Last time we talked about the basics of nurse-midwifery. Today we will talk about what it means to be a direct entry midwife. Just like nurse-midwifery, direct entry midwifery is a term that holds many types of training and practice.
The term direct entry midwifery is a bit awkward, and probably only exists in the United States (I haven’t heard any non-US midwives use it). It seems to be a term used to differentiate between midwives who are trained first as a nurse from those who were not — you are either a nurse-midwife or a direct entry midwife. In the rest of the world midwives seem to be all called “midwives.” If they are differentiated, it seems to be based on where or how they practice rather than how they were trained.
The term direct entry midwife tells you nothing about the actual training received, except that the individual did not train as a nurse first. The term is used to describe midwives with and without formal school training in midwifery. It encompasses everything from the one-on-one apprenticeship training to a four year university training. As you can see, it isn’t a very discrete term.
Where I live in the United States, the term is often used to describe midwives who train to work outside the hospital, but this is not exclusive. Any midwife may work outside the hospital, and some direct-entry midwives can obtain hospital privileges.
In many countries all midwifery training is direct entry regardless of where the midwife will ultimately work. For example, consider this information about training as a midwife in the UK. Anyone can take the three year university course and become a midwife who will work in hospital or community — and nurses can take a shortened version of the course.
Similar rules exist in Australia, where you can obtain a bachelor of midwifery or train as a midwife after obtaining a nursing degree. However notice the comment about rural work on that page. Just as I experienced with the Kenyan midwives, there is a preference for nurse training if you desire to work in areas with low access to health care.
Taking the regulatory and system issues out of the equation (because they vary by country), what benefit does training as a direct entry midwife provide?
1. Focused training in midwifery allows faster entry to practice.
2. Less required education (no nurse training), means potential for less cost of education.
Is Direct Entry Midwifery for Me?
You might want to consider direct entry midwifery if:
1. You plan to only provide basic maternity care.
2. You plan to provide care in high-resource areas (easy to transfer care when needs arise).
These lists may look different depending on the context of where you live. Be sure to understand the unique challenges of direct entry midwifery in your country before making the final decision. What unique benefits does direct entry midwifery have where you live?