Midwifery FAQ

1. What is a midwife?

A midwife assists a woman with birth. This includes prenatal, postpartum, and newborn care; in addition she can provide well-woman gynecology such as regular PAP smears. Traditionally, a midwife was female, often an older family member such as a grandmother or aunt. She was often also a general healer for the community. Midwives are used to this day in most traditional cultures, and in many "modern" countries such as the Netherlands. In America, the rise of the American medical system during the 19th century led to births in hospitals with obstetricians becoming the norm. However, many people still continue to use midwives and give birth at home or in a birth center.

2. Is it safer to give birth in a hospital?

Only if you or your baby have health problems or are at high-risk for complications. For a healthy mother and baby, giving birth at home with a midwife is perfectly safe. In fact, studies show out-of-hospital birth to be as safe, or safer, than hospital birth for healthy women. Women were giving birth safely with midwives for thousands of years before hospitals and doctors, and they continue to do so today.

3. What is the difference between a nurse-midwife and a direct-entry midwife?

Certified Nurse-Midwives are nurses with hospital-based midwifery training; most CNMs practice in clinics and hospitals. A direct-entry midwife is a specialist in birth outside of the hospital, particularly at home and at birth centers. The legal requirements for direct-entry midwifery education and licensing vary by state. In some states it is illegal to practice direct-entry midwifery. If for health or emotional reasons you do not feel safe giving birth at home, using a CNM in a hospital is a good alternative.

4. How do I find out the legal status of direct-entry midwives in my state?

You may contact Citizens for Midwifery at 1-888-CfM-4880 or www.cfmidwifery.org for a list of the states with the legal status of midwifery in each.

5. How are certified and licensed midwives different?

In the United States, there is national certification, but no national licensing. A Certified Professional Midwife (CPM) is nationally certified through the North American Registry of Midwives (NARM). If a midwife is licensed, it will be by the state(s) she practices in. Not all states offer licensing. In Oregon, midwives may choose to become a Licensed Direct-Entry Midwife (LDM).

6. Where does a direct-entry midwife work?

Direct-entry midwives are generally self-employed, providing care in a private office or at the client's home. Sometimes they work at birth centers.

7. What does a direct-entry midwife earn?

This varies by how many births a midwife attends, what her fees are, and her expenses. Midwifery is not a profession that will make you rich, but one to choose because you have a commitment to helping women and your community. A midwife attending 4 or 5 births per month, every month, can expect to support her family comfortably, though not extravagantly.

A very rough estimate would be: A midwife attending 33 births a year, charging $2000 per birth, would gross $66,000 before expenses. After expenses and taxes, this number would likely be closer to the $30,000-$40,000 range. Keep in mind that it can take a couple years for a new midwife to gain a reputation and “build up” her practice.

8. What is a doula? How is a doula different from a midwife?

A doula assists women by providing physical and emotional support during labor (Labor Doula) or as a mother's helper (Postpartum Doula). A doula is not trained to provide health care for mother or baby. There are several organizations that offer workshops and certification for doulas. At Birthingway, we offer a course and certification for Labor Doulas, as well as coordination between doulas in our program and pregnant women.

9. What do all those abbreviations stand for?

There is a wide variety of organizations and types of credentialing available to midwives and related professions. Here are some of the most common:

ACNM = American College of Nurse-Midwives. The national certifying organization for CNMs.

ALACE = Association of Labor Assistants and Childbirth Educators. One certifying agency for doula and childbirth educators.

AMCB = American Midwifery Certification Board. Credentialing agency for CNMs and CMs. Formerly "ACNM Certification Council, Inc."

CD = Certified Doula.

CFM = Citizens for Midwifery. A consumer support organization.

CM = Certified Midwife. A non-nurse midwife credentialed by AMCB.

CNM = Certified Nurse Midwife. A nurse who has special training in midwifery.

CPM = Certified Professional Midwife, credentialed through NARM (see below)

DONA = Doulas of North America. One certifying agency for labor/birth and postpartum doulas.

LDM = Licensed Direct Entry Midwife. This is the title for a direct-entry midwife licensed through the Oregon State Board of Direct Entry Midwifery. See LM.

LM = Licensed Midwife. Licensing body varies by state

MANA = Midwife's Alliance of North America. An international professional midwifery organization.

MEAC = Midwifery Education Accreditation Council. The accrediting body for direct-entry midwifery schools.

NACPM = National Association of Certified Professional Midwives. The professional organization for CPMs.

NARM = North American Registry of Midwives. The national certifying organization for direct-entry midwives. NARM standards and tests are used by many midwifery schools and state licensing boards.

OMC = Oregon Midwifery Council. The Oregon state organization for direct-entry midwives.