What Sets CNMs Apart? A Look at Midwife Definitions in the United States

Midwife Definitions

In the United States, the term “midwife” encompasses several types of healthcare professionals, all of whom are dedicated to providing maternity and reproductive healthcare. These professionals include Certified Nurse Midwives (CNMs), Certified Midwives (CMs), and Certified Professional Midwives (CPMs), each with their own educational paths, credentials, and regulatory standards.

CNMs are midwives who have also completed education in nursing. They must earn a graduate degree, complete a midwifery education program accredited by the Accreditation Commission for Midwifery Education (ACME), and pass a national certification examination administered by the American Midwifery Certification Board (AMCB). Certified Midwives (CMs) follow a similar path, though their education is focused solely on midwifery without the nursing component. CMs and CNMs are required to meet the same certification standards and pass the same national certification exam.

Certified Professional Midwives (CPMs), on the other hand, are independent practitioners who must meet the certification standards set by the North American Registry of Midwives (NARM). Unlike CNMs and CMs, CPMs are not required to graduate from an accredited midwifery program to qualify for certification, although they must still pass a rigorous examination.

Table: Key Differences Among Midwives

For more information, please refer to American College of Nurse-Midwives.

US Midwife Categories

1. Certified Nurse Midwives (CNMs)
   CNMs are healthcare professionals trained in both nursing and midwifery. To become a CNM, an individual must first earn a graduate degree in nursing, then complete an ACME-accredited midwifery education program, and finally, pass the national certification examination administered by the American Midwifery Certification Board (AMCB). CNMs are legally recognized in all 50 states and have full prescriptive authority.

2. Certified Midwives (CMs)
   Certified Midwives follow an educational path similar to CNMs but do not have nursing training. They must earn a graduate degree in midwifery, complete an ACME-accredited program, and pass the same AMCB certification exam as CNMs. However, the legal recognition of CMs varies, with only seven states offering licensure and three states allowing prescriptive authority.

3. Certified Professional Midwives (CPMs)
   CPMs are independent midwifery practitioners who meet the certification standards of the North American Registry of Midwives (NARM). Unlike CNMs and CMs, CPMs do not need a graduate degree or formal education from an ACME-accredited program to qualify for certification. CPMs must pass an exam administered by NARM and are legally recognized in several states, though this varies widely. They do not have prescriptive authority.

4. Direct Entry Midwives (DEMs) and Lay Midwives
   Direct Entry Midwives (DEMs) and lay midwives include a wide variety of practitioners who may have undergone formal education, apprenticeship training, or a combination of both. The scope of practice and legal recognition of DEMs vary significantly across states. Some DEMs may have prescriptive authority or the ability to obtain licenses in certain states, while others may practice outside of formal healthcare systems.

FAQs on Midwife Definitions

Q: What is the difference between a CNM and a CM?
A: The main difference lies in their educational background. CNMs are trained in both nursing and midwifery, while CMs are solely educated in midwifery. Both must pass the same national certification exam, but CMs are not recognized in as many states as CNMs.

Q: Do Certified Professional Midwives (CPMs) need a graduate degree?
A: No, CPMs are not required to have a graduate degree. They must meet the certification standards set by NARM and pass a certification exam, but there is no formal requirement for education from an accredited program.

Q: Are all midwives legally recognized in every state?
A: No, legal recognition of midwives depends on the type of midwife and the state in which they practice. CNMs are recognized in all states, while CMs and CPMs are recognized in fewer states, and DEMs may have limited recognition depending on local regulations.

Q: What does prescriptive authority mean for midwives?
A: Prescriptive authority allows midwives to prescribe medications, including controlled substances. CNMs have full prescriptive authority in all states, while CMs and CPMs may have restricted or no prescriptive authority, depending on the state.

Q: How do lay midwives differ from certified midwives?
A: Lay midwives may not have formal education or certification, whereas certified midwives (CNMs, CMs, and CPMs) must meet specific educational and certification requirements. Lay midwives often practice based on traditional or community-based knowledge.