Midwife vs Nurse Midwife: What Are the Differences?

Many people often wonder about the differences between a midwife and a certified nurse midwife. Both professions play crucial roles in providing healthcare and support during pregnancy, childbirth, and postpartum care. However, there are clear distinctions between the roles.

This article compares midwife vs nurse midwife duties and explores the different types of midwives, the certifications needed, salaries, and education and training requirements.

What’s the Difference Between a Midwife vs a Nurse Midwife?

When looking at a certified nurse midwife (CNM) vs a midwife, the main differences lie in their education, scope of practice, and typical work settings. In short, a nurse midwife is an advanced practice registered nurse with a certification in midwifery, while other types of midwives are not registered nurses and have obtained some other form of midwifery training. Let’s look at the differences in more detail. 

>> Related: Doula vs Midwife: What's the Difference?

What is a Midwife?

A midwife is a healthcare professional specializing in providing care to women during pregnancy, childbirth, and postpartum. Midwives receive specialized education and training in midwifery. This training focuses on the natural process of birth and promoting the mother's and baby's well-being.

Midwives obtain their education through dedicated midwifery programs. The American College of Nurse-Midwives notes that you can become a certified midwife (CM) without first being a registered nurse (RN). To pursue that path, you must obtain a health-related bachelor's degree followed by a graduate midwifery program degree.

However, other midwifery pathways, such as a certified professional midwife (CPM), direct-entry midwife, or lay midwife, require much less education. We'll get into those a little later in the article. 

What is a Nurse Midwife? 

On the other hand, a certified nurse midwife is an advanced practice registered nurse (APRN) who has obtained certification in midwifery. Nurse midwives begin their journey as registered nurses and then pursue further education and training in midwifery. Check out our CNM meaning guide to learn more about what it means to be a nurse midwife.

What do nurse midwives do? Certified nurse midwives have a broader scope of practice as they possess both nursing and midwifery expertise. In addition to providing pregnancy, childbirth, and postpartum care, nurse midwives offer women primary healthcare services throughout their lifespans.

All midwife and nurse midwife graduate programs must have accreditation from the Accreditation Commission for Midwifery Education (ACME). Midwives and nurse midwives must also pass an exam administered by the American Midwifery Certification Board (AMCB) exam to obtain certification.

>> Show Me Online Nurse Midwife Programs

What Are the Different Types of Midwives? 

There are broadly five types of midwives: certified nurse midwives (CNMs), certified midwives (CMs), certified professional midwives (CPMs), direct-entry midwives, and lay midwives. 

However, the types of midwives and their roles may vary depending on individual state regulations. Check with your state to learn the scope of practice and level of authority where you plan to work.

1. Certified Nurse Midwife (CNM)

A CNM is an APRN certified through the AMCB in midwifery. CNMs are qualified to provide a full range of healthcare services to women, including but not limited to the following:

• Prenatal care
• Labor and delivery support
• Postpartum care
• Gynecological services
• Reproductive health visits

2. Certified Midwife (CM) 

A CM is a non-nurse midwife who completed a midwifery program and attained AMCB certification.  CMs provide comprehensive care to women throughout childbirth, including prenatal, intrapartum, and postpartum care.

3. Certified Professional Midwife (CPM)  

CPMs are non-nurse midwives who have obtained their education through various pathways. They earn midwife certifications through apprenticeships or educational programs that have received accreditation from the Midwifery Education Accreditation Council (MEAC).

Certified professional midwives primarily focus on out-of-hospital births. They care for women during pregnancy, childbirth, and the postpartum period in settings such as birthing centers or home births.

Most CPM graduates typically receive a certificate or an associate's degree. CPMs may legally practice in 35 states and the District of Columbia as of 2020.

4. Direct-Entry Midwife 

Direct-entry midwives are all midwives who enter the profession without first becoming registered nurses. Types of direct-entry midwives include certified midwives, certified professional midwives, and lay midwives.

Direct-entry midwives typically don’t require a bachelor’s, master's, or doctoral degree. They undergo midwifery training through various educational pathways, such as apprenticeships or direct-entry midwifery programs. Direct-entry midwives typically care for women outside hospitals, often in home birth settings.

