Midwives are trained health professionals who assist women throughout the entire childbearing cycle, and the answer is definitively yes, they deliver babies. They provide care during pregnancy, childbirth, and the postpartum period. The scope of their practice is rooted in the philosophy that birth is a normal, healthy life process, minimizing unnecessary technological intervention. The specific setting and services they offer depend significantly on the type of professional certification they hold.
Understanding the Different Types of Midwives
Midwifery in the United States is primarily defined by three distinct certifications, each with different educational pathways and legal scopes of practice.
Certified Nurse Midwives (CNMs) possess a graduate degree in nurse-midwifery and are also registered nurses, granting them the broadest practice authority across all 50 states. Certified by the American Midwifery Certification Board (AMCB), CNMs typically hold prescriptive authority, managing a wide range of women’s health needs.
Certified Midwives (CMs) follow the same graduate-level education and certification exam as CNMs but do not have a prior nursing degree. While their scope of practice is essentially the same as CNMs, their legal recognition and licensing vary by state. Both CNMs and CMs are trained to provide care in all settings, including hospitals, birth centers, and homes.
In contrast, Certified Professional Midwives (CPMs) are certified by the North American Registry of Midwives (NARM) and are trained specifically for out-of-hospital birth settings. CPMs gain education through formal schooling and clinical apprenticeship, focusing on low-risk pregnancies. CPMs typically do not have prescriptive authority and their practice is generally limited to home births and birth centers.
The Settings Where Midwives Provide Care
Midwives attend births across a variety of settings, which influences available resources and access to medical intervention.
CNMs and CMs frequently practice within hospital systems. This allows them to offer low-intervention birth options while having immediate access to pain medications and surgical services if needed. In this setting, the midwife manages labor and birth, often independently, within hospital protocols.
Many midwives, particularly CPMs, attend births in accredited freestanding birth centers. These facilities offer a home-like atmosphere while providing medical tools for common needs, such as oxygen and medications to manage postpartum hemorrhage. Designed for healthy, low-risk clients, birth centers maintain clear protocols for transferring care if complications arise.
Home birth is the third common setting, where the midwife brings necessary equipment and monitors the natural progression of labor in the client’s residence.
The Full Range of Midwifery Services
The midwife’s role extends far beyond attending the birth, encompassing a comprehensive approach to reproductive health across the lifespan.
Midwives provide extensive prenatal care, monitoring the mother’s physical and psychological well-being, and offering personalized education. This includes routine physical exams, ordering laboratory tests, and screening for conditions like gestational diabetes or pre-eclampsia.
Following the birth, midwives remain engaged through the postpartum period, typically including home visits or office appointments for the first six weeks. They monitor the mother’s recovery, check the newborn’s growth and health, and provide support for breastfeeding and family planning. Many CNMs and CMs also offer routine gynecological care, such as annual well-woman exams, Pap smears, and contraceptive counseling, ensuring continuity of care.
Collaboration and Transfer of Care
A systematic approach to safety in midwifery includes established protocols for collaboration with obstetricians and other medical specialists.
Midwives are trained to recognize deviations from normal progression that may require a change in care provider or setting. Consultation occurs when a client develops a condition, such as chronic hypertension, that exceeds the midwife’s scope of practice but does not require a transfer of primary care.
If a complication arises during labor, such as prolonged labor, fetal distress, or the need for a surgical procedure, a planned transfer of care to a hospital is initiated. For clients planning an out-of-hospital birth, midwives have pre-established relationships and detailed guidelines with local hospitals to ensure a safe transition of the client and their medical records. This collaborative model ensures clients receive seamless, evidence-based care while maintaining the safety net of medical intervention.