Midwives Are Trained Professionals
Midwives are the traditional care providers for mothers and infants. Midwives are trained professionals with expertise and skills in supporting women to maintain healthy pregnancies and have optimal births and recoveries during the postpartum period. Midwives provide women with individualized care uniquely suited to their physical, mental, emotional, spiritual and cultural needs. Midwifery is a woman-centered empowering model of maternity care that is utilized in all of the countries of the world with the best maternal and infant outcomes such as The Netherlands, United Kingdom and Canada.
Midwives in the United States
There are approximately 15,000 practicing midwives in the United States. Midwives may practice in private homes, clinics, birth centers, and hospitals. In most countries, midwives are primary health care providers and the central pillar in maternity care and women’s health care. However, slightly more than 10% of births in the U.S. are attended by midwives. Countries that utilize midwives as primary health care providers are also those countries in which mothers and infants fare best. The United States continues to rank behind most of the developed world in terms of infant and maternal mortality.
Midwives Foster Relationships with Women
Midwives value communication and developing a trusting, working relationship with the women and families they serve. In the course of developing that relationship, midwives provide personalized and thorough care at many levels: preconception, pregnancy, labor, birth, postpartum, and beyond. Many midwives provide primary health care, gynecological care, and care of the normal newborn. Some midwives prescribe medications including family planning and contraceptive methods. In addition to being trained to conduct comprehensive physical exams and order laboratory, screening and other diagnostic tests, midwives provide extensive health care education and counseling, as well as engage in shared decision-making with their clients and patients.
International Definition of the Midwife
(Updated and Endorsed by the International Confederation of Midwives (ICM), June 2011)
A midwife is a person who has successfully completed a midwifery education programme that is duly recognized in the country where it is located and that is based on the ICM Essential Competencies for Basic Midwifery Practice and the framework of the ICM Global Standards for Midwifery Education; who has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery and use the title ‘midwife’; and who demonstrates competency in the practice of midwifery.
The midwife is recognized as a responsible and accountable professional who works in partnership with women to give the necessary support, care and advice during pregnancy, labour and the postpartum period, to conduct births on the midwife’s own responsibility and to provide care for the newborn and the infant. This care includes preventative measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care or other appropriate assistance and the carrying out of emergency measures.
The midwife has an important task in health counselling and education, not only for the woman, but also within the family and the community. This work should involve antenatal education and preparation for parenthood and may extend to women’s health, sexual or reproductive health and child care.
A midwife may practise in any setting including the home, community, hospitals, clinics or health units.
(Adopted June 15, 2011, due for review 2017.)
Types of Midwives
In the United States there are several pathways to midwifery education and training. Most pathways result in midwifery certification and qualify the candidate for licensing in her/his state or municipality. Candidates seeking to become certified and licensed midwives can choose among several routes of entry into the profession using nurse-midwifery or direct-entry midwifery educational programs. The most common types of midwives are listed below including the three professional U.S. midwifery credentials, Certified Professional Midwives (CPM), Certified Nurse-Midwives (CNM), and Certified Midwives (CM).
Certified Midwife (CM): A Certified Midwife (CM) is an individual educated in the discipline of midwifery, who possesses evidence of certification according to the requirements of the American College of Nurse-Midwives.
Certified Nurse-Midwife (CNM): A Certified Nurse-Midwife (CNM) is an individual educated in the two disciplines of nursing and midwifery, who possesses evidence of certification according to the requirements of the American College of Nurse-Midwives.
Certified Professional Midwife (CPM): A Certified Professional Midwife is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the midwifery model of care. The CPM is the only midwifery credential that requires knowledge about and experience in out-of-hospital settings.
Direct-Entry Midwife (DEM): A direct-entry midwife is an independent practitioner educated in the discipline of midwifery through self-study, apprenticeship, a midwifery school, a college, or university-based program distinct from the discipline of nursing. A direct-entry midwife is trained to provide the Midwives Model of Care to healthy women and newborns throughout the childbearing cycle primarily in out-of-hospital settings. Licensed Midwives (LM) and Registered Midwives (RM) are examples of direct-entry midwives.
In addition, there are midwives who—for religious, personal, and philosophical reasons—choose not to become certified or licensed. Typically they are called traditional or community-based midwives. They believe that they are ultimately accountable to the communities they serve; or that midwifery is a social contract between the midwife and client/patient, and should not be legislated at all; or that women have a right to choose qualified care providers regardless of their legal status.