What Is a Nurse-Midwife?

Medically Reviewed by Dan Brennan, MD on October 25, 2021
3 min read

Midwives have helped women to deliver babies for centuries and they were present at most births until the early twentieth century. Today, more than 7% of all births, both vaginal and C-section, in the U.S. are delivered by certified nurse-midwives.

Nurse-midwifery developed in the U.S. throughout the twentieth century when the Frontier Medical Service was founded in 1925. This early practice used registered nurses that were trained in nurse-midwifery in England. Throughout the 1900s, nurse-midwives, or midwives with medical training, revived the practice of having a midwife present at birth.

Today, a certified nurse-wife is a registered nurse who is qualified to give care during pre-conception, throughout pregnancy, during birth, and in the postpartum phase. They are able to provide women with a more low-tech approach to birthing, as they guide women through safe, natural birth techniques.

In addition to assisting women through childbirth, a certified nurse-midwife offers holistic care to women at many different stages of life. They conduct physical exams, diagnose and treat medical conditions, and may even write prescriptions for certain conditions. Nurse-midwives also advise and counsel mothers-to-be.

Certified nurse-midwives may practice nurse-midwifery in a number of settings, including:

  • Hospitals
  • OB/GYN clinics
  • Health clinics
  • Birthing centers
  • Midwifery practices
  • Private homes

A nurse-midwife can give women primary care in addition to gynecological care. They can provide holistic care to women who are going through menopause or perimenopause. A nurse-midwife can even treat a woman’s male partner who is experiencing a sexually transmitted disease (STD).

Nurse-midwives offer women a more holistic approach to childbirth than modern gynecologists and obstetricians do. This approach calls for little or no technology involved in birth. However, a nurse-midwife is trained to know which situations may call for the help of an obstetrician during birth.

During pregnancy, a nurse-midwife monitors the health of both the mother and the baby. They help the mother to make a birth plan and offer individualized advice to each woman. When the time comes, nurse-midwives assist in the delivery and then provide aftercare to both the mother and baby. A nurse-midwife can provide newborn care during the first month of the baby’s life.

There are several steps to becoming a certified nurse-midwife. The first step is to earn a bachelor’s degree in nursing that is approved by the local State Nursing Board. After earning a bachelor’s degree, the candidate must then take and pass the NCLEX-RN exam, which gives them the title of Registered Nurse (RN). Once a nurse has this title, they can begin to practice nursing and get experience in the field.

The next step is to earn a graduate degree, either a master’s or doctoral degree in nurse-midwifery. Most schools require candidates to have a minimum of one year’s experience practicing nursing to be considered for these programs. Depending on the program, earning an advanced degree in nurse-midwifery may take two years or more.

After earning an advanced degree in nurse-midwifery, the last step to becoming a CNM is to take and pass the exam offered by the American Midwifery Certification Board. This allows a CNM to practice nurse-midwifery in all 50 states and U.S. territories.

While it’s true that nurse-midwives deal with childbirth, that’s only one reason why women seek care from them. In reality, about 90% of a nurse-midwife’s time is spent providing preventative care.

Holistic Care

The main reason that women choose nurse-midwives is for the approach to holistic care that they provide. This approach is low-tech, high-touch, without unnecessary technological intervention. Instead, a CNM focuses on health, wellness, and prevention. This includes care that is tailored to each woman and their needs and recognizing that birth is a normal, physiological process.

Lower Cost

Since nurse-midwives focus on not using technology during birth, the overall cost of birthing is lower. About 2% of births assisted by nurse-wives take place in birthing centers, and about 1% take place at home. There is little-to-no technology or equipment used in these births, so they are much cheaper and less invasive than traditional hospital births.

High-Quality Care

Research shows that midwifery care results were comparable to those in physcian-led births in hospitals, including infant mortality rates. These studies also show lower rates of C-sections or birth inductions, as nurse-midwives focus on natural birthing techniques. Mothers who were assisted by nurse-midwives during birth also have higher rates of breastfeeding.