5. Lay Midwife 

Lay midwives are typically self-taught or informally trained individuals who practice midwifery without formal education or certification. They often provide care in home birth settings, primarily for uncomplicated pregnancies and births. 

We want to emphasize that the term "lay midwife" may have different legal and regulatory implications depending on where you live. Some states require specific certifications or licensure to practice midwifery.

Now that you know the different types of midwives, let's get into the specifics of their different roles.

What Is a Certified Nurse Midwife?

A certified nurse midwife (CNM) is an APRN specializing in providing healthcare services to women throughout childbirth. They provide comprehensive care, including prenatal, intrapartum, postpartum, and gynecological services.

Education & Training Requirements 

Certified nurse midwife education begins with a Bachelor of Science in Nursing (BSN) degree and RN licensure. After working as an RN for at least one year, you may attend a CNM program. CNM programs specialize in midwifery and grant either Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) degrees.

CNM graduate-level education focuses on advanced knowledge in midwifery, reproductive healthcare, and women's health. CNMs also undergo clinical training, which includes hands-on experience in providing care during pregnancy, labor and delivery, and postpartum periods.

A CNM must take the American Midwifery Certification Board (AMCB) Nurse-Midwifery/Midwifery Examination to earn CNM certification.

Salary 

The salary of all types of midwives can vary depending on geographic location, years of experience, and practice setting.

According to the US Bureau of Labor Statistics (BLS),  the median nurse midwife salary is $129,650. The bottom 10% of earners make about $95,530 annually, and the top 90% earn $211,820 or more.

Duties & Scope of Practice

CNMs have the widest scope of practice of any type of midwife and have and can perform various duties, including:

• Prenatal care
• Labor & delivery
• Postpartum care
• Gynecological services
• Health education
• Family planning
• Providing evidenced-based care throughout the reproductive lifespan

CNMs often collaborate with other healthcare professionals, such as obstetricians, pediatricians, and lactation consultants, to provide comprehensive and coordinated care. They can practice in various settings, including hospitals, birthing centers, and clinics. Some even practice at-home births, depending on local regulations and individual preferences.

>> Show Me Online Nurse Midwife Programs

What is a Certified Midwife (CM)?

A CM is a non-nurse midwife who has completed a midwifery education program with a graduate degree. CMs receive specialized training in midwifery and are qualified to provide comprehensive care to women throughout childbirth. The services CMs provide include prenatal, intrapartum, and postpartum care.

Education & Training Requirements

Since CMs have a direct entry into midwifery, their programs do not include a nursing curriculum. Instead, their educational focus is solely on midwifery practice. Additionally, there are very few CM programs available in the US (here is one example of a CM graduate program).

Becoming a CM requires first obtaining a bachelor's degree, preferably in a health-related field. CM graduate programs include academic coursework, clinical training, and supervised practical experience. The education and training encompass all aspects of midwifery care, including pregnancy, childbirth, postpartum care, and gynecological services.

Like nurse midwives, CMs must take the AMCB  Nurse-Midwifery/Midwifery Examination to earn CM certification.

Salary 

The BLS does not differentiate between the salaries of CMs and CNMs. However, they report that the median annual salary for midwives with specialized graduate-degree education is $131,570, with salaries typically ranging between $87,320 to $177,530.

Duties & Scope of Practice 

CMs collaborate with other healthcare professionals, including obstetricians and nurses, to ensure comprehensive and coordinated patient care. They provide essential services such as:

• Conducting physical exams
• Ordering and interpreting laboratory tests
• Providing prenatal and postpartum care
• Assisting with labor and delivery
• Offering contraceptive counseling

The role of a CM may vary depending on the legal and regulatory framework in the state where they practice. It's important to note that CMs are recognized and authorized to practice in some states but not universally recognized throughout the country.

What Is a Certified Professional Midwife (CPM)?

A CPM is a healthcare provider specializing in providing midwifery care to women during pregnancy, childbirth, and postpartum. CPMs primarily focus on out-of-hospital birth settings, such as homes and birth centers.

