For centuries, women have turned to midwives for support and assistance in childbirth. (Midwife means "with woman.") Today's certified nurse-midwives continue to provide this personal care, which represents a bridge between traditional birth practices and modern technology.
A certified nurse-midwife (CNM) is a registered nurse who has also completed an accredited educational program in nurse-midwifery and passed an examination given by the American Midwifery Certification Board (AMCB). In California, nurse-midwives are licensed by the state Board of Registered Nursing (BRN).
Despite the most advanced medical technology in the world, the United States has higher rates of maternal and infant mortality compared to many countries that use midwifery as their primary model of care.
In the United States, some studies have indicated that midwife-attended births have lower NICU admission rates and lower cesarean birth rates and greater patient satisfaction with care. Midwifery is increasingly perceived as an appropriate alternative to traditional obstetrical care. Consequently, the use and need for midwives continues to grow.
Nurse-midwives provide primary care to childbearing women in a variety of inpatient and outpatient settings including hospitals, homes, and birth centers. They provide care that is informed by a core belief that birth is not a medical event, but a normal physiologic process among healthy women.
The Women's Health Nurse Practitioner
The Women's Health Nurse Practitioner (WHNP) is a registered nurse who has completed advanced education with a focus on the primary health care needs of women across the life cycle, with emphasis on conditions unique to women from menarche through the remainder of their lives.
Besides clinical care, WHNPs focus on health promotion, disease prevention, health education and counseling, and helping patients make wise health and lifestyle choices. Program graduates earn a certificate as a WHNP that enables them to be board certified as a WHNP and licensed in the State of California.
The UCSF Nurse-Midwifery and Women's Health Nurse Practitioner Program
In 1975, the San Francisco General Hospital Nurse-Midwifery Service was established through the UCSF School of Medicine to provide a site for the education of Nurse-Midwives and Women's Health Nurse Practitioners (WHNP) and to demonstrate that nurse-midwifery practice was a safe alternative to traditional obstetrical care in the hospital environment. The program subsequently partnered with the School of Nursing and was co-located, hence its name: The UCSF/SFGH Interdepartmental Nurse-Midwifery Program. In 2011, administrative and financial functions were moved to the School of Nursing but the program maintains strong ties to its original home through faculty and clinical preceptors.
Since its inception, the program has graduated hundreds of nurse-midwives while the midwifery faculty practice has attended births for more than 15,000 women. The program is dedicated to increasing service to vulnerable and underserved women and families and adheres to the philosophy of the American College of Nurse-Midwives (ACNM).
This is a two-year program leading to the Master of Science degree, with certificates in nurse-midwifery and as a WHNP. The core curriculum includes courses in:
- advanced health assessment
- nurse-midwifery management of the antepartum,
intrapartum, and postpartum woman
- well woman health care and the newborn
- nurse-midwifery management of complications
- health promotion and disease prevention
- assessment and management of common
primary care signs and symptoms
- clinical pharmacology
- assessment and management of psychiatric symptoms
- issues in nurse-midwifery professional practice, and
- cultural and linguistic competency
Students in the Master of Science program also take a series of theory and research courses throughout their two-year program. This culminates in a final comprehensive scholarly paper.
Clinical residencies include rotations in antepartum, intrapartum, postpartum, well woman's health, newborn, and primary care. Students also complete an integration residency which is a full scope clinical experience in sites that range from private midwifery practices to tertiary care hospitals.
The Nurse Midwifery/WHNP specialty area also offers a two-year post-master's certificate program to registered nurses who are already prepared at the Master of Science level and seeking to become a CNM/WHNP. Further, CNMs who have completed their undergraduate education may earn a Master of Science degree through a one year, 36 unit, individualized program of study.
Students who graduate from the program are eligible to take the national board certification exams administered by the American Midwifery Certification Board (AMCB) and the National Certification Corporation (NCC).
Please note that the CNM/WHNP specialty curriculum and schedule are subject to change. As indicated by the curriculum table, the combined specialty track has a rigorous academic unit load, and graduates will complete more than one thousand hours of clinical training. Depending on the quarter, students are expected to be on campus 1-2 days per week and in clinical settings 1-4 days each week. Classes are usually held on Wednesdays, with additional class time on Tuesdays or Thursdays during some quarters. Some program content is provided on-line, but all specialty courses and most general courses currently have in-person class sessions. Both overnight and weekend shifts should be anticipated during intrapartum clinical rotations, including the final quarter--when students may be required to travel or temporarily re-locate for a full-time, full-scope midwifery residency. The CNM/WHNP specialty makes every effort to accommodate student preferences when assigning clinical placements, but requests cannot always be accommodated due to factors beyond our control including site and preceptor availability.
Philosophy and Beliefs
For information on UCSF SON MS Program application procedures:
Post-Master's Certificate OptionFor information about the post-Master's certificate option in this dual specialty program, please contact the coordinator: Jenna Shaw-Battista (email).
- UCSF Nurse Midwives Program (at San Francisco General Hospital):
Frequently Asked Questions
Our program is fortunate to be an integral part of a busy committed community-based nurse-midwifery practice in a culturally diverse urban community. We enjoy a stable and collegial relationship with our fellow clinicians in the Ob/GYN Department of the UCSF School of Medicine. This affords our students excellent clinical opportunities as well as access to superb consultants and world-class speakers on obstetric complications. Our nurse-midwifery faculty members are all expert clinicians, clinical preceptors, as well as skilled classroom teachers. Just as importantly, our students have the opportunity to take their primary care and core graduate classes from the outstanding faculty in the UCSF School of Nursing. Our curriculum offers extensive coursework in primary care as well as cultural sensitivity and linguistic competency. The three program strengths consistently identified by students at graduation are 1) excellent clinical rotations and training, 2) excellent nurse-midwifery faculty and preceptors, and 3) wonderful classmates.
The program does not provide opportunities to attend home births as part of our clinical rotations due to the University's inability to provide malpractice insurance for home birth. However, some students attend integration at select birth center practices. The program supports a woman's right to choice of birth setting and encourages students to learn the skills necessary for safe out of hospital birth practice.
Experience as a labor and delivery nurse can be very helpful in developing an appreciation of the process of labor and birth. However a variety of experiences in women's health are valued and this experience is not an absolute requirement.
Yes. NP students meet with faculty to design a program which reflects the student's experience and knowledge. Past coursework, professional experiences and student goals are evaluated to determine if any coursework should be challenged. We do not expect students to repeat curriculum they have already mastered.
The graduates of this program work as midwives throughout California and the United States and the world. They practice in many types of hospitals from small community settings to large tertiary hospitals, in birth centers and in home birth practices. A recent survey of the program graduates of the last 5 years indicates that 95% are employed, with over 75% caring for underserved, uninsured, Medi-Cal or minority families.
Over 95% of our students study full time and complete their program in two years. The majority of specialties hold classes two days a week (Tuesday/Wednesday or Wednesday/Thursday) to allow for clinical part-time work and family obligations. "Official" part-time status is highly restricted and is available only by special arrangement. In certain circumstances, also by special arrangement, faculty will allow a student to extend a two-year program over three years.