A midwife is a trained birth professional. There are two distinct classifications and several pathways to becoming a midwife. First, a Certified Professional Midwife (CPM), also known as a direct-entry midwife, can attend at home or in a free-standing birth center. The Certified Nurse Midwife (CNM) is usually a hospital provider, though they can also work in free-standing birth centers. There are a few CNM’s that provide care in the home setting as well, but not in every location.
Many women receive care from an obstetrician (OB) during their pregnancy. An OB is a birth professional and a surgeon. There are wonderful OB’s and sometimes this higher level of care is needed, but not always.
A midwife can attend to prenatal, birth, postpartum and newborn needs but cannot perform surgery (other than suturing a perineum after birth). These care providers work with the low- to low-moderate risk pregnancies. If a case presents itself as higher risk, a transfer of care to an OB is usually needed, regardless of your intended birth location.
A doula is a trained labor support person but has no medical training or licensure. Their role is to provide emotional and physical support as well as education and advocacy. The terms doula and midwife often are mistakenly used interchangeably, but are very different roles and training.
A CNM obtains a 4-year RN degree and then goes on to receive a masters degree in midwifery.
They can apply for hospital privileges and practice while supervised under an OB or work in collaboration.
A direct-entry midwife (CPM) does not become a nurse first, but goes directly into midwifery training and certification (this is not the same as a lay midwife). This can be done several ways. There are apprenticeship-only midwives that complete on-the-job training and then sit the skills and written exams to pass for certification, often taking longer to complete training. There are also accredited schools that provide education and training. Students have options to receive an associate’s degree in midwifery, for example in Southwest Tech’s program or a bachelor’s degree program at Midwives College of Utah. One can then go on to receive a masters in midwifery, like I did.
These routes all require the skills and written exams to become nationally certified. At the end of certification, a midwife applies to be licensed by the state (as is required in WI). Each state has their own path to licensure and not all states allow midwives to practice out of hospital.
Free-standing birth locations are also different from in-hospital birth centers. These can be run by OB’s, CNM’s or CPM’s and often have cross-collaborative relationships.
In our area, hospital providers and out-of-hospital providers have worked to create an environment of civility and cooperation. Most of the time, birth is smooth and lovely (though exhausting) but sometimes we need a higher level of care and will transfer in.
In our state of WI, families have the option of birthing in a hospital, birth center or at home with midwives. Some even choose to birth at home alone, taking the responsibility for their care and safety on themselves. These options are legal in WI, though they come with different levels of safety and risk. Research what fits with your family and your needs and choose the provider and location that matches with your situation.
About Erin (she/her): She has four children, all born at home. She always wants to learn more and honor all cycles of life. She works with another midwife at Abundant Moon Birth & Wellness LLC out of Menomonie, WI. See www.abudantmoonbirth.com for more information.
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