What Is a Nurse-Midwife?

Medically Reviewed by Dan Brennan, MD on October 25, 2021

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.  

Show Sources

SOURCES:

GraduateNursingEDU: “What Do Midwives Do?”

MedlinePlus: “Certified nurse-midwife.”

MSNedu: “What is a Certified Nurse Midwife (CNM)?”

Nurse Journal: “Nursing Midwife + Salary, Careers & Jobs Outlook”

Nurse: “Certified Nurse Midwife.”

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