Kinds of midwives in the United States
For a number of reasons, midwives in the United States vary in their expertise,
their education, their credentials, their legal status and the place where they
can help a woman give birth. Knowing about the different kinds of midwives can help
you be an informed consumer and aid you in finding and choosing a midwife. Remember,
not all midwives practice the Midwives Model of Care.
"Two broad categories of midwives exist in the United States: nurse-midwives and
direct-entry midwives. Nurse-midwives are educated in both nursing and midwifery,
while direct-entry midwives focus their professional preparation on midwifery alone.
… In order to practice as a nurse-midwife, one must be a certified nurse-midwife
(CNM)." From, "The Future of Midwifery," a Joint Report of the Pew Health Professions
Commission and the University of California, San Francisco Center for the Health
Professions, April 1999 linked here.
Certified Professional Midwives (CPMs) are midwives (mostly direct-entry midwives)
who have met all the requirements for the CPM credential. (Learn more here.) Other direct-entry
midwives may have met certification requirements of their state midwifery organization
or practice without outside certification.
Direct-entry midwives are especially prepared to attend births in out-of-hospital
settings (free-standing birth centers and individual homes), and almost all practice
in these settings exclusively.
Most Certified Nurse-Midwives (CNMs) practice midwifery and attend births in the
hospital setting, though some work in birth centers and a very few attend births
in the home setting. You can find out more about CNMs here.
Many direct-entry midwives, with or without a certification credential, are also
licensed by their state. Some states license direct-entry midwives; in other states
these midwives practice but are not regulated by the government; and in other states,
practicing midwifery may be illegal or unlawful.
Lack of national certification or licensure does not necessarily mean that the midwife
lacks the knowledge or skill to practice the Midwives Model of Care. At the same
time, just because a person is a midwife does not guarantee that they provide the
Midwives Model of Care. Therefore, if you are looking for a midwife, ask questions
to find out if an available midwife (or other caregiver) will be able to meet your
needs and provide the kind of care you seek.
For more detailed information about the different kinds of midwives and their legal
status in your state, visit Answers to Frequently Asked Questions.
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