Most midwives in the United States are health care providers who offer services to women of all ages and stages of life. With their advanced education and their focus on research and partnering with women, they are among the most modern, forward-thinking health professions in the United States today.
With all the changes happening in health care, the midwifery approach to caring for women has never been more important. Today’s woman expects the best care. She expects her provider to understand and value her individual needs. She wants a provider who will partner with her to make health decisions.
Midwives focus on what is most important to each woman’s unique situation and values and often work with other members of the health care team. It’s time to think about whether a midwife might be the right choice for you.
When considering a health care provider who will best meet your needs, keep in mind that many midwives focus not only on maternity care, but also on the full range of a woman’s health needs. Certified nurse-midwives (CNMs) and certified midwives (CMs) provide care starting with a woman’s first period until after menopause, plus all the important health events in between, such as:
CNMs and CMs are independent health care providers. They also work with other members of the health care team, such as physicians and nurses, to provide the highest quality care. They work in a variety of settings, such as hospitals, medical offices, clinics, birth centers, and homes. They provide general health care services, gynecology care, family planning, as well as maternity care (before, during, and after childbirth). They are covered by most insurances.
Types of Midwives
Midwives are dedicated to providing you with the personalized health care experience you deserve. When looking for a midwife who will best meet your needs, it is important to understand the different options available to you in the United States.
Certified Nurse-Midwife (CNM®)
CNMs are registered nurses with graduate education in midwifery. They have graduated from a nurse-midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME). This education includes a university degree as well as hands-on clinical training by practicing CNMs. They also have passed the national certification exam of the American Midwifery Certification Board (AMCB). CNMs provide general women’s health care throughout a woman’s lifespan. These services include general health check-ups and physical exams; pregnancy, birth, and postpartum care; well woman gynecologic care; and treatment of sexually transmitted infections. CNMs are able to prescribe a full range of substances, medications, and treatments, including pain control medications. CNMs work in many different settings, such as hospitals, health centers, private practices, birth centers, and homes. Most midwives in the United States are CNMs.
Certified Midwife (CM®)
CMs are midwives with a bachelor’s degree in a field other than nursing who have graduated from a graduate-level midwifery education program accredited by ACME. The midwifery education program for CMs includes health-related skills and training in addition to midwifery education, which is the same as that of CNMs. Like CNMs, they have passed the national certification exam of the AMCB. CMs provide the same services as CNMs, practice in the same settings, and receive the same preparation as CNMs to safely prescribe a full range of substances, medications, and treatments, including pain control medications.
Certified Professional Midwife (CPM)
CPMs prepare for a national certification exam administered by the North American Registry of Midwives (NARM) in different ways. There are two primary pathways for CPM education with differing requirements: apprenticeship training alone or an accredited formal education program. The health care services provided by CPMs are not as broad as those of CNMs and CMs. CPMs provide pregnancy, birth, and postpartum care for women outside of the hospital—often in birth centers and homes. CPMs are not able to prescribe most medications.
FAQs about Midwives
How is a nurse-midwife different from a doctor?
Nurse-midwives are trained in the care of primarily healthy women, both pregnant and non-pregnant. The model used is a holistic model of care that incorporates physical, mental, and social needs of the entire family. Studies show that this model of behavior results in fewer use of interventions such as medications, cesareans, etc.
Can a nurse-midwife administer medications in labor for pain relief?
Yes, nurse midwives working in hospitals have access to all of the pain medications that physicians do, including narcotics and epidurals. However, nurse midwives use a variety of nonpharmacological techniques for laboring women including position changes, hydrotherapy, and other techniques. Evidence has shown that many of these techniques offer equal and in some cases, improved pain relief and are well received by laboring women.
Women who choose to birth at home or in a freestanding birth center would not have access to epidurals or an extensive list of medications, but do have the opportunity to use the nonpharmacological techniques discussed above.
If I go to a nurse-midwife, do I need a doula or labor assistant?
These are two different issues. A nurse-midwife does provide labor support but the decision for a doula is something you should discuss with your midwife. Some women with special needs find that they need both professionals while others are comfortable with a nurse midwife alone.
Nurse midwives and doulas are a perfect team for women giving birth, but the decision on who will attend a birth is a personal decision that can only be answered by mothers, their midwives, partners, and family.
Can a nurse-midwife take care of my baby?
Nurse-midwives are trained to take care of newborns as part of their basic education. If you choose to deliver your baby at home or in a birth center, your nurse-midwife will be responsible for the care of your baby at birth and up to a month thereafter. If you deliver in a hospital, the nurse-midwife is less likely to take care of your baby unless she/he works with a family physician. You would be asked to identify a provider for your baby. That could be a family physician, pediatrician, or other health care provider.
How can I find a midwife?
ACNM hosts a database of around 4,000 midwifery practices. For more information, or to find a midwife, please visit the ACNM Find a Midwife page.