When seeking health care from adolescence through menopause, women may choose different providers for primary care; gynecologic care; family planning and preconception care; and during pregnancy, birth, postpartum and newborn care. Throughout these experiences, women may receive care from healthcare professionals in various settings, including:
• Medical assistants, nursing assistants, and other unlicensed assistive personnel (UAPs)
• Nurses including licensed practical nurses (LPNs) and registered nurses (RNs)
• Advanced practice registered nurses (APRNs)
• Physician assistants (PAs)
Women seeking care during pregnancy, birth, and postpartum may choose to be cared for by one or more licensed independent providers (LIPs) below. In addition to selecting a provider, women may also choose for their care and birth experience to occur in hospitals, birthing centers, or in their homes. However, due to preference or unforeseen circumstances, a woman may be transferred to a higher level provider or care setting. Each LIP has a scope and standard of practice that is determined by educational experience and training, certification, professional organizations, and individual state laws.
- Physicians providing care to pregnant women may specialize in family practice, obstetrics/gynecology (OBGYN), or perinatology – OBGYNs who specialize in maternal fetal medicine and highrisk pregnancies. Physicians complete undergraduate education, medical school, residency, and often obtain board certification in their specialty. Physicians typically provide care to women in hospital settings, but may choose to do so in any birth setting.
- APRNs may specialize in family practice, women’s health, or midwifery. A certified nurse midwife (CNM) is an APRN who has completed nursing school (baccalaureate prepared), holds a RN license, and has completed additional advanced education, training, and certification. CNMs are the only APRNs who are able to provide care to women during childbirth in any birth setting.
- In Kentucky and 36 other states, women may also seek care from professional midwives where the profession is regulated in that state.1 A LCPM is a direct entry midwife who has a different pathway for training and clinical experiences than from CNMs. LCPM education and clinical training focuses on providing midwifery care to women who have a low-risk pregnancy and childbirth. Care is often provided in homes and freestanding birth centers rather than in hospitals and physician practices.
- Additionally, women may choose to have a doula to provide physical, emotional, and informational support. A doula is not licensed like the above healthcare professionals and does not perform clinical or medical tasks or diagnose and treat, but works as part of a woman’s team to achieve a healthy, safe, and satisfying birth experience.
For more information on the various LIPs and healthcare professionals providing care to women during pregnancy and childbirth, you may learn more on the following websites:
The Kentucky Board of Nursing is charged with the task of regulating LPNs, RNs, APRNs, and LCPMs, and does not have jurisdiction or provide regulatory guidance for medical assistants or other UAPs or physicians.
In Kentucky, as of April 30, 2021, there are 24 LCPMs and zero LCPM training programs. There are 126 CNMs and one CNM graduate program.
To become a LCPM in Kentucky, an individual may choose to complete their training and education from any CPM training program in the United States that is accredited by the Midwifery Education Accreditation Council (MEAC). Additionally, the individual shall provide evidence of having passed the North American Registry of Midwifes (NARM) Examination and been granted certification by NARM. Additional requirements to be met for licensure can be found on the following web link https://apps.legislature.ky.gov/law/ kar/201/020/620.pdf
To become a CNM in Kentucky, an individual may choose to complete their training and education from any nursing and graduate nursing program in the United States. The individual must have an active RN license and APRN licensure with CNM certification. Additional requirements to be met for licensure can be found on the following web links https://kbn.ky.gov/aprn/Pages/default.aspx https://kbn.ky.gov/aprnlicenseinfo/Pages/default.aspx
For LCPM credentialing inquiries please contact Suha QattanWalsh at Suha.Qattan-Walsh@ky.gov. For CNM credentialing inquires, please contact Tomeca Faulkner at Tomeca.Faulkner@ky.gov. For LCPM practice inquiries please contact Kim Richmond at Kim.Richmond@ky.gov. For CNM practice inquiries please contact Myra Goldman at MyraK.Goldman@ky.gov.
For additional information you may choose to review the following web links for LCPMS and CNMs statutes and regulations:
- KRS 314.011(8) APRN Definition https://apps.legislature.ky.gov/ law/statutes/statute.aspx?id=48246
- KRS 314.400 LCPM Definition https://apps.legislature.ky.gov/ law/statutes/statute.aspx?id=48873 APRN Kentucky Revised Statutes KRS 314.193 – 314.199 LCPM Kentucky Revised Statutes KRS 314.400 – 314.416 https://apps.legislature.ky.gov/law/statutes/chapter.aspx?id=38813
- APRN Kentucky Administrative Regulations 201 KAR 20:056 – 201 KAR 20:065 LCPM Kentucky Administrative Regulations 201 KAR 20:600 https://apps.legislature.ky.gov/law/kar/ TITLE201.HTM
- Kentucky Administrative Regulations Governing LCPM Practice: 201 KAR 20:670, 201 KAR 20:650 https://kbn.ky.gov/lcpm/Documents/ LCPM_Practice.pdf
KIM RICHMOND has been an RN for a decade and has focused her career on working in high-risk obstetrics as a labor and delivery nurse, clinical research nurse, and adjunct faculty. She spent six years teaching clinically and didactically and has enjoyed mentoring new nurses and nursing students. She has an MSN in Nursing Education, a DNP focusing on global health and health policy, and is currently enrolled in a postmaster’s FNP certificate program.