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.

Certified Nurse Midwives (CNMs)

• Educated in both nursing and midwifery, primarily in the hospital setting; are “advanced practice nurses” with prescribing authority.
• Must have a Masters Degree when training is complete.
• Have successfully completed a university-affiliated nurse-midwifery program accredited by the American College of Nurse-Midwives and have  passed the national certification exam by the American Midwifery Certification Board.  http://www.amcbmidwife.org/

• Are legal and can be licensed in all states.   http://www.dopl.utah.gov/index.html
• Can practice in hospitals, birth centers and homes.
• In Utah, may have an informal agreement with a physician for consultation and referral.

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

The Certified Professional Midwife (CPM)

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

Midwifery in the US