Education & Training Requirements 

CPMs gain entry into the field through MEAC-accredited educational programs. Certification in this field does not require an academic degree but does require a demonstrated level of competency. 

Applying to a CPM program requires that the candidate holds a high school diploma or equivalent degree. Most CPM graduates typically receive a certificate or an associate's degree.

Salary 

ZipRecruiter reports that CPMs earn a medium annual salary of $116,674 per year or $56 per hour. However, the highest-earning CPMs make yearly salaries of $141,000 or more.

Duties & Scope of Practice 

According to the American College of Nurse-Midwives, CPM duties may include:

• Providing hands-on support and assistance during pregnancy, labor, birth, and the immediate postpartum period
• Helping provide maternal and well-baby care for approximately 6-8 weeks following childbirth
• Conducting comprehensive assessments and providing appropriate treatment
• Performing  some physical examinations and administering some medications (within state law limits)
• Ordering and interpreting laboratory and diagnostic tests

What Is a Direct-Entry Midwife?

The term "direct-entry midwife" describes a midwife who enters the profession through a pathway other than nursing. Unlike certified nurse-midwives, direct-entry midwives pursue midwifery education and certification without first becoming RNs.

Types of direct-entry midwives may include:

• Certified midwives
• Certified professional midwives
• Lay midwives

Education & Training Requirements 

The education requirements for direct-entry midwives can vary depending on the type of direct-entry midwifery credential:

• Certified midwife: Health-related bachelor's degree, a master’s degree in midwifery, and pass the AMCB Midwifery Exam to earn certification
• Certified professional midwives: A MEAC-accredited CPM certificate or diploma program
• Lay midwives: no formal education (not legally recognized throughout most of the US)

Salary 

The salaries for each type of direct-entry midwife can vary depending on factors, which include:

• Type of program and education
• Location
• Experience
• Practice setting

In general, certified midwives earn significantly more than a CPM or lay midwife. This salary difference is because CM certification requires more specialized graduate-degree education. 

Duties & Scope of Practice 

The scope of practice also varies depending on the type of midwife and the level of education. In general, the higher the level of required education required, the broader the scope of practice the direct-entry midwife will have.

What Is a Lay Midwife?

A lay midwife provides midwifery care without formal certification or licensure. Lay midwives typically acquire skills and knowledge through informal training, apprenticeships, or personal experiences. They may assist women during childbirth, provide prenatal and postnatal care, and offer general support and guidance throughout the childbirth process.

While CNMs can legally practice in all 50 states, and CMs and CPMs are recognized as legal practitioners in some US states, lay midwives are not widely recognized as practitioners. In some states, lay midwifery is illegal or unregulated. However, other states may have specific regulations or guidelines in place. 

Education & Training Requirements 

There are no formal education or training requirements for lay midwifery. A lay midwife typically learns through apprenticeships, classes, or midwifery workshops.

However, some lay midwives who wish to build a career in midwifery go on to become CPMs through a certification or associate's degree program.

Salary 

According to Comparably, the median annual salary of a lay midwife is $54,201.

Duties & Scope of Practice 

Lay midwife duties may include:

• Provide massages or baths
• Help the mother with breathing exercises
• Help during the delivery of babies outside hospital settings

Midwife vs Nurse Midwife: Key Takeaways 

Nurse midwife vs midwife differences lie primarily in their educational backgrounds, the scope of practice, and work settings. 

Midwives obtain their education through dedicated midwifery programs, which don’t require a nursing background. Many midwives work in out-of-hospital settings, including birthing centers and home births. They provide care to women who prefer a more natural and personalized approach to childbirth. 

On the other hand, nurse midwives begin as registered nurses and then pursue education and training through a graduate-level APRN midwifery program. Nurse midwives may practice in various settings, including hospitals, birthing centers, and clinics.

Nurse midwives also have a broader scope of practice as they possess both nursing and midwifery expertise. In addition to providing comprehensive care during pregnancy, childbirth, and postpartum, nurse midwives can offer women primary healthcare services throughout their lifespans. However, the scope of practice and regulations for midwives vs nurse midwives will vary depending on individual state regulations.