Hey there, mama-to-be! Choosing your care provider is a big step in your pregnancy journey. You might be wondering, “What is a midwife, anyway?”.
Well, grab a cup of tea and settle in, because your favorite labor nurse is here to answer all your questions!
Follow @mommy.labornurse on Instagram to join our community of over 650k for education, tips, and solidarity on all things pregnancy, birth, and postpartum!
What Exactly is a Midwife?
A midwife is a trained health professional that works with women to provide healthcare and support during:
- Pregnancy
- Labor and delivery
- The postpartum period (including breastfeeding support and newborn care!)
A midwife might also provide family planning, preconception, and gynecological care to women throughout their lives.
Different types of midwives
In the United States there are actually a few different types of midwives. In other countries, typically there is only ONE way to go about getting your midwifery license and ONE set of standards – in the United States there are a few different ways.
It’s important to recognize this when choosing a midwife because it’s very important for you as a patient to understand how your midwife is licensed (or not licensed). This will help you in selecting the best care possible for you during your pregnancy!
Certified-Nurse Midwives (CNMs)
- A registered nurse who receives additional training in pregnancy and childbirth
- Offers complete prenatal care, as well as attending births
- Has a bachelor’s in nursing (BSN) degree from an accredited institution
- Has a master’s degree in nurse-midwifery
- Certified by the American College of Nurse-Midwives (ACNM)
- Eligible to become licensed in all 50 states
- Can practice in hospitals and OB offices, but their scope also allows them to provide care in any birth setting
- Cannot perform Cesarean deliveries, and in most cases do not perform vacuum or forceps deliveries
- Generally care for low-risk pregnancies
- Most deliver in hospitals and are affiliated with a physician
Certified Midwives (CMs)
- An individual certified and trained in midwifery
- Offers complete prenatal care, as well as attending births
- Has a bachelor’s degree from an accredited institution. The bachelor’s degree is not in nursing
- Has a master’s degree in nurse-midwifery
- Certified by the American College of Nurse-Midwives (ACNM)
- Relatively new specialty. Currently only Delaware, Hawaii, Maine, Maryland, New Jersey, New York, Oklahoma, Rhode Island, Virginia, and the District of Columbia license CMs
- Can practice in hospitals and OB offices, but their scope also allows them to provide care in any birth setting
- Cannot perform Cesarean deliveries, and in most cases do not perform vacuum or forceps deliveries.
- Generally care for low-risk pregnancies
- Most deliver in hospitals and are affiliated with a physician
Certified Professional Midwives (CPMs)
- Provide complete prenatal care and attends births
- Works independently, usually delivering women at home or in freestanding birth centers
- Do not have to hold a specific degree or be a registered nurse. A high school diploma is the minimum requirement
- Experience may be gained through formal programs, apprenticeships, or a combination of both
- Is the only midwifery credential that requires knowledge about and experience in out-of-hospital settings
- Must pass a competency test by the North American Registry of Midwives (NARM)
- Licensed or otherwise regulated in 31 states
Direct Entry Midwives (DEMs)
- Provides complete prenatal care
- Specializes in births at home and in freestanding birth centers
- Practices independently and has learned midwifery through a midwifery school, apprenticeship, or college program in midwifery
- No national licensing or certification is available. Each state has its own legal requirements for education and licensing (if any)
Traditional/Lay/Empirical/Community-based midwives
- Not certified or licensed as a midwife but has received informal training through self-study or apprenticeship
- Training is not regulated, therefore abilities may vary
- Generally do not deliver babies in a hospital, but instead attend home births and may practice in a birth center
Benefits of using a midwife
According to the American College of Nurse-Midwives, benefits of receiving midwifery care include:
- Decreased risk of needing a Cesarean section
- Reduced rates of labor induction and augmentation
- Reduced use of regional anesthesia
- Decreased infant mortality rates
- Lower risk of preterm birth
- Decreased third and fourth-degree perineal tears
- Lower costs for both clients and insurers
- Increased chances of having a positive start to breastfeeding
- Increased satisfaction with the quality of care
- Empowered birth experience
What is an Obstetrician (OBGYN)?
An obstetrician is a medical doctor who specializes in the management of pregnancy, labor, and birth. They have specialized education in surgical care, focusing on the detection and management of the female reproductive system if obstetrical or gynecological problems occur. OBGYNs are required to attend and graduate from medical school, and then complete an additional four years of residency training in obstetrics, gynecology, gynecology oncology, ultrasonography, and preventative care.
Midwife vs. OBGYN
Midwives are trained to care for healthy, low-risk women during pregnancy and childbirth. Many work closely with obstetricians and will refer out high-risk pregnancies.
If you have a high-risk pregnancy or anticipate complications, it is recommended to choose a practice that has access to obstetricians, perinatologists, and other professionals who are trained to address these complications.
Doula, Midwife, Labor Nurse – What’s the Difference?
| Feature | Doula | Midwife | Labor Nurse |
| Training | Specialized training in labor support | Registered nurse with advanced midwifery training | Registered nurse specializing in labor and delivery |
| Medical Care | Emotional, physical, and informational support | Provides full-scope medical care for low-risk pregnancies | Provides medical care and assists with procedures |
| Focus | Does not provide medical care | Holistic care throughout pregnancy, labor, and postpartum | Medical care and monitoring during labor in a hospital setting |
| Setting | Home, birth center, or hospital | Home, birth center, or hospital | Hospital |
Is a Midwife right for you?
While every mama is unique, here are a few signs that a midwife might be the perfect fit for you:
- You’re hoping for a low-intervention birth: Midwives are experts in supporting natural childbirth. They trust your body’s innate ability to birth and will encourage you to embrace the process. They’ll offer guidance on natural pain management techniques, help you navigate labor positions, and minimize interventions unless medically necessary
- You value personalized care: Midwives take the time to get to know you, your preferences, and your birth vision. They’ll create a personalized care plan that honors your choices and supports your individual needs
- You want to be an active participant in your care: Midwives believe in shared decision-making. They’ll provide you with evidence-based information and empower you to make informed choices about your care
- You’re drawn to a holistic approach: Midwives consider your physical, emotional, and spiritual well-being throughout your pregnancy and postpartum journey. They offer a nurturing and supportive environment where you can feel comfortable and confident.
Still not sure? Here are some questions to ask yourself:
- What kind of birth experience do I envision for myself?
- What are my priorities for labor and delivery?
- How important is it for me to have a close relationship with my care provider?
- Am I comfortable with a more natural approach to childbirth?
By reflecting on these questions and exploring your options, you can make an informed decision that feels right for you and your baby. Remember, mama, you deserve a care provider who supports your vision and empowers you to have the birth experience you desire.
Resources
- Midwives Alliance of North America
- American College of Nurse-Midwives
- American Pregnancy Association
- Midwifery laws state-to-state
- State law chart for CPMs
- Find a CNM or CM
