The Midwife Effect

KIWI, Pregnancy & Baby | February 7, 2011

From KIWI’s February/March issue

Slowly, midwife-attended births are growing: They jumped from 240,000 per year in 1996 to nearly 320,000 in 2007. Still, the number as a whole is small, accounting for less than a tenth of U.S. births. “There are several misconceptions that prevent midwifery from becoming even more popular,” says Beard. These are some of the biggest concerns women have:

“Can I trust them?”

Some people think midwives lack an educational background, which may only be true for some midwives. These are four common types of midwives:

  • Certified Nurse-Midwife (CNM) Midwives who are also registered nurses with college degrees, CNMs practice mostly in hospitals and/or birthing centers and are required in almost all states to have agreements with local doctors so that a birth can occur in a hospital with backup support. Their certification comes through the American Midwifery Certification Board and integrates apprentice training with a formalized education. Many ob-gyns, including Meserow, see CNMs as the gold standard in midwifery: “The CNM license is an important qualification that’s essential for a safe practice.”
  • Certified Midwife (CM) CMs are midwives who do not have nursing degrees, but who receive training and education identical to CNMs as it relates to midwifery. “They take the same midwifery exam as CNMs, and in terms of ability to attend pregnancy and birth, are the same,” says Beard. CMs are only licensed to practice in New York, New Jersey, and Rhode Island.
  • Direct-entry Midwives As midwives who may or may not be certified by a state or national organization, direct-entry midwives typically receive training through a combination of methods. These might include apprentice- ships, workshops, and formal programs. Direct-entry midwives usually attend home births, are not typically required to have an agreement with a local doctor, and are not supported by ACOG. Their legal status varies by state; find out their status in your area at
  • Certified Professional Midwife (CPM) CPMs can be Certified Nurse-Midwives or direct-entry midwives who have met the certification standards of the North American Registry of Midwives, which requires out-of-hospital training in addition to clinical training. CPMs usually attend births outside of the hospital setting.

“I don’t think there are any near me.”

CNMs are licensed to practice in all 50 states: “It’s just a matter of taking t hat extra step to find them,” Alpern says.

“I don’t want to give birth at home.”

Though 92 percent of midwife-attended births occur in hospitals, many people believe midwifery is reserved for home births

“My insurance probably won’t cover it.”

Many insurance plans cover midwife ser- vice: 33 states require midwife coverage from private plans (including HMOs), and it’s mandatory in all 50 states through Medicaid.

“What if something goes wrong?”

Midwife-attended births in hospitals have been shown to be just as safe as those attended by an ob-gyn.

Get the full answers to the rest of these questions, plus learn lots more about midwifery by purchasing KIWI’s digital edition.

Talk About It

Have you worked with or considered working with a midwife? What was the experience like—and what factors contributed towards your decision?

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