A certified midwife is a healthcare provider trained to manage pregnancy, labor, and birth, and to care for newborns and postpartum people

The term "certified midwife" refers to someone who has completed specific education and passed a national exam, but the details matter because midwifery in the United States includes several different credentials, and they are not interchangeable. A certified midwife (CM) is distinct from a certified nurse-midwife (CNM) and a certified professional midwife (CPM), and each has different training, scope of practice, and legal standing depending on which state you live in.

If you are considering midwifery care for pregnancy or birth, or if you are exploring midwifery as a career, understanding these distinctions helps you know what training someone has received, what they are legally permitted to do, and what insurance or payment options may be available to you.

Key Takeaways

  • A certified midwife (CM) has completed a graduate-level midwifery program and passed the American Midwifery Certification Board exam, but does not have nursing credentials.
  • Certified nurse-midwives (CNMs) are registered nurses who completed additional midwifery training, and they are more widely recognized by insurance and hospitals than CMs.
  • Certified professional midwives (CPMs) typically attend home births and have different training pathways that vary by state; they are not licensed in all states.
  • State law determines whether a CM can prescribe medications, order tests, or manage birth in a hospital or birth center, so the same credential means different things in different places.
  • Insurance coverage and payment options depend on the credential and the state, so you will need to check with your insurance and local providers about what is covered.

The difference between a certified midwife and a certified nurse-midwife

The most common source of confusion is between a certified midwife (CM) and a certified nurse-midwife (CNM). Both are certified, but they arrive at that credential through different paths. A certified nurse-midwife is a registered nurse (RN) who completed a nursing degree first, then pursued additional graduate-level education in midwifery. A certified midwife is someone who completed a graduate-level midwifery program without first becoming a nurse.

In practice, this means CNMs are more widely integrated into hospital systems and are recognized by most insurance plans. Many hospitals employ CNMs and allow them to manage low-risk pregnancies and births within the hospital setting. CMs, by contrast, are less common and their scope of practice varies more by state. Some states do not recognize the CM credential at all, while others allow CMs to work in hospitals or birth centers under specific conditions.

Both CNMs and CMs must pass the American Midwifery Certification Board (AMCB) exam to use their credential. The exam covers the same clinical knowledge, but the educational pathways differ. If you are looking for midwifery care, asking whether a provider is a CNM or a CM will tell you something about their training and likely about what settings they work in.

How certified professional midwives differ from certified midwives

A certified professional midwife (CPM) is a separate credential from both CM and CNM. CPMs typically attend births outside of hospitals — usually at home or in freestanding birth centers. The CPM credential is awarded by the North American Registry of Midwives (NARM) after someone completes training through one of several pathways, which may include apprenticeship, self-study, or formal midwifery school.

The key difference is that CPM training does not require a nursing degree or a graduate-level university program. This makes CPM training more accessible in terms of cost and time, but it also means CPM scope of practice is narrower and more variable by state. Some states license CPMs and allow them to practice independently; other states do not recognize the credential at all or restrict CPMs to working under a physician's supervision.

If you are considering a home birth or birth center birth, you may encounter a CPM. If you are considering hospital birth, you are more likely to work with a CNM or, less commonly, a CM. The credential tells you something about where and how someone was trained, but state law determines what they are actually permitted to do.

What certified midwives can and cannot do

The scope of practice for a certified midwife — what they are legally permitted to do — depends on the state where they practice. There is no single national standard. In some states, CMs can prescribe certain medications, order lab tests, and manage birth in a hospital or birth center. In other states, CMs cannot prescribe anything or work in hospitals and are restricted to birth centers or home settings. In still other states, the CM credential is not recognized by law at all.

Generally, midwives of all types are trained to manage low-risk pregnancy and birth. This includes prenatal care, labor support, delivery, and postpartum care for the person who gave birth and the newborn. Midwives are also trained to recognize complications and refer to a physician when needed. However, whether a midwife can order an ultrasound, manage gestational diabetes, or prescribe antibiotics depends on state law and the specific practice agreement they have with their employer or collaborating physician.

If you are considering midwifery care, asking your provider what they can and cannot do in your state is more useful than relying on the credential alone. You can also contact your state's health department or nursing board to learn what the law permits for CMs in your area.

