Pregnancy is a time of excitement! It is also a time of responsible decision-making! Women and their families have to decide where and with whom to receive prenatal care as well as birth and postpartum support. The Midwives Model of Care is one of the options available, in home births, birth center births, and at hospitals. Midwifery care is recognized throughout the world as the most appropriate maternity care for most women. The use of Direct-entry Midwives has been endorsed by the American Public Health Association (APHA), the World Health Organization (WHO), the National Organization for Women (NOW), the Coalition for Improving Maternity Services (CIMS), the Safe Motherhood Initiatives–USA, the US Department of Education, and other national and international organizations. Midwives offer: prenatal care that promotes informed decision-making; choice of birth place; education and counseling; labor support, birth and postpartum care; support for bonding; examination and evaluation of the newborn; breastfeeding support; counseling in early parenting; and well-woman care. There are several different types of midwives available, each carrying specific credentials, training, and specialties. Licensure procedures and scope of practice vary from state to state:

  • Direct-entry Midwife (DM) – Typically learn midwifery by apprenticeship, they are not required to train as nurses before becoming midwives. They specialize in normal home birth. The Midwifery Education and Accreditation Council (MEAC) is currently accrediting direct-entry midwifery educational programs and apprenticeships in the U.S. Legal status varies from state to state. Ohio legal status of Direct-Entry Midwives is not defined.
  • LM (Licensed Midwife) – Direct-Entry Midwives who live in states where midwifery is legal by statute, and who have passed the individual state’s licensing procedures. Licensure is not currently available in Ohio.
  • CPM (Certified Professional Midwife) – May gain their midwifery education through a variety of routes. They must have their midwifery knowledge, skills and experience evaluated through the North American Registry of Midwives (NARM) certification process and pass the NARM Written Examination and Skills Assessment. The legal status of these nationally credentialed direct-entry midwives varies from state to state. In some of the states where they are also individually licensed, midwifery services are reimbursable through Medicaid and private insurance carriers.
  • CNM (Certified Nurse-Midwife) – Are educated in both nursing and midwifery. After attending and educational program accredited by the American College of Nurse-Midwives (ACNM) Certification Council (ACC), they must pass the ACC examination and can be licensed in the individual states in which they practice. Certified nurse midwives practice most often in hospitals and birth centers.
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