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Don’t let the BBC hit Call The Midwife fool you: Midwives are not relegated to 1960s London! In fact, in 2021, certified midwives and certified nurse-midwives attended over 390,000 births in the United States—which is a 26% increase in just 10 years. And, surprise, nearly 97% of those births occurred at hospitals or birth centers—not home births. Curious why midwife-assisted births are steadily growing in popularity? Wondering what a midwife actually does? Or why would you use a midwife instead of a doctor? Here, we break down everything you need to know about midwives to help you make the best birthing decision for you.

What is a midwife?

Licensed midwives are highly-qualified healthcare professionals trained to handle many aspects of women’s healthcare, including pregnancy, childbirth, and postpartum care.

Midwife Certification

To become a certified nurse-midwife (CNM) or certified midwife (CM), one must complete an accredited graduate-level midwifery program, pass a national certification exam, and be licensed by their preferred state. In addition, CNMs and CMs need to be recertified every five years and meet specific continuing education requirements. Midwives work in a variety of settings, like hospitals, birthing centers, private practices, health maintenance organizations (HMOs), and health departments. While midwives are not physicians, they often (not always) work with obstetrician-gynecologists (OB/GYNs) to help ensure you have access to the exact kind of care you need.

Different Types of Midwives

Here is quick cheat sheet on the most common types of midwives in America:

  • Certified nurse-midwife (CNM): A certified nurse-midwife is also a registered nurse with at least 1 to 2 years of prior nursing experience. These midwives are hospital-trained in both nursing and midwifery. The majority of CNMs practice in clinics and hospitals, but they can provide care in any birth setting. CNMs are licensed to deliver babies in all 50 states and the District of Columbia.

  • Certified midwife (CM): A CM is qualified to provide the same level of healthcare as a CNM, but don’t have a background nursing. Only a few states (including New York, New Jersey, and Maine) legally recognize and license certified midwives. (These midwives are also dubbed direct-entry midwives or licensed midwives.)

  • Certified professional midwife (CPM): These midwives are not required to have an academic degree, but they must have experience in out-of-hospital settings. In some states, CPMs practice in clinics or doctors’ offices, in homes, and freestanding birth centers. (CPMs also fall under the direct-entry and licensed midwife umbrella.)

  • Lay midwives: These midwives (also called traditional midwives) don’t have certification nor a license to practice.

What does a midwife actually do?

Here’s a sample of some of the services your midwife may provide:

  • Nutrition, lactation, fertility, and other reproductive health counseling

  • Holistic, family-centered care, focusing on wellness and emotions

  • Prenatal care, including routine pregnancy monitoring

  • Ultrasounds and prenatal blood work

  • Attend birth and deliver babies

  • Possibly attend home births

  • Newborn care during the first 28 days of life

  • Postpartum care

  • Birth control and family planning

  • Prescribe medications

  • Pap tests and breast exams

  • STI screenings and screenings for other vaginal infections and diseases

Can midwives offer pain medicine in labor and delivery?

Yes! Midwives can offer medications for pain management. And if you are in a hospital setting, that includes an epidural.

Why choose a midwife instead of a doctor?

OB/GYNs are specially trained in all aspects of women’s reproductive health, pregnancy, childbirth, and primary care, making them beyond qualified to shepherd you from preconception to postpartum and beyond. In fact, MDs deliver the vast majority of babies in America and are the go-to healthcare professional if you’re going to have a c-section or if your pregnancy is considered high-risk. But still, many birthing people opt for a midwife instead. That decision often comes down to your overall health, your personal preference, and if your birthing philosophy gels with the midwifery philosophy. That underlying belief is essentially: For most, childbearing is a natural, healthy, innate physiological process that should be protected and supported.

Birthing parents-to-be might choose a midwife if they’re…

  • Interested in a “high-touch, low-tech” birthing experience with minimal intervention

  • Relatively healthy

  • Considered low-risk

  • Looking for a holistic provider

  • Looking for support throughout labor and delivery

  • Considering a home or water birth (About 80% of home births are attended by a midwife.)

