THE TRANSITION FROM LAY MIDWIFE TO CERTIFIED NURSE-MIDWIFE IN THE UNITED-STATES

This paper presents the results of a survey that was conducted between November 1992 and March 1993. Its target group consisted of midwives in the United States who began their careers as lay midwives and later decided to become certified nurse-midwives (CNMs). Questions address their demographic and socioeconomic characteristics to compile a profi le that can be compared with other midwife populations. The survey eli cited information regarding what motivated the decisions to change sta tus and how these decisions have made an impact upon respondents' pers onal lives, family life styles, and income; identified how becoming a nurse-midwife changed the respondents' work in regard to their own com munity, the clientele they serve, and their style and site of practice , and how the change in identity affected their self-perceptions as mi dwives as well as their relationship to the health care system, the le gal system, and the established midwifery system; it investigated how respondents viewed their preparation for midwifery and how they felt a bout the relationship of nursing to midwifery; and, it addressed how t hese midwives related to, were influenced by, and influenced the two m ajor professional midwifery associations in the United States, the Mid wives Alliance of North America and the American College of Nurse-Midw ives. The results showed that, overall, the respondents valued their l ay midwifery background, felt positive about their CNM educational pro grams, and showed a preference for direct entry and apprenticeship pro grams in which the RN is not a prerequisite.