Types of Midwives Explanation from Midwives Alliance of America (NARM)
In the United States there are several pathways to midwifery education and training. Most pathways result in midwifery certification and qualify the candidate for licensing in her/his state or municipality. Candidates seeking to become certified and licensed midwives can choose among several routes of entry into the profession using nurse-midwifery or direct-entry midwifery educational programs. The most common types of midwives are listed below including the three professional U.S. midwifery credentials, Certified Professional Midwives (CPM), Certified Nurse-Midwives (CNM), and Certified Midwives (CM).
Nurse Midwives Certified Nurse-Midwife (CNM): Certified Nurse-Midwives are trained in both nursing and midwifery. Their training is hospital-based, and the vast majority of CNMs practice in clinics and hospitals. Some CNM's attend homebirths or birth centres. Although their training occurs in medical settings, the CNM/CM scope of practice allows them to provide care in any birth setting. They also have a wider scope of practice, mainly with well-women care including prescribing privileges.
Direct-Entry Midwives: Direct-entry midwives; Licensed Midwives/Certified Professional Midwives are trained in the apprenticeship model, either with an experienced midwife in a home birth practice and/or in a LM/CPM ran birth centre providing the Midwives Model of Care to healthy women and newborns in out-of-hospital settings. LM's do not have, nor is it required to complete a nursing education as a prerequisite for midwifery education. Certified Midwife (CM): Certified Midwives are individuals who have or receive a background in a health related field other than nursing, then graduate from a masters level midwifery education program. They have similar training to CNMs, conform to the same standards as CNMs, but are not required to have the nursing component. Certified Professional Midwife (CPM): The vast majority of direct-entry midwives (i.e. Licensed Midwives) in the United States are Certified Professional Midwives. The CPM is the only midwifery credential that requires knowledge about and experience in out-of-hospital settings. Their education and clinical training focuses on providing midwifery model care in homes and freestanding birth centers. In some states, CPMs may also practice in clinics and doctors offices providing well-woman and maternity care. LM/CPM/CM do not have prescribing privileges.
"Traditional" or unlicensed Midwives In addition, there are midwives who—for religious, personal, and philosophical reasons—choose not to become certified or licensed. Typically they are called traditional midwives. They believe that they are ultimately accountable to the communities they serve; or that midwifery is a social contract between the midwife and client/patient, and should not be legislated at all; or that women have a right to choose qualified care providers regardless of their legal status. I strongly encourage you to ask about a Midwives training and licensing. It is important to know unlicensed/"traditional" midwives are unable to order ultrasounds or lab work. They cannot easily refer women to other providers. "Traditional" midwives may not have medical equipment they bring with them to births; i.e. anti-hemorrhagic medications, oxygen, neonatal resuscitation, suturing equipment in the event of a vaginal laceration from birth. They also cannot file a birth certificate or order a SSN card for your baby.
What is a Doula? A trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible. The birth doula does not provide medical care, clinical tasks such a cervical checks or fetal heart tones and does not speak on behalf of the client.
Interested in hiring a birth or Postpartum Doula? Doulas I recommend that have experience with home births, and also have been at births me: Kim Rachette at www.Angeltouchdoula.com (505) 228-6163 Sarah Allen at www.emberbirth.com/ (505) 369-2112