What is a nurse midwife?

What is a nurse midwife?

A certified nurse-midwife (CNM) is an advance practice registered nurse, who is educated in the specialty of midwifery and women’s health. This means they are nurses first and then attend an accredited nursing university that specializes in midwifery to obtain their master’s degree of science in nursing. CNMs are certified by the American Certification Midwifery Board (ACMB) and uphold the philosophy of the American College of Nurse Midwives (ACNM). They are re-certified every 5 years. CNMs provide acute primary care to women from adolescence onward including:

  • Well-women’s/annuals

  • Family Planning Services

  • Gynecological visits

  • Preconception counseling

  • Prenatal care

  • Labor and birth

  • Postpartum care

  • Newborn care

  • Acute illness

  • Health maintenance and disease prevention

  • Menopausal care/counseling

  • CNMs primary work in hospitals but do work in birth centers and homes as well.

CNMs are licensed by the nursing board and are independent health care providers with prescriptive authority in all 50 states, the District of Columbia, and Puerto Rico. CNMs are defined as primary care providers under federal law. This means they consult appropriately with other health care providers when indicated but do not require any type of supervision or collaborative practice agreement.

What is a licensed midwife (LM) or direct entry midwife (DEM)?

In 2013 Wyoming midwives were required by law to be licensed by attending a formal educational program or equivalent (which involves an extensive apprenticeship under another midwife) and pass an exam administered by the North American Registry of Midwives (NARM) after which a license is granted. There are various levels of educational programs from associates all the way to a master’s degree; however, most attain an associates degree from a midwifery college. LMs and DEMs practice in the home setting or sometimes in a birth center.

Both care for women and are experts in normalcy from extensive study of the menstrual cycle, pregnancy, childbirth and beyond. Some treat certain abnormal cases as appropriate or refer to physicians if outside their scope of practice. Our focus is to be “with women” and to help provide autonomy and informed consent while fostering health and wellness.

Philosophy of the American College of Nurse-Midwives

We, the American College of Nurse-Midwives, affirm the power and strength of all people seeking midwifery care and the importance of health in the wellbeing of families, communities, and nations. We believe in the basic human rights of all persons and recognize that some incur disproportionate risk when these rights are violated. Human dignity and bodily autonomy are basic human rights that should be protected and respected in all areas of care, including in reproductive and sexual health.

We believe every person has a right to:

  • Equitable, ethical, accessible, quality health care that promotes healing and health.

  • Health care providers that demonstrate respect for human dignity, individuality, and diversity among groups; act without bias or discrimination; and actively seek to disrupt systems of power and privilege that cause harm.

  • Complete, accurate, and accessible information to make informed healthcare decisions.

  • Self-determination and active participation in health care decisions, as the final decision maker of the health care team.

  • Involvement of people the individual considers important to them, to the extent desired, in all health care experiences.

We believe the best model of health care:

  • Includes the full scope of health across the lifespan.

  • Involves a continuous and compassionate partnership between persons seeking care and their health care providers.

  • Recognizes the importance of interdisciplinary, collaborative care.

  • Respects the individual’s absolute right to bodily autonomy.

  • Honors a person's expertise, life experiences, community, and historical knowledge.

  • Includes methods of care and healing guided by research and best available evidence, centered on the individual’s decisions, values, and preferences.

  • Balances watchful waiting and support of physiologic processes with the appropriate use of interventions and technology.

  • Involves therapeutic use of human presence and skillful communication.

These beliefs and values, centered in cultural humility and delineated in ACNM’s Vision, Mission, and Core Values provide the foundation for commitment to individual and collective leadership at the community, state, national, and international levels to improve health. We affirm that midwifery care incorporates these qualities and that healthcare needs are well-served through midwifery care.