  • Interested in hypnobirthing

[ Learn more about how to choose the right prenatal care practitioner for you. ]

What are the risks of using a midwife?

Being under the care of a midwife was associated with no adverse effects when compared to doctor-led care—and several benefits for both the birth parent and the baby, according to the Cochrane Library.

What are the benefits of having a midwife?

Choosing a midwife over an OB/GYN is a personal decision and should be based on your own preferences, comfort level, and personal health. Here are some of the possible benefits of selecting a certified nurse-midwife or a certified midwife as your provider:

Are midwives covered by insurance?

Most states mandate private insurance reimbursement for certified nurse-midwife and certified midwife care. But it’s always a good idea to call your insurance provider to see if your midwife falls under the umbrella of your carrier's coverage. That said, Medicaid reimbursement for certified nurse-midwife care is mandatory in all states. Most Medicaid programs reimburse certified nurse-midwives and certified midwives at 100% of physician rates.

How do I find a midwife?

Some OB/GYN offices have midwives on staff, so it’s a good idea to investigate the practice you’re already part of first. No luck? Contact…

  • Your insurance company for a directory that lists nearby physicians and midwives who take your coverage.

  • The American College of Nurse-Midwives for help finding a licensed midwife in your area. While their online tool was under repair at press time, you can call them at 240-485-1800.

  • Sista Midwife Productions to locate a Black midwife in your area. You can narrow your search CNMs, CPMs, and more.

  • OutCare features a directory called OutList that recognizes LGBTQ+ affirming providers. Right now, there are only about 10 LGBTQ-friendly midwives listed, but it’s still worth checking to see if there’s one near you.

 

More on Labor, Delivery, and Recovery:

 

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REFERENCES

  • Centers for Disease Control and Prevention (CDC): CDC Wonder
  • American College of Nurse-Midwives (ACNM): Definition of Midwifery and Scope of Practice of Certified Nurse-Midwives and Certified Midwives
  • MedlinePlus: Certified nurse-midwife
  • University of Utah, Health: What Does a Midwife Do?
  • ACNM: Certified Midwife Credential
  • Midwives Alliance of North America: Types of Midwives
  • Cleveland Clinic: Midwife
  • Kaiser Permanente: Midwife Services for Pregnancy and Childbirth
  • National Partnership For Women & Families: Improving Our Maternity Care Now Through Midwifery
  • University of Iowa Hospitals & Clinics: Ask an expert: Should I consider a midwife?
  • Birth Settings in America, Outcomes, Quality, Access, and Choice: Percentage of Births Attended by Physicians, Certified Nurse Midwives (CNMs)/Certified Midwives (CMs), and Other Midwives by Place of Birth, United States, 2017
  • Intervention Midwife‐led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews Review. August 2013
  • Maternal perceptions of the experience of attempted labor induction and medically elective inductions: analysis of survey results from listening to mothers in California. BMC Pregnancy and Childbirth. August 2020
  • Midwives’ interventions for reducing fear of childbirth in pregnant women: a scoping review. JBI Evidence Synthesis. December 2022
  • Midwifery-led care can lower caesarean section rates according to the Robson ten group classification system. European Journal of Midwifery. March 2020
  • Midwife-led continuity models of care compared with other models of care for women during pregnancy, birth and early parenting. Cochrane Database of Systematic Reviews. April 2016
  • Comparison of labor and delivery care provided by certified nurse-midwives and physicians: a systematic review, 1990 to 2008. Womens Health Issues. Jan-Feb 2012
  • Mapping integration of midwives across the United States: Impact on access, equity, and outcomes. PLOS ONE. February 2018
  • Relationship Between Hospital-Level Percentage of Midwife-Attended Births and Obstetric Procedure Utilization. Journal of Midwifery & Women’s Health. November 2017
  • Association between Breastfeeding Duration and Type of Birth Attendant. Journal of Pregnancy. March 2018
  • Birth Settings in America, Outcomes, Quality, Access, and Choice: Maternal and Newborn Care in the United States
  • ACNM: Fact Sheet, Essential Facts about Midwives

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Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider.