Certified nurse midwives (CNMs) are advanced-practice registered nurses who specialize in the care of women's reproductive health and perinatal period. The benefits of CNMs include lower rates of cesarean births, inductions, perineal tears, and use of regional anesthesia. They are also highly skilled at patient education.

While CNMs have many benefits, many parents-to-be and even student nurses interested in a career as a CNM are curious as to their limitations in the delivery room. For example, are there any situations in which a CNM is not qualified to assist? More specifically, delivering multiples (twins, triplets, etc.).

There are no definitive rules as to what a CNM can or cannot handle. It depends on the state, as each state has its scope of practice laws. Some states allow independent practice while others require an MD present. It also depends on the facility or organization. Some private practices may enable CNMs to manage delivering multiples, while others do not. Larger organizations frequently have specific practice limitations as well.

In short, from an educational standpoint, a certified nurse midwife CAN manage multiple births. The question is if they are restricted by state and organizational regulations. CNMs should check with their state board of nursing to determine their specific scope of practice and for any physician oversight/ collaborative agreement requirements. Additionally, they should check with their employer to find out if there are any facility-based restrictions. Above all, a CNM needs to feel comfortable asking for assistance when needed.

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