What Is a Midwife?

A midwife is a trained health professional who helps healthy women during labor, delivery, and after the birth of their babies. Midwives may deliver babies at birthing centers or at home, but most can also deliver babies at a hospital.

Women who choose midwives usually want very little medical intervention and have had no complications during their pregnancy. Because giving birth to twins is more complicated than giving birth to a single baby, many doctors don't recommend using a midwife unless under the direct supervision of a doctor.

Midwives can have different levels of training:

  • Certified nurse-midwives (CNMs) are registered nurses who have graduated from an accredited nurse-midwifery education program and have passed a national exam. They can practice in all 50 states and the District of Columbia.
  • Certified midwives (CMs) are non-nurse midwives who have a bachelor's degree or higher in a health field, have completed an accredited midwifery education program, and have passed a national exam. Only a few states permit CMs to practice.
  • Certified professional midwives (CPMs) are non-nurse midwives who have training and clinical experience in childbirth, including childbirth outside of the hospital, and have passed a national exam. Not all states permit CPMs to practice.
  • Lay midwives are not certified or licensed but have apprenticed or received informal training. 

What Does Your Midwife Do?

Your midwife can provide care before, during, or after your pregnancy. Your midwife will:

  • Provide family planning and preconception care
  • Do prenatal exams and order tests
  • Watch your physical and psychological health
  • Help you make your birth plans
  • Advise you about diet, exercise, meds, and staying healthy
  • Educate and counsel you about pregnancy, childbirth, and newborn care
  • Give you emotional and practical support during labor
  • Admit and discharge you from the hospital
  • Deliver your babies
  • Make referrals to doctors when needed

How Your Midwife Works With Your Pregnancy Team

Midwives have a relationship with an OB-GYN who provides consultation as needed. Your midwife may refer you to an obstetrician for care if a problem develops during your pregnancy. Your midwife also may team up with another midwife or doula to help with your labor and delivery. Make sure your midwife is in practice with a doctor.

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Why You Might Want to Choose a Midwife

You may want to consider working with a midwife if:

  • You want your childbirth to be as natural as possible with little medical intervention, such as an episiotomy, fetal monitoring, labor induction, etc.
  • You want the emotional, practical, and social support that midwives provide.

How to Choose a Midwife

When deciding who to choose, start by asking your doctor or OB if they can make a recommendation. You also may want to talk with any friends who have worked with a midwife to see what their experience was like and who they might recommend.

No matter who oversees your care, it's important to choose a provider you feel confident in and comfortable with. The questions below can help you choose the right midwife for you.

  • What type of certification does the midwife have?
  • Is the midwife licensed by the state?
  • Is the midwife affiliated with a medical practice, hospital, or birthing center?
  • Does this midwife have a good reputation?
  • What type of experience does the midwife have and in what settings (hospitals, birthing centers, home births)?
  • What is the midwife's general approach to pregnancy care and delivery?
  • How does the midwife manage pain during delivery?
  • What percentage of the midwife's patients have episiotomies and under what circumstances are they performed?
  • Under what circumstances would the midwife recommend certain medical interventions, such as inducing labor or ordering an epidural or C-section?
  • What is the midwife's emergency back-up plan for an out-of-hospital birth?
  • Does the midwife listen to me and explain things clearly?
  • Is my spouse or partner comfortable with the midwife?
  • Who covers for the midwife when they are not available?
  • If another midwife or doula will also attend my delivery, can I meet them beforehand?
  • Does the midwife consult with an OB and can I meet them?
  • Does the doctor provide backup in case of complications or emergency?
  • Is the office location convenient?
  • How are emergencies and after-hour calls handled?
  • Does my insurance cover the midwife's services?
WebMD Medical Reference Reviewed by Nivin Todd, MD on June 21, 2020

Sources

SOURCES:

Medline Plus: "Certified Nurse Midwife."

Association of Midwifery Educators: "Certification."

American College of Nurse Midwives: "Comparison of Certified Nurse-Midwives, Certified Midwives, and Certified Professional Midwives," "Definition of Midwifery and Scope of Practice of Certified Nurse Midwives and Certified Midwives," "Differences between Nurse-Midwives, Other Midwives, and Doulas," "What is the difference between a nurse-midwife, midwife, and doula?"  "A brief history of nurse-midwifery in the U.S.," "More on CNMs/CMs," "What is a Midwife?"

Midwifery Alliance of North America: "Direct-Entry Midwifery State-by-State Legal Status, Last Updated 5-11-2011."

Agency for Healthcare Research and Quality: "What You Need to Know About Episiotomies."

American College of Obstetricians and Gynecologists: "ACOG Recommends Restricted Use of Episiotomies," "ACOG Statement on Home Births."

MacDorman, M. Journal of Epidemiology and Community Health, 1998; vol 52; pp 310-317.

Rosenblatt, R. American Journal of Public Health, 1997; vol 87; pp 344-351.

Blix-Lindstrom, S., Midwifery, 2004; vol 20; pp 104-112.

Grünebaum A, McCullough LB, Sapra KJ, et al. Early and total neonatal mortality in relation to birth setting in the United States, 2006-2009. Am J Obstet Gynecol 2014;211:390.e1-7.

American Journal of Obstetrics & Gynecology, Volume 211, Issue 4, Pages 390.e1-390.e7, October 2014.

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