The Five Types of Midwives
Throughout history, midwives have helped women through pregnancy and birthing. Today, five types of midwives provide varying levels of care to women and newborn babies:
- Certified Nurse-Midwife (CNM)
- Certified Midwife (CM)
- Certified Professional Midwife (CPM)
- Direct-Entry Midwife
- Lay Midwife
Certified Nurse-Midwife (CNM) and Certified Midwife (CM)
Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs) are highly trained health care professionals who provide care for women not only during pregnancy and birth but also from adolescence through the end of life.
CNMs are nurses who have completed a graduate-level nurse-midwife program and passed a certification exam from the American Midwifery Certification Board, while CMs are non-nurses who have complete a graduate-level midwifery degree program and passed a certification exam from the American Midwifery Certification Board.
CNMs and CMs are qualified to provide the same level of care. All states license CNMs for independent practice but not all states license CMs. The American College of Nurse Midwives reports that CNMs and CMs attended 312,129 births in the U.S. in 2010, representing 11.6% of all vaginal births and 7.8% of total births.
Certified Professional Midwife (CPM)
A Certified Professional Midwife (CPM) has met the certification requirements of the North American Registry of Midwives (NARM). Applicants can qualify to take the NARM exam by either apprenticing with a qualified midwife and completing an Entry-Level Portfolio Evaluation Process or graduating from a midwifery program or school. If the program or school isn’t accredited by the Midwifery Education Accreditation Council, applicants must complete the Entry-Level Portfolio Evaluation Program.
CPMs are committed to providing the Midwives Model of Care:
- Monitoring a woman’s complete (not just physical) well-being from pre-natal through post-natal
- Identifying women who need to see an obstetrician and giving them appropriate referrals
- Giving each mother individualized education, counseling, and prenatal care, assisting during labor and delivery, and supporting the mother and newborn after the birth
- Using as few technological interventions as possible
The practice privileges of CPMs vary by state.
Direct-Entry Midwife (DEM)
Direct-entry midwives specialize in births at home and in free-standing birth centers. No national certification or licensing is available for direct-entry midwives and each state has its own legal requirements for education and licensing (if any).
A Certified Professional Midwife, Certified Midwife, or Certified Nurse-Midwife can be a direct-entry midwife, and some states do require some type of certification, while other states don’t. Most direct-entry midwives are self-employed.
Lay midwife refers to an uncertified or unlicensed midwife who often has an informal education, such as apprenticeship or self-study, rather than a formal education. Some states do have licensing for lay midwives, while other states don’t.