original article by Citizens for Midwifery, reposted here
What Do Midwives Do?
The word “midwife” means “with woman.”
In the simplest terms, a midwife is a knowledgeable and experienced person (usually a woman) who helps a woman have a healthy, normal pregnancy and give birth to a healthy baby. A good midwife does this by offering education, counseling and support before, during and after the baby is born, by not interfering unnecessarily with the birth process, and by getting appropriate medical attention for mother or baby if it should be needed.
A midwife who provides the Midwives Model of Care offers the kind of thorough, respectful, woman-centered care that is described in the Midwives Model of Care brochure.
A midwife can be an excellent choice for maternity care for women who are healthy (no serious medical conditions) and expect to have a normal pregnancy. However, you should be aware that while midwives practice in many settings, it is still rare to get the Midwives Model of Care in a hospital setting. Typically, the most likely place to receive the Midwives Model of Care is in your home or a free-standing birth center, because usually it is difficult for caregivers to give the woman-centered, individualized Midwives Model of Care under the rules and standard practices of today’s hospitals.
Kinds of midwives in the United States
For a number of reasons, midwives in the United States vary in their expertise, their education, their credentials, their legal status and the place where they can help a woman give birth. Knowing about the different kinds of midwives can help you be an informed consumer and aid you in finding and choosing a midwife. Remember, not all midwives practice the Midwives Model of Care.
“Two broad categories of midwives exist in the United States: nurse-midwives and direct-entry midwives. Nurse-midwives are educated in both nursing and midwifery, while direct-entry midwives focus their professional preparation on midwifery alone. … In order to practice as a nurse-midwife, one must be a certified nurse-midwife (CNM).” From, “The Future of Midwifery,” a Joint Report of the Pew Health Professions Commission and the University of California, San Francisco Center for the Health Professions, April 1999 linked here.
Certified Professional Midwives (CPMs) are midwives (mostly direct-entry midwives) who have met all the requirements for the CPM credential. (Learn more here.) Other direct-entry midwives may have met certification requirements of their state midwifery organization or practice without outside certification.
Direct-entry midwives are especially prepared to attend births in out-of-hospital settings (free-standing birth centers and individual homes), and almost all practice in these settings exclusively.
Most Certified Nurse-Midwives (CNMs) practice midwifery and attend births in the hospital setting, though some work in birth centers and a very few attend births in the home setting. You can find out more about CNMs here.
Many direct-entry midwives, with or without a certification credential, are also licensed by their state. Some states license direct-entry midwives; in other states these midwives practice but are not regulated by the government; and in other states, practicing midwifery may be illegal or unlawful.
Lack of national certification or licensure does not necessarily mean that the midwife lacks the knowledge or skill to practice the Midwives Model of Care. At the same time, just because a person is a midwife does not guarantee that they provide the Midwives Model of Care. Therefore, if you are looking for a midwife, ask questions to find out if an available midwife (or other caregiver) will be able to meet your needs and provide the kind of care you seek.
For more detailed information about the different kinds of midwives and their legal status in your state, visit Answers to Frequently Asked Questions.
Finding out if a midwife will provide the Midwives Model of Care
The hallmark of the Midwives Model of Care is respect – for the mother and baby, for the family, for the birth process itself. The Midwives Model of Care is fundamentally different from the medical model of care for childbirth, and it offers numerous benefits to mother, baby and family. However, most parents will want to educate themselves about many aspects of childbirth and be willing to take responsibility for their choices. Reading the Midwives Model of Care brochure is a good place to start!
Whenever you are choosing a health care provider, it is important to interview the caregiver to learn about how she/he practices. Use the information in the Midwives Model of Care brochure as a basis for your questions when looking for a midwife or other maternity care provider. See how their answers compare with the information in the brochure. Think about the parts of the Midwives Model of Care that are most important to you, and be sure to ask specific questions.
Ask for references – other people who have had their babies with the midwife who would be willing to talk with you and answer questions. Asking the midwife questions and talking with several others who have worked with that midwife can help you understand the reality behind the words and avoid misunderstandings.
Many parents also have found it useful to ask themselves questions about what is most important to them and how they think they would feel in various “what if” situations. Asking these questions can help you understand your own values and feelings.
For help regarding questions you might want to ask, read the Midwives Model of Care brochure.
Additional resources (on other websites) that may be helpful are:
How Do I Choose My Caregiver (Childbirth Connection)
How Do I Choose My Birthsetting (Childbirth Connection)
“The Rights of Childbearing Women” (Childbirth Connection)
“Having a Baby? 10 Questions to Ask” (The Coalition for Improving Maternity Services (CIMS))
The information in these articles is compatible with the Midwives Model of Care.
How do I find a midwife?
Finding a midwife can be challenging, and because of differing legal status from state to state, finding a direct-entry midwife can be especially challenging! Your choices are going to be dependent on several criteria: the legal status of midwifery in your state, the kind of midwife you’re looking for, and the availability of midwives in your area. Here are some suggestions:
- Determine the legal status of direct entry midwives in your state by looking up your state in the Legal Status Chart. Legal midwives are more likely to feel comfortable advertising their services.
- If your state licenses midwives, you may be able to obtain a list of currently licensed midwives from your state government.
- Midwives may advertise in the Yellow Pages or in health care directories. Midwives may pay for listings on a number of “find a midwife” sites on the Internet. Bear in mind that not all midwives choose to advertise, so these listings are usually incomplete. Because of this, if there are no midwives listed for your area, this does not necessarily mean that no midwives practice in your area.
- Another way to find direct-entry midwives, and midwives who attend home births, is to contact your state midwifery organization for direct-entry midwives. Find this information by clicking on your state.
Internet directories of midwives
American College of Nurse-Midwives
Professional organization for nurse-midwives.
Searchable listings of midwives, doulas, childbirth educators, breastfeeding support, and much more.
Midwives Alliance of North America
Contact for lists of members in your area.
Comprehensive resource about midwives, listing many in their directory.
Childbirth at Home: A Labor of Love
A web site dedicated to information about midwifery and other childbirth options. Specifically Southern California.
Massachusetts Friends of Midwives
For seventeen years, MFOM has advocated for a broad spectrum of birthing options for women and families throughout Massachusetts. Check out their Seventh Edition Directory of Birthing Resources.
The journal for midwives across the country! Publications available for midwives and consumers. Web site includes searchable database for midwives, doulas, and other childbirth related options.
A Better Birth
Home to the Pregnancy and Child Directory
Midwives’ Association of Washington State
Includes directory of midwives for Washington State.
American College of Nurse-Midwives
For information and directory listings of Certified Nurse Midwives.