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Why Do Midwives Have Different Titles Behind Their Names???


Certified Professional Midwife (CPM)

Certified Professional Midwives are skilled professional who provide the Midwives Model of Care to women and families in a variety of settings, including birth centers, homes and hospitals. Preparation to become a CPM involves specialized, competency-based education programs and risk assessment training, that requires out-of-hospital clinical experience. A certified Professional Midwife is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the midwifery model of care. The CPM is the only international credential that requires knowledge about and experience in out-of-hospital settings. CPM’s are the only learning experience that require out-of-hospital training.

copy right May 1996 Midwifery Task Force

Certified Midwife (CM)

Certified Midwives are midwives who are certified by a state organizations or the ACNM (American College Nurse Midwives) Certified Midwifes are qualified midwives to provide you with great service.

CM's most often practice in hospitals and birth centers. Some may do home-births. Not all states allow CM's to practice and not all have prescriptive authority.

Direct Entry Midwife (DEM)

Direct Entry Midwife is one who has trained with a more experienced midwife, mastering the skills needed to practice the art of midwifery. A direct-entry midwife is an independent practitioner educated in the discipline of midwifery through self-study, apprenticeship, a midwifery school, or a college-or university-based distinct from the discipline of nursing. A direct-entry midwife is trained to provide the Midwives Model of Care to healthy women and newborns throughout the childbearing cycle primarily in out-of-hospital settings.

Many DEM's go on to become a CPM. Not all are allowed to practice in all states. Some states grant a license to practice as a DEM.

Certified Nurse Midwife (CNM)

Certified Nurse Midwife is a midwife who has first become a nurse, learning OB, and all other areas of nursing. They have then finished a program which may or may not require a masters degree in nursing. They attend an educational program accredited by the American College of Nurse Midwives Certification Council (ACC). They most often practice in hospitals and birth centers.

Some do home-births, and not all have prescriptive authority. All states recognize the CNM but not all do home-births. They usually do not practice independently from a physician. This means to practice in the home-birth setting they need to have a physician that backs them, not just have back up. This limits midwives in some states. This can be due to the back up Doctor or the state that regulates them. Sadly, this is a problem with CNM's working in the home-birth setting. In other states, some have been shut down from home-birth practice. Some have even went on to obtain their CPM in order to practice independently. In some states they are trying to make changes with laws so they can practice independently as the CPM does in most states. Hopefully for them -and for the birthing community, this change takes place.

Lay Midwife

This is a midwife who has not had any formal training, but has been trained by older and more experienced midwifes who could themselves be a lay midwife, or a CNM, CPM, CM or DEM. They are often called granny midwives, this does not reflect their skills and care. There are still many lay midwives who practice, and provide wonderful care to many women who may other wise not have access to midwifery style of care.

Certified Direct Entry Midwife (CDEM) 

This is the legal creditional's for the state of Indiana. 

Licensed Midwife (LM) 

This is the legal creditional for the state of Michigan.


You need to check into they type of midwife you want and are comfortable with.  You as the consumer, are responsible for understanding  what your state guidelines are, and what is expected out of you.  You need to do your research about the care provider you have chosen.  Does she have the skills you think are important for assisting you at your birth? Is she trained well? Does she carry emergency equipment? What will she do if you or your bay are transferred into the hospital? 

Photo by Wild Rose Photos

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