- To facilitate communication among midwives.
- To further the education of midwives.
- To educate the public regarding midwifery and childbirth.
- To respond to the legal needs of midwives.
- To further the alliance between midwives and other health care professionals.
- To maintain affiliation with local and national organizations that share our interests, as well as other state midwifery groups.
General Information About Midwives
Direct-entry midwives (DEMs) practice legally in approximately 34 states, with licensure available in 27 states. Direct-entry midwives are independent practitioners educated in the discipline of midwifery through self-study, apprenticeship, formal midwifery school, or a college- or university-based program distinct from the discipline of nursing. A direct-entry midwife is trained to provide care to healthy women and newborns throughout the childbearing cycle primarily in out-of-hospital settings.
States that provide licensure for DEMs vary in their requirements. Most require the midwife be certified through The North American Registry of Midwives (NARM) as a Certified Professional Midwife (CPM), although some still have their own requirements in place. All states which credential (or license) DEMs, with the exception of New York, use the NARM Written Exam as their state licensing exam.
Efforts are underway in many states to make the CPM credential the basis of licensure, or a route to licensure for direct-entry midwives who practice predominantly in out-of-hospital settings. The CPM credential was created in 1994 by and for midwives. It recognizes a broad range of educational pathways, is competency based, and requires out-of-hospital birth experience. Practice is based on the Midwives Model of Care. For more information about the CPM, go to the mission statement of the North American Registry of Midwives or contact them via email.
Certified nurse-midwives (CNMs) are licensed health care practitioners educated in the two disciplines of nursing and midwifery. They provide primary health care to women of childbearing age including: prenatal care, labor and delivery care, care after birth, gynecological exams, newborn care, assistance with family planning decisions, preconception care, menopausal management and counseling in health maintenance and disease prevention. The CNM practices within a health care system that provides for consultation, collaborative management or referral as indicated by the health status of the client. This collegial relationship with physicians allows many hospital-based CNMs the ability to care for women with a wide variety of risk factors and obstetrical needs. While the majority of CNMs deliver in hospital settings, some CNMs also work with low-risk clients independently in birth center or homebirth practices. CNMs now deliver 9% of all babies born in the US.
The majority of CNMs are educated in programs within institutions of higher education leading to a Masters Degree, and this has become the current standard of nurse-midwifery education. CNMs are certified through the American Midwifery Certification Board (AMCB) and practice legally in all states, though the scope of what they can legally do varies state by state.