The Different Types Of Midwives
There are several different types of midwives in the United States. The following descriptions
are meant to remove some of the confusion and help you determine which type is best for you. The
two types of midwives recognized by the state of Arizona are Certified Nurse-Midwives, and Licensed
Midwives.
Remember, though, that each caregiver has his or her own way to care for women, and the way
each practices varies greatly from one person to another. This is true even when comparing caregivers
with the same title. It is important to choose a caregiver based on your comfort with him/her (finding someone
you can trust is key!), and not so much on his/her title (See "Hints on how to choose a caregiver").
Certified Nurse-Midwives (CNM)
Certified Nurse-Midwives work in every state in the U.S. They first become nurses, and
then receive their midwifery training in schools accredited by the American College of
Nurse-Midwives (ACNM). CNM's have formal schooling and clinical rotations, and are required to pass an exam
given by the ACC (ACNM Certification Council). Most CNM's work in
hospitals and birthing centers, while few attend home births. CNM's independantly care for low-risk women with physician
back-up always available. They can also care for women who have high-risk pregnancies through a mechanism called
"Co-management". The midwife consults with a physician for those aspects of the pregnancy that are beyond her/his
scope of practice. In this way, the CNM-MD team Co-Manage the pregnancy and the pregnant family gets the best of both
worlds!
Find a Certified Nurse-Midwife in the Phoenix metro area
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Licensed Midwives (LM)
Licensed Midwives are licensed by the state in which they work. Each state has different requirements
for LM's. In Arizona, LM's can receive their training through formal education or self-study,
AND apprenticeships. They are required to pass the
North American Registry of Midwives (NARM) exam, which has a written test and a skills test and is given by
the state of Arizona. Licensed Midwives attend low-risk births at home or in birthing centers, with physician
back-up always available.
Find a Licensed Midwife in the Phoenix metro area
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Certified Midwives (CM)
Certified Midwives are accredited by the American College of
Nurse-Midwives (the same agency that accredits Certified Nurse-Midwives). CM's are required
to have formal schooling and apprenticeships, and receive a 4-year degree in midwifery. They are not, however, required
to first become nurses. As of 2002, CM's work almost exclusively in the state of New York.
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Certified Professional Midwives (CPM)
Certfied Professional Midwives receive their training through formal training or self-study,
AND apprenticships. CPM's may or may not be licensed by their state. If they are, then they are also called a
Licensed Midwife. CPM's are required to pass the
North American Registry of Midwives (NARM) exam, which has a written test and a skills test. CPM's
attend low-risk births at home or in birthing centers, with physician back-up always available.
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Direct-Entry Midwives (DEM)
Direct-Entry is the term given to a midwife who has midwifery training but is not first a nurse.
This is a general term that could mean Certified Midwife, Certified Professional Midwife,
Lay Midwife, or Licensed Midwife.
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Lay Midwives
Lay Midwives practice without licensure from their state. Because of this, there can
be a vast difference in the knowledge and experience from one Lay Midwife to another. Lay Midwives attend births at
home, and in some states are
illegal.
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References
American College of Nurse-Midwives, "Professional Information".
Choosing a Nurse-Midwife: Your guide to Safe, Sensitive
Care During Pregnancy and the Birth of Your Child Catherine M. Poole & Elizabeth Parr, Wiley, 1994
Midwives Alliance of North America, "Terms Defined".
Our Bodies, Ourselves for the New Century Boston
Women's Health Book Collective, Simon and Schuster, 1998
For more books on this topic, go to book list
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