What is a midwife? Here’s how they’re different from OBs and doulas

Whether you’re newly pregnant or just planning ahead, pregnancy can feel overwhelming. Each decision you make carries a lot of weight, and you’re expected to learn and do things you’ve never done before. From books to support groups to your doctor, there are plenty of resources that can help guide your journey. But if you’re looking for a more personalized experience, hiring a midwife might be the solution.

If you’re considering using a midwife for your pregnancy, we’ve got all the info you need.

What is a midwife?

A midwife is a trained healthcare professional who seeks to educate and inform pregnant people about pregnancy and childbirth. They encourage their patients towards active decision making and offer individualized methods of care for every family, viewing birth and pregnancy as “normal” processes and avoiding medical intervention unless necessary.

Related: A midwife’s guide to having your best birth

Types of midwives

In the United States, midwives have different levels of education, training and certification.

Certified Nurse-Midwives (CNMs)

Certified Nurse-Midwives (CNMs) hold a graduate degree and registered nurse (RN) license. CNMs have proven their competency in the knowledge and skills outlined by the American College of Nurse-Midwives (ACNM) and have graduated from an accredited midwifery program. They can practice in hospitals, homes, birth centers, and offices in any state, DC, Samoa, Guam, Puerto Rico, and USVI.

Certified Midwives (CMs)

Certified Midwives (CMs) hold a graduate degree and have studied the required science and health courses. Much like a CNM, CMs have graduated from an accredited midwifery program. They practice in all settings, but their certification is not recognized in every state.

Certified Professional Midwives (CPMs)

Certified Professional Midwives (CPMs) have earned a high school diploma or equivalent. CPMs are certified by NARM, or the North American Registry of Midwives, and have educational and supervised clinical training of at least two years. The majority of CPMs practice in homes and at birth centers, but their licensure is not recognized in every state.

Difference between midwife and doula

Although often grouped together with midwives, a doula is not a trained healthcare professional, but can also be valuable to your pregnancy as they offer physical, emotional, and informational support.

Related: What is a doula and why do I need one?

What does a midwife do?

Acting as an advocate for pregnant people, midwives help their patients by:

• Encouraging pregnant people to make informed choices and providing them with the resources to do so
• Skillful communication and counseling through the pregnancy and childbirth processes
• Monitoring your physical and emotional health
• Collaborating with and referring their patients to other skilled medical professionals
• Providing safe and effective care across various settings, including in homes, hospitals, and birth centers

Most midwives work with low-risk patients and can deliver your baby. However, if something is outside of their expertise or an emergency occurs, midwives work with obstetricians, perinatologists, and other healthcare professionals to help you get the medical care that you need.

And although many people first encounter midwives when they’re pregnant, midwives can also offer services beyond childbirth, including annual exams, writing prescriptions and reproductive health visits. As healthcare providers trained in both nursing and midwifery, midwives can help you to understand menstrual cycles, birth control and your personal health.

Related: To my midwife—thank you

Benefits of using a midwife

According to the National Center for Health Statistics, CNMs and CMs attended 9.1% of US births in 2017—that’s 351,968 births. In pregnancies and births where a Certified Nurse-Midwife was present, the American College of Nurse-Midwives reported the following:

• Lower rates of cesarean birth
• Lower rates of labor induction and augmentation
• Significant reduction in third and four degree perineal tears
• Lower use of regional anesthesia, and
• Higher rates of breastfeeding

When working with a midwife, parents reported a high readiness for labor and birth, better prenatal knowledge, and higher satisfaction with care.

Midwifery care also reduces healthcare costs. Health care costs associated with pregnancy and childbirth average almost $19,000 per person, including $2,854 paid out-of-pocket, a KFF analysis finds. Since midwives discourage unnecessary intervention, they can help save parents money.

Related: 84% of US pregnancy-related deaths are preventable, CDC says

9 questions to ask your midwife

If you’ve found a midwife who you think you want to work with, it’s important to understand their individualized process. Important questions to ask them include:

• How long have you been practicing as a midwife?
• What was your training like?
• Are you certified?
• What does a typical pregnancy and childbirth look like for you?
• How many patients do you have per year?
• How do you split your time if due dates coincide?
• If you are unable to deliver my baby or attend my birth, then who will?
• If I develop complications or risks as a pregnant person, at what point do I get transferred to a physician?
• What happens if there’s an emergency in the delivery room?

You can find a midwife that’s right for you by asking friends and family for referrals, consulting healthcare providers, or consulting professional associations such as the North American Registry of Midwives or the American College of Nurse-Midwives.

A version of this story was originally published on June 25, 2021. It has been updated.