You took a home pregnancy test, and it came back positive. You are over the moon excited! But now what? It’s time to find a healthcare provider to care for you during pregnancy. You have several options, including a doctor, a nurse practitioner, or a midwife. But what is a midwife?

What a Midwife Is

The word “midwife” means “with woman.” Midwives are trained experts in normal pregnancy and birth. They focus on keeping everything as normal as possible for mom and baby.^15,16

There are several types of midwives. The most highly trained are certified nurse-midwives. They independently care for low-risk women and often collaborate with an OB-GYN to care for high-risk women. Midwives play a crucial role in promoting the health of mothers and their babies.^3,5

Midwives have cared for pregnant women in their homes for centuries. The practice of midwifery goes back long before doctors received training. As physicians became trained, they took over the field of childbirth in the United States. By the 19th century, physicians attended almost all births in hospitals. Today, midwives in the United States attend about 8.7% of hospital births. In other countries, the numbers are much higher.^6,7

Types of Midwives

Choosing a midwife starts with understanding the different levels of training and care they provide.

There are four types of midwives. Each provides varying levels of care to women and newborns. When choosing a midwife, it’s good to understand the differences to select the type that best meets your needs and provides the safest care.^1,2,3,4

Certified Nurse-Midwife (CNM)

Certified nurse-midwives are registered nurses who complete a graduate-level nurse-midwifery program. They pass a national certification exam from the American Midwifery Certification Board (AMCB). CNMs care for women from their teenage years through menopause, not just during pregnancy. Their training is typically hospital-based, but CNMs can practice in various birth settings. With their licensing, CNMs can prescribe medications in all 50 states.

Certified Midwife (CM)

Certified midwives are highly trained but are not nurses. CMs have a non-nursing undergraduate degree, usually in a health-related field. They complete a graduate-level midwifery degree and pass the same national board exam as CNMs. CMs also care for women throughout their lifespans and can practice in any birth setting. They can practice in nine states and can prescribe medications in six.

Certified Professional Midwife (CPM)

Certified professional midwives receive training through either an apprenticeship or an educational program. Certification does not require a degree. They meet certification requirements through the North American Registry of Midwives (NARM). Their training focuses on providing midwifery care in homes and freestanding birth centers. CPMs are not nurses. They care for women during pregnancy, childbirth, and the 6-8 weeks following delivery. CPMs can practice in 28 states.

Lay Midwife

Lay midwives, also known as traditional midwives, are not certified or licensed. They usually have informal education, such as self-study or an apprenticeship. Lay midwives do not have nursing or medical training and are thus not considered healthcare professionals. They are not licensed, certified, or legislated.

What Midwives Do

Midwives offer a wide range of services throughout pregnancy, birth, and postpartum, depending on their training and credentials.

The scope of care that midwives provide depends on the type of midwife they are. We will focus here on CNMs and CMs as they can provide the most comprehensive care. Other types are limited in the care they can provide and in the locations where they can offer that care. CNMs and CMs can provide care that includes the following:⁵

• Pregnancy care
• Labor and birth, including delivering your baby
• Postpartum care after your baby is born
• Sexual and reproductive health
• Gynecologic health, including annual exams, cervical screenings, and breast exams
• Family planning services, such as contraception
• Preconception care
• Primary care for teens
• Newborn care for the first 28 days of life
• Breastfeeding support
• Prescribe medications, including pain medications for labor
• Assist with cesarean births if they have additional training
• Order and interpret lab results, ultrasounds, and other diagnostic tests
• Manage medical emergencies until a physician arrives
• Provide wellness education and counseling
• Provide services in clinics, private offices, hospitals, telehealth, birth centers, and homes

Difference Between an OB-GYN and a Midwife

OB-GYNs, or obstetricians and gynecologists, are medical doctors who specialize in women’s health. As doctors, they typically hold an undergraduate degree, attend four years of medical school, and then complete a four-year residency in obstetrics and gynecology. Obstetricians are experts in complications and disease processes. OB-GYNs are also surgeons and perform cesarean deliveries as well as gynecological surgeries.¹⁷

Midwives are not doctors. Certified nurse midwives and certified midwives provide comprehensive care to women. They can provide medical interventions and procedures but are not surgeons. They tend to adopt a more holistic approach, focusing on promoting natural birth and minimizing unnecessary interventions. Midwifery centers on wellness, health, empowering women and families, shared decision-making, and emotional support. Typically, they spend more time at the bedside caring for and interacting with their patients.⁸

Related: Midwife vs. OB-GYN: What’s the Difference?

Difference Between a Nurse Practitioner and a Midwife

A women’s health nurse practitioner (NP) has a nursing degree with advanced practice education and training. Certified nurse-midwives attend births, but nurse practitioners do not. NPs care for women throughout their lives, including during pregnancy and childbirth. You can see a nurse practitioner for your pregnancy, but a doctor or midwife will attend your birth.¹⁸

Difference Between a Doula and a Midwife

A doula has training and certification to provide you with physical and emotional support during labor. Some doulas also offer support in your home after your baby is born. Doulas are not required to have a medical or nursing background. Midwives are responsible for monitoring the health of you and your baby, while doulas are responsible for offering support.⁹

Related: Doula vs. Midwife: What’s the Difference?

Benefits of Midwifery Care

Midwifery care provided by educated, trained, regulated, and licensed midwives have many benefits, including the following:^10,11,12,13

• Lower rate of interventions
• Higher satisfaction with the birth experience
• Less likely to have a preterm birth
• Less use of vacuum or forceps for delivery
• Fewer episiotomies
• Decreased risk of cesarean birth
• Lower rate of labor induction
• Decreased severe tearing
• Lower use of epidurals
• Lower cost
• Increased chance of a positive start to breastfeeding
• More hands-on approach
• The mother has an increased sense of control
• Higher rates of vaginal birth after a cesarean section

Questions To Ask Before Choosing a Midwife

Choosing a midwife is an important decision. So it is essential to ask questions to ensure the midwife you choose is right for you. Some questions to consider are:

• Are they a certified nurse, certified professional, or lay midwife?
• What is their education and training?
• How many years of experience do they have?
• How many babies have they delivered?
• What is their philosophy of care?
• Are they accessible and available?
• What is their collaborative relationship with other healthcare providers?
• Do they work with a group?
• Do they deliver babies at home, in a birth center, or in a hospital?
• If they deliver out of the hospital, what is their plan for transferring you to the hospital if the need arises?

When understanding what a midwife is, it is essential to know that they have different practice models. Some follow you through pregnancy and birth, and you know they will be there when the big day comes. Unfortunately, this arrangement is no longer typical. Many work in groups, with one on-call each day for deliveries, who will be the one to care for you during labor and catch your baby. It can be helpful to meet all the midwives in the group so you will be comfortable when you go into labor.

Midwifery can be a vital component of healthcare. They provide comprehensive care to women throughout pregnancy, childbirth, postpartum care, and for routine gynecological needs. Certified nurse midwives and certified midwives work with a team of healthcare providers, including nurses, physicians, and doulas. Midwifery care offers numerous benefits for both the mother and child, making it a valuable option to consider during pregnancy.

Choosing a midwife is a personal decision, and understanding your options can help you find the care that feels right for your pregnancy and birth. Whether you want a more hands-on approach, a provider who supports low-intervention birth, or simply someone who takes time to listen, midwifery care can be a wonderful path for many families. Knowing the differences in training, philosophy, and services allows you to choose the provider who aligns best with your needs.