An Advanced Practice Registered Nurse (APRN) is a licensed registered nurse with a graduate-level education, typically a Master’s or Doctoral degree, in a specialized area of nursing. This advanced training prepares them for roles beyond a traditional registered nurse, often involving diagnosing, treating, and managing patient care. Whether an APRN can deliver babies depends entirely on the specific role and specialized certification they hold. This article clarifies which advanced practice roles are trained and legally authorized to manage and perform newborn delivery.
Defining the Advanced Practice Roles in Maternity Care
The ability to deliver babies is specifically tied to the Certified Nurse Midwife (CNM) credential, one of the four main categories of APRNs. Becoming a CNM requires a rigorous educational path starting with an active Registered Nurse (RN) license. Candidates must complete an accredited graduate program, earning a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) specializing in nurse-midwifery. This training focuses extensively on women’s reproductive health, including pregnancy, childbirth, and the postpartum period.
Following the graduate program, a CNM candidate must pass a national certification examination administered by the American Midwifery Certification Board (AMCB). Other APRN roles, such as Family Nurse Practitioners (FNPs) or Pediatric Nurse Practitioners (PNPs), are not educated or certified to manage or perform the physical process of childbirth. The CNM is the only advanced practice nursing role explicitly qualified for labor and delivery.
The Scope of Practice for Childbirth
Certified Nurse Midwives are fully qualified to manage and deliver babies for individuals experiencing low-risk, uncomplicated pregnancies and births. Their practice encompasses the complete continuum of care, starting with comprehensive prenatal risk assessment and monitoring. During labor, the CNM monitors the mother’s progress and fetal well-being, manages pain relief options, and supports the patient through the birthing process.
The CNM is trained to perform a spontaneous vaginal delivery, which includes assisting the baby’s emergence and managing the delivery of the placenta. Following the birth, their scope extends to immediate postpartum care for both the mother and the newborn, including repairing perineal lacerations. CNMs focus on a holistic, patient-centered approach, emphasizing natural childbirth techniques and wellness education.
The scope of practice for CNMs is defined by the absence of high-risk factors or complications. Should complications arise, such as significant fetal distress, hemorrhage, or the need for a Cesarean section, the CNM’s role transitions to collaboration and referral. They work as part of an interprofessional team, consulting with or transferring care to an obstetric physician to ensure the highest level of safety for the mother and baby.
State-Specific Authority and Practice Environments
While the CNM credential authorizes the delivery of babies, the specific level of independence is governed by state-level regulations. The scope of practice for all APRNs is categorized into three levels, which dictate the requirement for physician oversight. In “Full Practice Authority” states, CNMs can practice independently, including the ability to diagnose, treat, admit patients, and prescribe medications without a mandatory collaborative agreement.
In contrast, “Reduced” or “Restricted Practice” states require CNMs to have a formal collaborative or supervisory agreement with a physician for certain aspects of their practice, including the management of labor and delivery. This state-level variation determines whether a CNM functions as an autonomous provider or if their ability to deliver babies is legally tied to a physician relationship. CNMs practice in various environments, including hospitals, freestanding birth centers, and home birth settings; the hospital is the most common environment.