or group study. The Nizhoni Institute of Midwifery combines the best of didactic education with preceptorship and is designed to meet the most stringent requirements for state midwifery licensure.

In California, midwives are licensed by the Medical Board of California to practice in every setting: birth centers, homes, hospitals, public health clinics, and physician and midwifery offices. California’s standards for midwifery education are among the highest in the nation and licensed midwives enjoy a broad scope of practice.

Certified Nurse-Midwife or Certified Midwife

The Certified Professional Midwife (CPM) credential is widely recognized and is viewed increasingly as an entry-level professional standard for midwives providing care in out-of- hospital settings.
A student who is a registered nurse may enter a program approved by the American Midwifery Certification Board (AMCB) of the American College of Nurse-Midwives to become a certified nurse-midwife or CNM. These programs are university-affiliated and require a baccalaureate degree as a prerequisite to application. A few programs allow non-nurses with a baccalaureate in another field to enter a three-year Master of Science program. During this time they study basic nursing, obtain a nursing degree and then complete a Master of Science in Nursing or a Master of Science in Midwifery. They are then allowed to take the examination for certification as a nurse-midwife. The majority of CNMs in the United States practice in hospitals or birthing centers, although about 1% attend homebirths. A few AMCB-approved programs in the United States offer a direct-entry, Certified Midwife credential to non-nurses. at present only a small number of states in the United States recognize the CM credential.

OB/GYN Physician Assistant

Another route to working with birth and women’s health care involves becoming a Certified Physician Assistant (PA-C) with a specialty in obstetrics and gynecology. Physician Assistants must have a supervising physician and are allowed to practice to the full extent of their training, although in most states they have less practice autonomy in comparison to advanced practice nurses. Physician assistant programs are university-based but the prerequisites, length of training, and degree earned varies.

Direct-Entry Midwife

Apprenticeship is a time-honored method of midwifery training but does have two significant weaknesses. First, many midwives do not actually teach needed didactic information to their apprentices. Second, apprentices tend to inherit and perpetuate a preceptor’s areas of knowledge deficit and may not have sufficient knowledge or experience to recognize their problem areas.

You’ll obtain certification as a professional midwife through the North American Registry of Midwives as a condition of graduation.

“The entry level midwife is a primary health care professional who independently provides care during pregnancy, birth, and the postpartum period for women and newborns within their communities. Services provided by the midwife include education and health promotion. With additional education and experience, the midwife may provide well- woman gynecological care, including family planning services. When the care required extends beyond the midwife’s abilities, the midwife has a mechanism for consultation, referral and continued involvement.”

Graduates of Nizhoni Institute of Midwifery are prepared to:

  • Practice as professional midwives, meeting nationally accepted standards of midwifery practice, to promote the health and well-being of childbearing families and women throughout the life cycle.
  • Provide safe, competent midwifery care to childbearing women and their newborns through appropriate utilization of the midwifery model of practice in primary care, collaboration, and timely and appropriate consultation and referral.
  • Analyze, synthesize, and apply concepts from midwifery, nursing, obstetrics and complementary medicine within the framework of the midwifery model of care in order to improve maternal, perinatal and community health outcomes.
  • Midwives should be able to evaluate the adequacy of underlying knowledge from midwifery science, related fields and professional foundations, as it informs advanced midwifery practice.