Exploring the Differences Between Various Types of Midwives
- themoderncradle
- Dec 31, 2025
- 5 min read
Choosing the right midwife can make a significant difference in your pregnancy and childbirth experience. Midwives play a vital role in supporting women through pregnancy, labor, and postpartum care, but not all midwives have the same training or certifications. Understanding the different types of midwives and selecting one with appropriate credentials can help you make informed decisions for your health and your baby's well-being.
Types of Midwives Explained
Midwives come from various educational backgrounds and certifications. The Four primary types recognized in the United States are Certified Nurse-Midwives (CNMs), Certified Midwives (CMs), Certified Professional Midwives (CPMs) and Traditional midwives. Each type has distinct training, scope of practice, and legal recognition that varies by state.
Certified Nurse-Midwives (CNMs)
Certified Nurse-Midwives are registered nurses who have completed graduate-level midwifery education accredited by the American Midwifery Certification Board (AMCB). CNMs are licensed healthcare providers who can deliver babies in hospitals, birthing centers, and homes, depending on state laws.
Education: Bachelor of Science in Nursing (BSN) plus a master's or doctoral degree in nurse-midwifery.
Certification: Passed the AMCB national certification exam.
Scope of Practice: Provide prenatal, labor, delivery, postpartum, and newborn care. They can also prescribe medications and perform gynecological exams.
Settings: Hospitals, birthing centers, home births.
Regulation: Licensed in all 50 states.
CNMs combine nursing knowledge with midwifery skills, offering comprehensive care that integrates medical and holistic approaches.
Certified Midwives (CMs)
Certified Midwives have similar midwifery education as CNMs but do not have a nursing background. They complete accredited midwifery programs and pass the same AMCB certification exam as CNMs.
Education: Graduate-level midwifery education without nursing degree.
Certification: AMCB certification exam.
Scope of Practice: Similar to CNMs, including prenatal, labor, delivery, postpartum, and newborn care.
Settings: Hospitals, birthing centers, home births (varies by state).
Regulation: Licensed in fewer states than CNMs. and only have prescriptive authority in a handful of states
CMs focus exclusively on midwifery care and often work alongside other healthcare providers to support women through pregnancy and childbirth.
Certified Professional Midwives (CPMs)
Certified Professional Midwives specialize in out-of-hospital births, such as home births and birthing centers. Their training focuses on practical experience and midwifery skills rather than nursing.
Education: Midwifery education through accredited programs or apprenticeships. No formal academic degree required.
Certification: Passed the North American Registry of Midwives (NARM) exam.
Scope of Practice: Prenatal, labor, delivery, postpartum, and newborn care primarily in home or birth center settings.
Settings: Home births, birthing centers.
Regulation: Licensed or regulated in some states; in others, CPMs may not be licensed. No prescriptive authority but may be able to administer medication depending on state.
CPMs emphasize natural childbirth and personalized care, often supporting women who prefer less medical intervention.
Traditional Midwives
Traditional midwives, also known as lay midwives or community midwives, are often trained through apprenticeships and community-based education rather than formal academic programs. Their training typically includes:
Apprenticeship: Many traditional midwives learn through hands-on experience by working alongside experienced midwives in their communities.
Community Education: Training may involve attending workshops, seminars, and community health programs that focus on childbirth practices, maternal health, and newborn care.
Cultural Practices: Traditional midwives often incorporate cultural beliefs and practices into their care, which can vary significantly between different communities.
Self-Study: Many traditional midwives engage in self-directed learning through books, online resources, and networking with other midwives.
Scope of Practice
The scope of practice for traditional midwives can vary widely based on local laws and regulations, as well as the individual midwife's training and experience. Traditional midwives often focus on:
Providing prenatal care and education
Assisting with labor and delivery, in home or community settings
Offering postpartum care and support
Supporting breastfeeding and newborn care
Legal Recognition
Legal recognition of traditional midwives differs depending on the state and region. It's important to note that traditional midwives are neither certified or licensed. Consequently, many states impose restrictions on their practice, and in some states, they are even prohibited from practicing.
Why Certification Matters When Choosing a Midwife
Selecting a midwife with the right certification ensures you receive safe, evidence-based care. Certification reflects a midwife’s education, clinical training, and commitment to professional standards.
Safety and Quality of Care
Certified midwives have met rigorous educational and clinical requirements. They are trained to recognize complications early and know when to refer to or collaborate with obstetricians or other healthcare providers. This reduces risks during pregnancy and childbirth.
For example, CNMs work in hospital settings where emergency care is immediately available, providing a safety net for unexpected complications. CPMs, while skilled in home births, must have clear protocols for hospital transfer if needed.
Legal Recognition and Accountability
Certified midwives are licensed and regulated by state boards or professional organizations. This legal recognition means they must adhere to ethical standards and continuing education requirements. If issues arise, patients have recourse through licensing boards.
Uncertified or unlicensed midwives may lack oversight, increasing the risk of substandard care or legal complications.
Access to Comprehensive Services
Certified midwives can provide a wide range of services beyond delivery, including prenatal screenings, family planning, and newborn care. CNMs and CMs can prescribe medications and order diagnostic tests, which CPMs generally cannot.
How to Choose the Right Midwife for You
When selecting a midwife, consider your birth preferences, health history, and the setting where you want to give birth. Here are some practical tips:
Verify Credentials: Check if the midwife is CNM, CM, or CPM certified and licensed in your state.
Understand Their Scope: Ask about the services they provide and their experience with your preferred birth setting.
Discuss Emergency Plans: Ensure they have clear protocols for hospital transfer or emergency care.
Meet in Person: Build trust by meeting your midwife before pregnancy or early on.
Check Reviews and References: Talk to other families or read testimonials about their care.
The Role of Midwives in Modern Maternity Care
Midwives offer personalized, continuous support that many women find empowering throughout their pregnancy, labor, and postpartum experiences. This individualized care is characterized by a deep commitment to understanding each woman's unique needs, preferences, and circumstances. Midwives often spend more time with their clients compared to traditional obstetric care, allowing for meaningful conversations and the establishment of a trusting relationship. This supportive environment fosters a sense of autonomy and confidence in women, enabling them to make informed decisions regarding their childbirth experience. Furthermore, midwives focus on promoting natural childbirth whenever possible, while also being fully equipped to respect and address medical needs that may arise during the process. This dual focus ensures that women receive care that aligns with their desires for a natural birth, while still being prepared for any necessary medical interventions that could enhance safety and well-being for both mother and baby.
Research studies consistently show that midwife-led care can lead to lower rates of cesarean sections, fewer medical interventions, and higher overall satisfaction among birthing individuals. For instance, women who choose midwifery care often experience a lower likelihood of undergoing unnecessary procedures, which can sometimes be prevalent in more medicalized settings. The holistic approach of midwives emphasizes not only the physical aspects of childbirth but also the emotional and psychological well-being of the woman, contributing to a positive birth experience. Additionally, the continuity of care provided by midwives—where the same caregiver often attends to the woman throughout her pregnancy and birth—can significantly enhance feelings of security and support, which may further contribute to better outcomes.
Certified midwives work collaboratively with obstetricians and pediatricians, creating a balanced approach that prioritizes safety while also respecting the birthing person’s choices and preferences. This collaborative model is essential in ensuring comprehensive care, as it allows midwives to draw on the expertise of obstetricians for high-risk situations while also providing women with the personalized support they desire. Such teamwork fosters an environment where the birthing person feels heard and valued, and where their birth plan can be respected as much as possible.
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