Education and certification requirements for certified midwives

To become a certified midwife, someone must complete a graduate-level midwifery program accredited by the Accreditation Commission for Midwifery Education (ACME). These programs typically take two to three years and include classroom instruction in anatomy, physiology, pharmacology, and midwifery-specific skills, plus clinical experience attending births and providing prenatal and postpartum care.

After completing the program, the person must pass the American Midwifery Certification Board (AMCB) exam. This is a written test that covers the knowledge and clinical judgment expected of a midwife. Once someone passes, they can use the credential "CM" after their name. To maintain certification, CMs must renew every five years and meet continuing education requirements.

The educational pathway for a CNM is longer because it includes nursing school first (typically four years for a bachelor's degree in nursing), then a graduate midwifery program (two to three years). CPM education is more variable and may include apprenticeship, self-directed study, or formal school, and the requirements differ by state.

Insurance, payment, and where certified midwives work

Insurance coverage for midwifery care depends on the credential, the state, and your specific insurance plan. Most insurance plans cover CNMs because they are widely recognized and integrated into hospital systems. Coverage for CMs is less consistent; some plans cover them, but you will need to check with your insurance company directly. CPMs are rarely covered by insurance, though some plans may cover birth center births if the center is accredited.

Where a midwife works also affects payment. Midwives employed by hospitals or large medical practices typically bill through the hospital's insurance arrangements. Midwives in private practice or birth centers may bill directly to insurance or ask you to pay out of pocket and seek reimbursement yourself. Some people choose midwifery care specifically because it is less expensive than hospital birth, even without insurance coverage.

CNMs work in hospitals, birth centers, and private practice. CMs work primarily in birth centers and private practice, though some hospitals employ them. CPMs work almost exclusively in home birth and freestanding birth center settings. If you have a specific birth setting in mind, that will narrow down which type of midwife you are likely to find.

How to find a certified midwife in your area

To find a certified midwife, start by contacting birth centers or midwifery practices in your area. You can search online for "midwife near me" or "birth center," and most will list the credentials of their staff. You can also ask your primary care doctor or OB-GYN for a referral, though some physicians are more familiar with midwifery than others.

If you want to verify someone's credentials, you can check the American Midwifery Certification Board website, which maintains a registry of certified midwives and certified nurse-midwives. For certified professional midwives, you can check the North American Registry of Midwives website. These registries let you confirm that someone holds the credential they claim and that their certification is current.

When you contact a midwife or practice, ask about their specific training, what they can do in your state, what your out-of-pocket costs would be, and whether they accept your insurance. You can also ask about their philosophy of care, their transfer rate to hospitals (if they attend home or birth center births), and their experience with the type of birth you are planning.

Frequently Asked Questions

Is a certified midwife the same as a midwife?

No. "Midwife" is a general term for anyone who attends births, but "certified midwife" refers to someone with a specific credential. An uncertified midwife may have training and experience but has not passed a national exam or completed an accredited program. In most states, only certified midwives (CM, CNM, or CPM) are legally permitted to practice midwifery.

Can a certified midwife deliver a baby in a hospital?

It depends on the state and the hospital. Certified nurse-midwives commonly work in hospitals and deliver babies there. Certified midwives (CMs) may be permitted to work in hospitals in some states but not others. Certified professional midwives rarely have hospital privileges. Ask the hospital or midwife directly what is permitted in your area.

Do I need a doctor if I use a midwife?

Midwives are trained to manage low-risk pregnancy and birth, but they work within a system that includes physicians. If complications arise, a midwife will refer you to a doctor. Many midwives have a collaborative relationship with a physician or work within a practice that includes doctors. You should ask your midwife about their backup plan and how they handle emergencies.

Is midwifery care covered by Medicaid?

Medicaid covers certified nurse-midwives in all states and certified midwives in most states, though the details vary. Medicaid coverage for certified professional midwives is less common and depends on the state. Contact your state's Medicaid program or your local midwife to learn what is covered where you live.

What is the difference between a midwife and a doula?

A midwife is a healthcare provider who manages medical aspects of pregnancy, birth, and postpartum care. A doula is a trained birth companion who provides emotional and physical support during labor but does not perform medical tasks. Some people use both — a midwife for clinical care and a doula for continuous support.