What is a midwife?

A midwife assists a woman in the childbearing year.

This includes prenatal, birth, postpartum, and newborn care; in addition she can provide well-woman gynecology care, such as regular PAP smears and assistance with some forms of birth control.

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 still practice in most traditional cultures, and in many “modern” countries such as the Netherlands.

In the United States, the rise of the American medical system during the 20th century led to births in hospitals with obstetricians becoming the norm. However, the choice to use midwives is on the rise.

In the United States there are two types of midwives:

Certified Nurse-Midwives (CNMs) are nurses with hospital-based midwifery training; most CNMs practice in clinics and hospitals. For those interested in a career as a CNM, we recommend contacting the American College of Nurse Midwives.

Direct-Entry Midwives are specialists in birth outside the hospital, at home and in free-standing birth centers. The legal requirements for direct-entry midwifery education and licensing vary by state.

In the United States, there is national certification for direct-entry midwives, but no national licensing. A Certified Professional Midwife (CPM) is nationally certified through the North American Registry of Midwives (NARM).

If a direct-entry 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).

The Midwives Alliance of North America has a wealth of information about the practice of direct-entry midwifery.

Most direct-entry midwives are self-employed, providing care in a private office or at the client’s home.

Sometimes midwives work together at birth centers. Income varies depending on how many births a midwife attends, the area she lives in, what her fees are, and her expenses. A full-time midwife attending 3-5 births per month can expect to support herself and her family comfortably, but not lavishly.