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January 03, 2008



Yes, if you want to work w/in the medical community, having an RN (or even a BS or MSN) will help legitimize your efforts, in their eyes at least.

Of course, the more contact you have with the current birth systems, the more risk you run of sickening your soul - I worked as a hospital program administrator in a DC area hospital for 5 years and it effected me deeply. Take care of yourself if that is the route you go.



While I agree that having an RN will likely give you an advantage in the medical community and to help "legitimize" your career, I just want you to know that you will not likely acquire many relevant labor & delivery skills during nursing school. Obstetric nursing is generally a short 8-9 week rotation (which is divided among antepartum, postpartum, L&D, & nursery), so it's really just a few days on L&D, which, as a student, is mostly observation. My clinical instructor's goal was to have each of us get to see one vaginal delivery and one c/s--not much to speak of. Most skills you "want" (you mentioned "specializing in L&D") are learned during the first year as a new nurse. I attended the top-ranked nursing school in the country (UPenn) and never once did I get to do a vaginal exam, start an IV, draw blood, anything like that. ALL those are skills I learned "on the job" as a new nurse; in talking with my co-workers, I learned this is not unusual. In nursing school you mostly get a lot of theory and cursory exposure to different "kinds" of nursing, e.g, OB, psych, geriatrics, etc., but really develop the relevant skills once you're working in the field. I was hoping to learn a lot more in nursing school, but after 6 years as a doula, I found my OB theory classes painfully remedial (diagrams, "this is a uterus, this is a cervix"). I work as an L&D nurse now (and am in a CNM program) and EVERYTHING I learned about childbirth I learned previously as a doula, NOT in nursing school. (I've only been a nurse for a little over a year now, and am continually horrified by how little my coworkers know about birth, other than medications, EFM, and lithotomy.) Please know that I'm not trying to discourage you from pursuing an RN; I think there are definite advantages, including general assessment and critical thinking skills. I don't, however, believe that nursing school will in any way increase your knowledge or skills regarding childbirth. Maybe you don't know as much about medications, etc., as nurses, but if you work as a doula now and are a CPM student, I guarantee you that your knowledge of childbirth already far exceeds that of any nurse--INCLUDING most L&D nurses. Best of luck to you in whatever path you choose--I'm sure you'll be fantastic.


Thanks so much for sharing your insight. I think my primary interest in the RN is in its ability to help me organize/communicate with the medical community, in the future. I guess my final decision will depend on what kind of financial aid I can receive at the school of my choice etc. It is interesting to know then that RNs acquire knowledge in the same way apprentices do, on the job. The goal of one vaginal delivery and one c/s is rather disappointing. Lots to think about! Good luck pursuing your CNM!

Red Pomegranate

Hi Kat! I can certainly understand where you're coming from, I've been on "the path" for over a decade and, as a single Mom of eight of those years, felt becoming an RN was a good way to continue that path. It's a blessing and a curse. I now must decide whether or not to become a CNM or "drop out" and pursue lay midwifery. I now have a three month old and a supportive husband, but I also feel like I owe it to the entire family to move more towards Nurse Midwifery for stability and finance sake.

It's a hard choice, I wish you the best on you journey, and if you'd ever like to ask me anything I invite you to enter into a dialogue with me.


Red Pomegranate,
Thanks so much for your comments. And good luck making the decision whether or not to become a CNM or pursue lay midwifery. Regarding stability, my thought was that if I had the RN and for some reason my family need a bit more stability, I could always take a break from being a lay midwife and be an RN again for a year or two. Two of my aunts were RNs and practiced off an on over the years, both are "retired" but still go in every now and then.

Kelly Valceanu

hi there - i'm currently in an rn program and plan to enter a cnm program. nursing school is not what you may think it is! it certainly can give you insight on how the medical community thinks. i'm doing clinicals at arlington starting next weeek, in l & d, for six weeks. like a previous post mentioned, i feel like i know so much more than any instructors i've encountered so far. they just think in terms of drugs and controlling the effects of such. if you are serious about starting an rn program, send me an email and i'll give you a first hand account.


Hi there... great blog! I'm a RN and I work in a community hospital birth center. I thought I'd leave a comment.

I am all for midwifery. In fact, I have considered becoming a lay midwife myself. But I have small children and no childcare and the hours just won't work for our family. I do think becoming an RN is a valuable tool if your goals are to gain some credibility with the medical community and some insight as to what goes on during hospital birth. My advice is this: Keep your eye on the goal... never deviate! Hospital birth is not pretty. You will see things that will devastate you and that go against everything you believe. If you are the labor nurse, you will be forced to do things to women that you don't believe in and know cause harm and risk. But you will attain your goal of gaining experience and inside knowledge. It just depends on what price you are willing to pay for that knowledge. And you'll need to learn in nursing school that you need to tell your instructors what they want to hear, not what you know to be correct. Nursing is a harrowing world. Good luck!


Thanks for the comment, and for the support. I agree that I will have to "stay tough" to make it through the hospital and I am thinking long and hard about whether I a have it in me to do it. It seems that my end goal will be worth it, especially if I can find an affordable way to pay for my studies. They have a Peace Corps fellows program and I am a former Peace Corps volunteer so I am crossing my fingers. Good luck to you as well!

katie g

I started nursing school because I was bit by the birthing business bug, but I was still very young and wanted some letters behind my name.

Thru the nursing school experience, I learned to hate hospitals, hate L&D, and ultimately decide that Hospice was much more my thing (talk about a 180).

Strangely, through quite a bit of serendipity, I have just started a new job in a tiny hospital in rural America as a L&D nurse. There is no newborn nursery here (all "Rooming In"), we do a lot of Amish/Mennonite births, and the cesarean rate is much lower here than anywhere around. The most important thing about this place is that the nurses here TRUST BIRTH.

That doesn't mean I don't see horrible things. Michel Odent says the first intervention that laboring women do is leave their homes. I have seen many broken hearts. I've seen babies torn from mama's arms.

At least 99% of women have their babies in hospitals. That means that I have the ability to influence many people that maybe didn't trust birth. I may have the chance to help that mom who had the emergency cesarean birth breastfeed her baby, when maybe she couldn't have otherwise. I have the chance to use the term "cesarean birth" rather than "sectioned."

Basically, I feel that my path has led me here and that I can do good where I've found myself.

But it is hard work, sister. And a horrifying battle once you get there.

I've thought about going back and becoming a CNM, but I've decided not to till I'm an old woman. Our ancestors did it that way for a reason. I have a family to take care of and the midwives in my community don't set a very good example for having both family and a career in midwifery.

Whatever you decide, it will be hard work. Good luck on your path.

women's lacoste shoes

At least 99% of women have their babies in hospitals. That means that I have the ability to influence many people that maybe didn't trust birth. I may have the chance to help that mom who had the emergency cesarean birth breastfeed her baby, when maybe she couldn't have otherwise. I have the chance to use the term "cesarean birth" rather than "sectioned."

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