Midwife

Birth Doula, Certified Midwife, Certified Professional Midwife   More Names
Certified Professional Midwife, Licensed Midwife, Direct-Entry Midwife, Director of Midwifery/Staff Midwife, Homebirth Midwife, Lay Midwife, Licensed and Certified Midwife, Licensed Direct Entry Midwife, Licensed Midwife, Licensed Midwife, Certified Professional Midwife, Midwife, Midwife and Birth Center Owner, Midwives, Staff Midwife, Staff Midwife at Birth Center, Certified Professional Midwife, Licensed Midwife, Staff Midwife/Apprenticeship Director
Description

Provide prenatal care and childbirth assistance in home, birth center, or hospital settings. They conduct ongoing prenatal health assessments tracking both physical and emotional health. During labor midwives monitor the mother's vital signs and offer comfort and relaxation measures using massage, breathing techniques, music, and other means. After childbirth, they ensure that mother and child are in a safe, clean, and comfortable setting with available needed supplies.

Midwives may work for private companies, non-profit organizations, or be self-employed. Employers can include hospitals, clinics, and birth centers. The basic kinds of services they provide to expectant mothers during pregnancy, at childbirth, and afterwards (to both mothers and newborns) go back thousands of years.

In general, midwives' education and training stress that pregnancy and childbirth are normal, healthy events until proven otherwise. They view their role as supporting the pregnant woman as they prepare her for a natural childbirth. Midwives also focus on the psychological aspects of how the mother-to-be feels about her pregnancy and the anticipated birth experience. They encourage women to trust their own instincts and seek the information they need to make their own decisions about pregnancy, birth, and parenthood.

Throughout the period of their work, midwives usually develop, implement, and evaluate individual plans of midwife care. They also are familiar with various emergency and back-up plans for mothers and newborns; plans that may or may not involve close cooperation with physicians.

Some midwives work more closely with doctors on a regular basis than others during pregnancy and childbirth. Especially in the case of high-risk pregnancies, midwives may work closely with doctors and use their various assessment and tracking technologies, such as ultrasound, as well as specific medications to help address difficult problems. However, many midwives find it unnecessary to use such technologies and medications for uncomplicated pregnancies. In addition, only the more highly trained, and certified or licensed, midwives may directly administer certain treatments.

Depending on the degree of formal training and credentialing, there are at least three well-defined levels of midwives.

At the entry-level of the healthcare workforce, direct-entry midwives (DEMs) usually have on-the-job or informal apprenticeship training. They may have some postsecondary training, but no nursing background. DEMs usually practice in homes or non-hospital birth centers and not all states require them to work in conjunction with doctors. About half of the states license or regulate DEMs; the rest do not.

With experience and the ability to pass a written exam and a hands-on skills evaluation, direct-entry mid-wives can earn the Certified Professional Midwife (CPM) credential sponsored by the North American Registry of Midwives (NARM). This certification focuses on out-of-hospital birth experience. As a result, CPMs usually are found practicing in homes and birth centers rather than in hospitals.

At the highest level are nurse midwives, more formally known as certified nurse midwives (CNMs). These midwives are registered nurses who hold at least a bachelor's degree, and often a master's or doctoral degree, in nursing. They have also completed formal midwife training, have passed national certification exams, and state licensing exams. CNMs are required to be licensed by every state. Over ninety percent of births that are assisted by CNMs occur in hospitals and in association with doctors. The CNM credential is administered by the American College of Nurse Midwives; it is considered the highest level of midwife certification.

In between middle (CPM) and highest (CNM) levels are the certified midwives (CMs). They are not registered nurses, but otherwise meet many of the same remaining qualifications as CNMs. The CM credential is also administered by the American College of Nurse Midwives. CMs are licensed in some states, but not in a number of others.

CNMs, like doctors, may use certain medical interventions, such as electronic fetal monitoring, labor-inducing drugs, pain medications, epidurals, and episiotomies, if the need arises. However, the other levels of midwives usually are not legally permitted to use these techniques without a doctor's supervision, and many birthing centers simply are not equipped to perform these procedures.

As this discussion suggests, the midwives occupation has its own distinctive career ladder. In addition, midwives also have the option to branch out and pursue other career specialties within the overall nursing career pathway, including at the entry- and mid-levels training to become a licensed practical nurse (LPN) or registered nurse (RN).

Credentials Needed: About half the states require direct-entry midwives (DMNs) to be licensed or registered. In these cases, while not required to have any nursing training or degree, they do have to meet the national certification requirements to earn the Certified Professional Midwife (CPM) credential sponsored by the North American Registry of Midwives (NARM). To earn the CPM, an individual must pass a written exam and have at least a year of clinical experience observing and participating in births as a lead midwife.

To check what your state may require regarding licensing or other requirements for midwives, check with your state's licensing board.

Some Key Things to Remember: Midwives provide prenatal care and childbirth assistance in home, birth center, or hospital settings. Their education and training stress that pregnancy and childbirth are normal, healthy events until proven otherwise. They view their role as supporting the pregnant woman as they prepare her for a natural childbirth. Depending on their degree of formal training and credentialing, midwives have at least three well-defined levels for career pathway progression.

More Details
Job Growth and Wages
Percent Job Growth:  
14% - Average
Typical Wages (National):  
Annual: $33,580 - $77,400    Hourly: $16 - $37
Physical/Medical/Health Requirements

No specifc requirement is identified at this time.

Legal Requirements
General/Nationwide
State-Specific
 
      

Career Snapshot

Typical Education:

Bachelor's Degree (High School + 4 or more Years)
Find Programs

Percent Job Growth:

14% - Average
Find Jobs

Typical Wages:

Annual: $33,580 - $77,400

Hourly: $16 - $37