A midwife is a trained healthcare professional who manages and attends the birth of a baby. Midwives are specialists in low-risk pregnancy and childbirth, providing comprehensive care that views birth as a normal, physiological life process. While the term “deliver” is often used in common language, many midwives prefer the term “catch” or “assist” to emphasize that the birthing parent is the one actively giving birth, and the midwife is the skilled attendant ensuring safe passage. The scope of their practice extends far beyond the moment of birth, encompassing continuous care throughout the childbearing cycle.
The Midwife’s Role in Assisting Birth
The midwife’s primary role during labor is to provide continuous support and expert clinical monitoring. They assess the mother’s and baby’s well-being, checking the baby’s heart rate and the progression of cervical dilation. Midwives employ non-pharmacological comfort techniques, such as hydrotherapy, massage, and positional changes, to help the birthing parent manage labor pain. As birth becomes imminent, the midwife guides the final stage, coaching the mother through pushing and using physical techniques to safely maneuver the baby. Midwives are trained to recognize complications early and are prepared to initiate emergency procedures or consult with an obstetrician if the situation moves beyond a low-risk birth.
Types of Midwives and Their Practice Settings
The training and practice settings of midwives vary significantly, which affects where they attend births, particularly in the United States.
Certified Nurse-Midwives (CNMs)
CNMs are advanced practice registered nurses who have completed a master’s or doctoral degree in nurse-midwifery and are certified by the American Midwifery Certification Board (AMCB). CNMs are licensed to practice in all 50 states and primarily attend births in hospitals, though they also work in birth centers and homes. Because of their advanced nursing background, CNMs have a comprehensive scope of practice that often includes prescriptive authority. Their ability to practice in a hospital setting allows them to offer a blend of the midwifery model of care with immediate access to medical interventions, such as epidurals or surgical backup, should the need arise.
Certified Professional Midwives (CPMs) and Certified Midwives (CMs)
CPMs have a different training pathway, often focusing specifically on out-of-hospital birth settings. Their certification is granted by the North American Registry of Midwives (NARM), and their training frequently includes an apprenticeship model. CPMs specialize in low-risk births and typically practice in homes or freestanding birth centers. The legal recognition and scope of practice for CPMs are highly dependent on individual state regulations. CMs are a less common credential, following the same graduate-level education and AMCB certification pathway as CNMs but without the initial registered nursing degree. CMs have a scope of practice identical to CNMs, but their legal licensing and prescriptive authority are limited to a small number of states.
The Holistic Model of Maternal Care
The care provided by a midwife is rooted in a philosophy that defines pregnancy and birth as normal physiological events. This approach, known as the Midwives Model of Care, emphasizes personalized education, continuous support, and minimizing unnecessary technological interventions. Midwives focus on the physical, psychological, and social well-being of the pregnant person across the entire childbearing cycle. During the prenatal period, care involves extended visits, allowing time for thorough risk assessment, individualized nutritional counseling, and emotional support to empower the mother to make informed decisions. Postpartum care is also a crucial component, supporting the mother’s physical healing, monitoring the newborn’s transition, and providing assistance with breastfeeding, newborn care, and mental health adjustments.