Types of Midwives
A midwife is a trained health professional who supports healthy women during labor, delivery, and after childbirth. A midwife can deliver babies at birthing centers, at home, or in hospitals. Women who work with a midwife usually have healthy pregnancies without complications.
Midwives are grouped into different types based on their training and certification.
Certified nurse-midwives (CNMs)
They are registered nurses with a master’s or doctoral degree in nurse-midwifery. They pass a national exam and get certification from the American Midwifery Certification Board (AMCB). They can practice in all 50 states and the District of Columbia.
Certified midwives(CMs)
The word "nurse" isn't part of their title. CMs have a background in health, but they aren't nurses. Just like CNMs, they complete the same graduate-level midwifery education program and pass the national exam. They also need certification from the AMCB. Only a few states allow CMs to practice.
Certified professional midwives (CPMs)
CPMs aren't nurses. They train through a midwifery school, an apprenticeship program, or direct experience with childbirth in birth centers or homes. They pass a national exam. Not all states allow CPMs to practice.
There are lay (not certified) midwives, as well. They support pregnancy and childbirth, but they don't have formal medical training or a certificate. They usually learn through experience, training under a more experienced midwife, traditional practices, or self-study courses.
What Does Your Midwife Do?
Like a doctor or an obstetrician (OB), who specializes in pregnancy and childbirth, your midwife can offer care before, during, or after your pregnancy. Your midwife can:
- Offer family planning and preconception care
- Do prenatal exams and order tests
- Watch your physical and psychological well-being
- Help you make your birth plans
- Advise you about diet, exercise, meds, and staying healthy
- Educate and counsel you about pregnancy, childbirth, and newborn care
- Offer emotional and practical support during labor
- Deliver your baby
- Refer you to doctors when needed
How Your Midwife Works With Your Pregnancy Team
Midwives should be in contact with an obstetrician who can advise when needed. Unexpected problems may arise, or you may simply change your mind.
"If something changes during pregnancy that could affect the mother or baby, the midwife either refers the patient to a doctor or works alongside the doctor," says Melissa Enama Bair, CNM, clinical director of midwifery at Mount Sinai Hospital in New York City.
"You may come in wanting a natural birth or what we call a 'physiologic labor and birth experience,' meaning your body goes through the process on its own. But once you are at the hospital, you might change your mind and want an epidural. We have the anesthesia team ready to help," Bair says.
They also may team up with another midwife or doula to help with your labor and delivery.
Bair says that doulas focus on comfort and support before, during, and after labor. They help with both physical needs and emotional support. "Sometimes, it's too early to go to the hospital, so the doula can stay with you at home while you wait for active labor to start," she says.
Why You Might Want to Choose a Midwife
You may want to consider working with a midwife if:
- You want your childbirth to be as natural as possible, without procedures like cutting to help deliver the baby (episiotomy), starting labor with medicine (induction), or other surgeries.
- You want the emotional, practical, and social support that midwives offer.
- You want care that respects your culture and beliefs during pregnancy and birth.
- You prefer postpartum care that lasts from two to six weeks after delivery.
Midwife FAQs
Are midwives doctors?
No, midwives aren't medical doctors. They train to specialize in pregnancy, childbirth, postpartum care, and women's health. Some midwives earn a Doctorate in Nursing Practice (DNP), which is the highest degree in midwifery.
What is the difference between an OB/GYN and a midwife?
OB/GYNs and midwives differ in their training, the types of care they provide, and how they approach childbirth. OB/GYNs care for all pregnancies, including high-risk ones, and can perform surgery if needed. Midwives usually work with low-risk pregnancies and focus on a more natural, mind-and-body approach.
Is a midwife better than an OB/GYN?
One isn't better than the other. The right choice depends on your situation and preferences. Ideally, a pregnant woman has a team that includes both a midwife and an OB/GYN working together.
- OB/GYN: A good choice for women with high-risk pregnancies or those who may need surgery or advanced medical care.
- Midwife: A good choice for women with low-risk pregnancies, those who want a natural birth, or those who prefer fewer medical interventions.
Should I have a midwife?
A midwife may be right for you if you want a natural birth with fewer medical interventions. A midwife is also a good option if you have a specific birth plan in mind, such as hypnobirthing, water birth, or a hospital birth with minimal procedures.
Are there risks to having a midwife?
Midwifery care is very safe for low-risk pregnancies. Some risks may come up, especially outside of a hospital. Having a team that includes both a midwife and a doctor adds extra support.
What's the difference between a doula and a midwife?
A doula gives emotional, physical, and informational support but doesn't provide medical care. A midwife gives medical care during pregnancy, birth, and postpartum.
Do midwives do C-sections?
No, midwives don't do C-sections. Some midwives with special training can help a doctor during surgery as a first assistant.
Do midwives give epidurals?
Midwives don't give epidurals, but they can order one for you in a hospital.
What questions should I ask before choosing a midwife?
- What certifications and training do you have?
- Where do you attend births?
- What's your approach to pain management?
- Do you work with OB/GYNs in case of emergencies?
- What is your C-section transfer rate?
- How do you monitor the baby during labor?
- What happens if I'm no longer low-risk?
- Are you available for postpartum support?
- Can I meet the rest of your birth team?
