The simple answer is that we are all midwives.  Midwives have different styles of practicing, but should all be practicing similarly with the  Midwifery Model of Care™. 

All midwives do some kind of apprenticeship training. That is the traditional way of learning and the only way to learn hands-on skills. The main difference is in the academic training and where they did their apprenticeship training. A midwife that only trained in the hospital may not be comfortable with out-of-hospital settings and vice versa.

DEM stands for Direct-Entry Midwife. This is someone who may or may not of had a formal or structured academic training, but likely did self-study along with an apprenticeship. This midwife is trained for out-of-hospital settings.

CPM stands for Certified Professional Midwife. This is given to midwives that pass the North American Registry of Midwives (NARM) national exam. The midwife may or may not have had formal education, but the exam requires academic education. This can be acquired through an accredited school, non-accredited school or through self-study. Many states are requiring that new midwives take this exam before practicing as a midwife. In Colorado, new midwives are required to pass the NARM exam to apply as a Registered Midwife (RM) in Colorado. RMs and LMs (licensed midwives) are a midwife that can practice in the state that she is registered, under certain regulations. Every state has different regulations around midwifery. Please go to MANA to find out more about your state. These midwives are out-of-hospital.

Finally, a CNM stands for Certified Nurse Midwife. A CNM goes through standard nursing school: undergraduate and Registered Nurse. Then, a graduate program for midwifery. CNMs have trained in hospital settings, and may or may not have trained out-of-hospital. Depending on the state regulations, CNMs can run birth centers and might be able to do home births. Regulations are often different for CNMs than for DEMs, CPMs, LMs, or RMs.

Cheryl Furer is a Registered Midwife in Colorado and also a CPM.

Unfortunately, Medicaid does not cover Registered Midwives in Colorado.

For private insurance carriers, you, or an insurance biller, can file GAP exceptions or out-of-network claims, if the insurance allows it.

For private insurance companies, you, or the insurance biller, will need to contact your insurance company directly to find out what your policy covers. You can call the insurance company yourself to verify your benefits or you can have an insurance biller do it for you.  We use SLB Billing to file all insurance claims for our practice.  

Insurance is billed after the birth, but as midwives our financial agreement is to be paid before birth.  (Payment plans and sliding scale is available.)  If your insurance company reimburses for your care, then your midwifery deductible will be refunded the amount that you have paid, minus the registration fee, co-pays, and deductibles.

When laboring and giving birth, many find that entering the water during labor greatly reduces the intensity of contractions. It can be calming and comforting to be in a bath of warm water. Water birth/labor also increases a sense of privacy and encourages a sense of control. Water birth has been shown to reduce the amount of interventions and can help reduce the length of labor. Water can help you move into positions that are optimal for you and the baby and help reduce perineal tears.

Typically a midwife will stay between 3-6 hours after the birth. In the immediate postpartum, the midwife monitors the newborn’s transition, the placenta’s birth, and how you are adjusting postpartum.  Then after everyone is stable and comfortable, we will clean up and work on our charting. We monitor yours and your baby’s vitals without interfering with bonding and breastfeeding. When the timing is right, we will do the newborn exam, help you freshen up, and remind you the postpartum instructions. Once you and your baby are comfortable and cleaning is finished, we will depart your home.  We return the next day for your first postpartum visit! 

The primary midwife will file your birth certificate. This must be completed within 10 days after the birth. It’s okay if you don’t have a name picked out right away. You have a few days available to figure it out. A social security number will be given automatically and sent to you about 14 days after the birth is filed. To order official copies of your birth certificate visit: https://www.colorado.gov/pacific/cdphe/birth-certificates

The Colorado Midwives Association has lots of great information about midwifery in Colorado. The Find a Midwife section has a list of practicing homebirth midwives in the state.
Nurse-Midwives is Colorado can operate birth centers and some work in hospital settings. Please visit Colorado Nurse Midwives website for more information.