I. Direct-Entry Midwives (including Licensed Midwives)

II. Certified Professional Midwife (CPM)

III. Certified Nurse Midwives (CNMs)

IV. Certified Midwife (CM)

I. Direct-Entry Midwives (including Licensed Midwives)

Not required to be nurses.

Multiple routes of education (apprenticeship, workshops, formal classes or programs, etc., usually a combination).

May or may not have a college degree.

May or may not be certified by a state or national organization.

Legal status varies according to state (it is neither illegal or legal in ND)

Licensed or regulated in 21 states.

In most states licensed midwives are not required to have any practice agreement with a doctor.

Educational background requirements and licensing requirements vary by state.

By and large maintain autonomous practices outside of institutions.

Train and practice most often in home or out-of-hospital birth center settings.

Legal Status of Direct Entry Midwives

As of 2003, 21 states recognize and regulate direct entry midwives (although for two of the states, New York and Rhode Island, only the CM credential is acceptable). Regulation varies from state to state, including licensure, certification, registration and documentation. Only 9 states and the District of Columbia actually prohibit the practice of direct entry midwives, but in 5 more states licensure is required but unavailable. In the remaining states direct entry midwives practice without any kind of state regulation, and in a few the legal status in not entirely clear. So, direct entry midwives are practicing essentially legally in about 34 states, but are considered unlawful or illegal in 14 states. However, these figures are subject to change as new legislation is enacted or new legal opinions are established that can change status in the a-legal states where direct entry midwives are neither specifically regulated nor specifically prohibited.

For further information, visit www.cfmidwifery.org

II. Certified Professional Midwife (CPM)

Not required to be nurses.

Multiple routes of education recognized; direct entry midwives and certified nurse midwives can qualify for this credential.

Education programs accredited by the Midwifery Education

Accreditation Council prepare students to meet the requirements for the CPM.

Out-of-hospital birth experience is required.

Have met rigorous requirements and passed written exam and hands-on skills evaluation.

Administered by the North American Registry of Midwives.

Legal status varies according to state (Visit "The Big Push for Midwives at http://www.thebigpushformidwives.org/ for more info.)

Practice most often in homes and birth centers.

For more information e-mail info@narm.org or call 1-888-84-BIRTH (eastern time) or visit the website, "The Big Push for Midwives": http://www.thebigpushformidwives.org/

The North American Registry of Midwives (NARM)

In 1987 educators, program directors and experienced midwives in the field of direct entry midwifery decided it was time to begin developing a national credential, the Certified Professional Midwife (CPM) credential, which is administered through the North American Registry of Midwives and has rigorous standards for knowledge, skills and experience.

As of January 2004, there are over 850 CPMs in the United States, Mexico, and Canada. The nineteen states that license direct-entry midwives to attend births out of the hospital use the NARM exam or the CPM process as the basis for licensure. States that are seeking licensure for direct-entry midwives are planning legislation which requires the CPM credential for licensure.

The North American Registry of Midwives has a free brochure "How to Become a Certified Professional Midwife (CPM)." You can request a copy or ask for more information about the CPM by contacting the North American Registry of Midwives at 1-888-84-BIRTH (eastern time), or by e-mail North American Registry of Midwives.

III. Certified Nurse Midwives (CNMs)

Educated in both nursing and midwifery, primarily in the hospital setting; are "advanced practice nurses."

Must have at least a Bachelors Degree when training is complete.

Have successfully completed a university-affiliated nurse-midwifery program accredited by the American College of Nurse-Midwives, and passed the exam.

Out-of-hospital clinical experience is not required.

Are legal and can be licensed in all states.

Most practice in hospitals and birth centers.

In most states must have some kind of agreement with a doctor for consultation and referral; practicing without such an agreement can lead to loss of license.

For more information visit the American College of Nurse-Midwives website or contact them at 240-485-1800, or write to 8403 Colesville Road, Suite 1550, Silver Spring, MD 20910.

IV. Certified Midwife (CM)

The Certified Midwife (CM) is a new credential from the ACNM that does not require a nursing degree but is otherwise similar to the CNM credential. As of 2007, the CM is legally recognized in three states: NY, MA, and NJ, but does not meet existing direct entry midwife licensing requirements in any other states.

For more information visit the American College of Nurse-Midwives website or contact them at 240-485-1800, or write to 8403 Colesville Road, Suite 1550, Silver Spring, MD 20910.