What is a Midwife?

A midwife is a trained professional with special expertise in supporting women to maintain a healthy pregnancy and birth, offering expert individualized care, education, counseling and support to a woman and her newborn throughout the childbearing cycle.

A midwife works with each woman and her family to identify their unique physical, social and emotional needs. When the care required is outside the midwife’s scope of practice or expertise, the woman is referred to other health care providers for additional consultation or care.

The Midwives Alliance of North America, the North American Registry of Midwives, the Midwifery Education Accreditation Council and Citizens for Midwifery agreed on a short definition of what “midwifery care” means. However, just because a person is a midwife does not guarantee that they provide this kind of care: consumers looking for a midwife should ask questions to determine if a prospective caregiver will be able to provide the kind of care they seek.

The Midwives Model of Care

The Midwives Model of Care is based on the fact that pregnancy and birth are normal life processes. The Midwives Model of Care includes:

• Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
• Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery and postpartum support
• Minimizing technological interventions
• Identifying and referring women who require obstetrical attention

The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section.

Midwives in the U.S.

There are two main categories of midwives in the U.S., nurse-midwives, who are trained in both nursing and midwifery, and direct entry midwives, who trained as midwives without being nurses first. Within the category of direct entry midwives are several subcategories reflecting the varying legal status of these midwives in different states and the fact that until recently there was not a nationally recognized credential available for direct entry midwives. Direct entry midwives include highly trained and very competent midwives; however, anyone may call herself a midwife at this time, and if you are looking for a midwife, it is up to you to find out if the midwife is qualified and experienced to your satisfaction. If a midwife is a Certified Professional Midwife (CPM), you are at least assured that she has met specific requirements for certification (and re-certification every three years).

Direct-Entry Midwives (including Licensed Midwives)

1. Not required to be nurses.
2. Multiple routes of education (apprenticeship, workshops, formal classes or programs, etc., usually a combination).
3. May or may not have a college degree.
4. May or may not be certified by a state or national organization.
5. Legal status varies according to state.
6. Licensed or regulated in 21 states.
7. In most states licensed midwives are not required to have any practice agreement with a doctor.
8. Educational background requirements and licensing requirements vary by state.
9. By and large maintain autonomous practices outside of institutions.
10. Train and practice most often in home or out-of-hospital birth center settings.

For more information, contact your state’s midwifery organization or CFM.

The Certified Professional Midwife (CPM) credential and the North American Registry of Midwives

1. Not required to be nurses.
2. Multiple routes of education recognized; direct entry midwives and certified nurse midwives can qualify for this credential.
3. Education programs accredited by the Midwifery Education Accreditation Council prepare students to meet the requirement for the CPM.
4. Out-of-hospital birth experience is required.
5. Have met rigorous requirements and passed written exam and hands-on skills evaluation.
6. Administered by the North American Registry of Midwives.
7. Legal status varies according to state.
8. Practice most often in homes and birth centers.

For more information e-mail info@narm.org or call 1-888-84-BIRTH (Eastern Time)

Certified Nurse Midwives (CNMs) and the ACNM’s CM credential

1. Educated in both nursing and midwifery, primarily in the hospital setting; are "advanced practice nurses."
2. Must have at least a Bachelors Degree when training is complete.
3. Have successfully completed a university-affiliated nurse-midwifery program accredited by the American College of Nurse-Midwives, and passed the exam.
4. Out-of-hospital clinical experience is not required.
5. Are legal and can be licensed in all states.
6. Most practice in hospitals and birth centers.
7. In most states must have some kind of agreement with a doctor for consultation and referral.

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