Health Care Providers: Midwives

What Is a Midwife?

A midwife is a health care provider who specializes in female reproductive health care needs. This includes prenatal care, labor, delivery, postpartum care, and newborn care for low-risk pregnancies without complications. It may also include other aspects of women’s health, such as birth control, family planning, and menopause.

There are different types of midwives with different levels of training. Midwives often work together with doctors, but in some states they might work independently.

What Do Midwives Do?

In the United States, the type of care midwives offer depends on their education, their credentials, and where they practice. 

• Certified nurse midwives (CNMs): CNMs complete a registered nursing degree (about 4 years), followed by a graduate degree in midwifery (about 2–3 years). Then they pass an exam to get certified as a midwife. They can provide a wide range of care, including pregnancy, delivery, and post-partum care, as well as gynecological care for non-pregnant women. CNMs can receive a license in any of the 50 states, but their ability to practice independently might differ from state to state. They practice in hospitals, birth centers, and clinics, and they also provide care during home births. Most midwives in the U.S. are CNMs.
• Certified midwives (CMs): CMs do not have a nursing degree. They complete an undergraduate degree in a field other than nursing (about 4 years), followed by a graduate degree in midwifery (about 2–3 years). Then they pass an exam to get certified as a midwife. They provide the same type of care as CNMs, and can practice in hospitals, birth centers, and clinics, and can also provide care during home births. They can receive a license to practice in only a few states, and like CNMs, their ability to practice independently depends on the state.
• Certified professional midwives (CPMs): CPMs complete a midwifery program (about 3–4 years), but they don’t need to have a degree. They do need to pass an exam to get certified as a midwife. They focus on providing care to women with low-risk pregnancies who deliver in birth centers or at home. They cannot do as much as CNMs and CMs (for example, they cannot prescribe medicines or work in a hospital). And they don’t provide gynecological care for non-pregnant women. They can receive a license to practice in many, but not all, states.

Some midwives have not gone through formal training and are not certified. They are sometimes called “lay” or “traditional” midwives. They may have learned midwifery by studying on their own, by shadowing another midwife as an apprentice, or in other informal ways. They can be licensed in some states, and usually only provide care during home births.

Why Would Someone Need One?

Pregnancy care can involve an OB-GYN, a family doctor who does obstetrical care, or a certified midwife (or a midwife and a doctor). People may choose a midwife because the training and philosophy of care of a midwife more closely aligns with their desires.

Midwives care for women who are in good health and not likely to develop problems during pregnancy and delivery. Someone whose pregnancy is considered high-risk is not a good candidate for midwife care. This can include anyone who has health conditions like high blood pressure, diabetes, or heart disease. It can also include a pregnancy with multiples, a fetus in the breech (feet- or bottom-first) position, or a previous C-section.

Good to Know

In the U.S., pediatricians (doctors who specialize in children’s health) and OB-GYNs (doctors who specialize in pregnancy and childbirth) recommend giving birth in hospitals or birth centers. Research has shown that these are the safest places for babies to be born. U.S. pediatricians and OB-GYNs believe that the best pregnancy care involves doctors and certified midwives working as a team.

In some other countries, midwife services are more common for reasons that can be historical, cultural, or related to improving access to care.