Navigating your maternity care: types of midwives
So, you’ve decided to go with a midwife for your maternity care, but now you’re overwhelmed about which type of midwife is right for you and your family. Well here I will review the four main types of midwives that can support you which are certified nurse midwives(CNM), certified midwives (CM), certified professional midwives(CPM), and traditional/lay midwives(TM). In this article, you will learn the required education and training, scope of practice, practice settings, and insurance coverage for each type of midwife. I will start with the midwives with the most restricted scope of practice and work my way up to the midwives with the most expanded scope of practice. I will, also, mention specific laws and restrictions in the state of Florida since many states have different standards.
Traditional midwives(TM’s) have supported and served the maternal community for hundreds of years. They, historically and currently, are typically women in a community with plenty of anecdotal experience with childbirth and postpartum care with little to no formal education in the process of childbirth. They may have apprenticed under other women more experienced than them to gain most of their knowledge, have many of their own children, or somehow continued to end up in the birthing space often enough to learn the mechanics and patterns of childbirth. In the 20th century TM’s played a significant role in having safe deliveries in the Black community especially where access to OBGYN’s were limited due to factors such as racism and scarcity in rural areas. There was some level of standards and educating bodies led by nurses in the late 1900’s in the states where it was legal to practice as a TM; however, today there are only a few states that legally allow TM’s to practice with Florida not being one of them.
Certified professional midwives(CPM’s) are considered direct-entry midwives which means that certification does not require a bachelor’s degree or higher. CPM’s must attend an accredited midwifery program which is accredited by the Midwifery Education Accreditation Council(MEAC) or participate in an apprenticeship with an approved preceptor through the North American Registry of Midwives (NARM). Preceptor is a fancy way of saying that your mentor meets all of the requirements outlined by the NARM and has registered with the organization. CPM’s scope of practice encompasses education during the prenatal period about pregnancy, birth, and the postpartum period. CPM’s typically provide continuous hands-on care throughout labor, birth, and immediate postpartum care of the birthing person and baby. They, also, conduct postpartum visits between 4-6 weeks after the baby is born to ensure that the birthing person is healing appropriately. CPM’s typically serve in the birth center or home settings and administer medications on a limited basis depending on the state. In the state of Florida, holding the title of CPM is not enough to be a legally practicing midwife- midwives must become licensed through the state. Most licensed midwives(LM) are CPMs but not all CPMs are LMs. LMs are covered by Florida medicaid and some private insurances not including Tricare.
Certified Midwives (CM’s) are currently limited to the states of Maine, Maryland, New York, Rhode Island, Virginia, and Washington, DC. Their care, education, and scope of practice is extremely similar to that of certified nurse midwives with the exception of being a registered nurse.
Certified Nurse Midwives (CNM’s) are registered nurses who obtained additional education within a midwifery education program. The certifying body for CNM’s is the American Midwifery Certification Board. CNM’s provide care during pregnancy, childbirth, and the postpartum period along with reproductive health such as birth control, gynecological health, and fertility. CNM’s have the most comprehensive care of the varying levels of midwifery practice; however, they generally are less hands-on than CPM's and will generally spend less time with you during labor than CPM’s. They are seen practicing in all birth settings including birth centers, but most commonly practice in the hospital setting. They have the ability to prescribe medication in every state, and insurance coverage encompasses most private insurance, Medicaid, and Tricare.
Sources:
“Comparison of Certified Nurse Midwives, Certified Midwives, and Certified Professional Midwives.” Midwife.Org, American College of Nurse-Midwives, Apr. 2022.
“Licensed Midwifery.” Licensed Midwifery | Florida Department of Health, 2023, www.floridahealth.gov/licensing-and-regulation/midwifery/index.html#:~:text=A%20license%20is%20required%20to,by%20the%20Board%20of%20Nursing.
