Let's Explore Different Types of Midwives
Understanding Your Midwifery Options: Finding the Right Midwife for You
If you're planning to get pregnant, are already expecting, or preparing for postpartum care, you may be exploring midwifery as part of your journey. But in the U.S., the world of midwifery can feel confusing—full of different titles, certifications, and types of care.
The truth is, not all midwives are trained or licensed the same way, and their approaches can vary widely—from highly medicalized to deeply holistic. Some work closely with hospitals, while others focus on homebirth and traditional care.
This guide breaks down the different kinds of midwives (and birth workers) so you can find the provider who best fits your needs, values, and vision for birth.
What Makes a Midwife?
A midwife is a trained professional who provides care during:
Preconception
Pregnancy
Labor and birth
Postpartum
Some also offer newborn care, well-woman gynecology, and primary care
Midwives follow what’s called the midwifery model of care, which emphasizes:
Informed choice
Individualized care
Continuity of support
Trust in the body’s natural processes
That said, training, credentials, and philosophies vary a lot—so let’s break down the main types you might meet.
Certified Nurse-Midwife (CNM)
Who they are:
A CNM is a registered nurse (RN) who has completed advanced graduate training in midwifery.
Key facts:
Licensed in all 50 states
Can practice in hospitals, clinics, birth centers, and homes
Covered by most insurance plans
Often work in collaboration with OB/GYNs
Some are more medical in approach; others are very holistic
Trained in well-woman care, gynecology, family planning, newborn and even primary care
Where they’re trained:
CNMs must graduate from an accredited nurse-midwifery program and pass the national board exam through the American Midwifery Certification Board (AMCB).
Professional org:
American College of Nurse-Midwives (ACNM)
Certified Midwife (CM)
Who they are:
Like CNMs, CMs complete accredited midwifery training—but they aren’t nurses.
Key facts:
Education and clinical training are equivalent to CNMs
Take the same national certification exam
Currently only licensed in a few states (like NY and NJ)
Offer the same full scope of care: preconception through menopause
Covered by insurance in some licensed states
Best for:
People wanting midwifery-led care with a strong academic and clinical foundation, especially outside the nursing profession.
Certified Professional Midwife (CPM)
Who they are:
CPMs are midwives trained specifically to attend homebirths and birth center births.
Key facts:
National certification through the North American Registry of Midwives (NARM)
Most trained through MEAC-accredited programs, apprenticeships, or a blend of both
Legally recognized in many—but not all—states
Not all are licensed to carry medications or medical equipment (depends on state law)
Most are not trained in well women gynecology, common health issues a woman might experience not related to pregnancy and primary care, so a woman would need another provider for addressing these.
Focus on physiologic birth, informed choice, and community-based out of hospital care
Usually not covered by insurance unless licensure is recognized by the state
Professional org:
Midwives Alliance of North America (MANA)
Direct-Entry Midwife (DEM)
Who they are:
“Direct-entry” simply means someone who enters the profession without a nursing degree. DEMs come from various backgrounds and training paths.
Key facts:
May or may not be certified (e.g., as a CPM)
May be self-taught, apprenticed, or formally trained
Legal status and training quality varies by state
Typically attend home or birth center births
May not carry medications or have hospital privileges
Some DEMs are deeply experienced and community-rooted. Others may practice without formal regulation by choice, often for philosophical or spiritual reasons.
Terms you might hear:
Traditional Midwife
Community Midwife
Granny Midwife
Lay Midwife
Many serve underrepresented or marginalized communities and may prioritize cultural or ancestral birth practices.
Licensed Midwife (LM)
Who they are:
An LM is any midwife (CNM, CM, CPM, or DEM) who is licensed to practice legally in a specific state.
Key facts:
Licensure requirements differ by state
Some states only license CNMs
Others also license CPMs, CMs, or other direct-entry midwives
A midwife must hold a license to legally carry medications, order labs, and bill insurance (in most cases)
Important:
In states where midwifery is restricted, unlicensed midwives risk legal consequences—and transfer to a hospital in an emergency may be complicated if the midwife can’t identify herself.
Registered Midwife (RM) (state-specific)
Who they are:
A Registered Midwife is a term used in some states (e.g., Colorado) to describe licensed direct-entry midwives who meet legal standards for homebirth practice.
Key facts:
Typically CPMs or equivalently trained midwives
May have legal scope for homebirth and birth center care
May or may not offer gynecologic care
Traditional Birth Attendants / Birth Workers
Who they are:
These are individuals who attend births but do not call themselves midwives. They may serve as:
Birth keepers
Traditional or spiritual birth workers
Cultural birth attendants
Unlicensed traditional midwives
They often bring wisdom passed down through families, communities, or ancestral lines. They may not have formal licensure or certification, but they offer deep, culturally rooted support—especially in Indigenous, Black, immigrant, and rural communities.
Important:
While many are deeply trusted and experienced in their communities, they may not be recognized by state law or insurance systems. Also, the wisdom, experience and expertise of, for example a traditional Mexican or African midwife, who has learned and apprenticed from following her wise elder family member as she provided midwifery care in the community to an older generation, and now has attended thousands of births, is quite different from a westernized woman who calls herself a birth keeper or traditional midwife having seen and attended a small number of births. Also depending on locality, traditional or unlicensed midwives and birth keepers tend to not be able to carry or are skilled in life saving emergency medications and supplies like IV fluids, or even suturing tears needing repair.
Art by Catie Atkinson @spiritysol
Final Thoughts
Birth is deeply personal. So is choosing a midwife. Whether you want a licensed nurse-midwife in a hospital, birth center or home, or a traditional midwife for your homebirth, you deserve respectful, empowering care that aligns with your values.
Take your time. Dig deep. Ask questions. And trust your instincts.
For more information about midwives and the midwifery model of care visit: http://cfmidwifery.org/midwifery/faq.aspx
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