Options in Midwifery

There are various paths that a person may take to become a midwife:
  • Direct-Entry Midwife: 
    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 program distinct from the discipline of nursing. Direct entry midwifery is based upon the European model of professional midwifery practice, which does not require becoming a nurse as a prerequisite, although some nursing skills are taught as part of a comprehensive midwifery education. 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.
  • Certified Professional Midwife (CPM): 
    A CPM is a knowledgeable, skilled, and professional independent midwifery practitioner who has met the standards for certification set by 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.
  • Certified Nurse-Midwife (CNM): 
    A CNM is an individual educated in the two disciplines of nursing and midwifery, who possesses evidence of certification according to the requirements of the American College of Nurse-Midwives (ACNM).
  • Certified Midwife (CM): 
    A CM is an individual educated in the discipline of midwifery who possesses evidence of certification according to the requirements of the ACNM.
  • Lay Midwife: 
    The term "lay midwife" has been used to designate an uncertified or unlicensed midwife who was educated through informal routes such as self-study or apprenticeship rather than through a formal program. This term does not necessarily mean a low level of education, only that the midwife either chose not to become certified or licensed, or there was no certification available for her type of education, as was the fact before the CPM credential was available. Other terms to describe uncertified or unlicensed midwives are traditional midwife, traditional birth attendant, granny midwife, and independent midwife.
  • Licensed Midwife: 
    A licensed midwife is a midwife who is licensed to practice in a particular jurisdiction, usually a state or province.
Laws and regulations for midwives vary greatly from location to location. Anyone interested in becoming a midwife should be familiar with the laws affecting midwives in the state, province or country where they expect to practice. Students coming to MLL are solely responsible for understanding the requirements and requesting applications for licensing in their own state, province or country. In some jurisdictions one must be a certified nurse-midwife in order practice midwifery.
Maternidad La Luz cannot guarantee any certification or licensing in any jurisdiction. Many challenges face midwives in the future due to political and economic changes. The health care field is in a time of change, and there are no guarantees for employment for anyone pursuing a career in direct entry midwifery. Maternidad La Luz school and birth center have no malpractice or liability insurance for staff or students.

NARM Requirements: Students must meet the NARM requirements listed below to become a Certified Professional Midwife (CPM).
  • Attending 10 births in any setting in any capacity as observer, doula, family member or friend, or beginning apprentice.
  • Clinicals as assistant under supervision before attending births as primary under supervision, including 20 births, assisting at 20 newborn exams, 25 prenatals, and 10 postpartum visits.
  • Attending a minimum of 20 births as an assistant under supervision (active participant).
  • Attending an additional 20 births functioning in the role of primary midwife under supervision.
    • 10 of these require that the student did at least one prenatal with the client
    • 5 of these require full continuity of care that includes at least 5 prenatals spanning two trimesters, the birth, the newborn exam, and least 2 postpartum visits
  • Attending a minimum of 5 home births in any role, and 2 planned hospital births in any role
  • Attending a minimum of 75 prenatal exams including 20 initial exams.
  • Attending a minimum of 20 newborn exams.
  • Attending a minimum of 40 postpartum exams.
For more information on NARM or the Certified Professional Midwife credential, write:
North American Registry of Midwives
5257 Rosestone Drive 
Lilburn, GA 30047
(888) 84-BIRTH 
www.narm.org 
E-mail: info@narm.org
For an application, write to:
NARM Applications
P.O. Box 420
Summertown, TN  38483
Midwifery Licensure

Texas Requirements for Midwives: Maternidad La Luz’s clinical placement programs are approved by the State of Texas, and meet the requirements for students interested in becoming a Licensed Midwife in Texas. To become a licensed midwife in Texas, an applicant has to have graduated from a Texas state approved school, and pass the Texas state examination (NARM exam), or already be a NARM Certified Professional Midwives. Applicants must also pass an on-line course on Texas midwifery rules and regulations. Specific requirements to become licensed in Texas include:
  • Attending a minimum of 20 births as an active participant.
  • Attending an additional 20 births functioning in the role of primary midwife under supervision.
  • Attending a minimum of 75 prenatal exams including 20 initial exams.
  • Attending a minimum of 20 newborn exams.
  • Attending a minimum of 40 postpartum exams.
The student is advised to contact the Texas Department of State Health Services in Austin for current information. For more information on Texas laws and a copy of the Texas Midwifery Manual, write:
Texas Department of State Health Services 
The Midwifery Program 
1100 W. 49th Street 
Austin, Texas 78756-3199 
(512) 834-4523

New Mexico Licensing: Many students attending Maternidad La Luz anticipate being licensed midwives in New Mexico. The student is advised to contact the Department of Health in Santa Fe at the following address for current information and a copy of the regulations governing midwives:
Department of Health Maternal Health Program 
2040 Pacheco 
Santa Fe, NM 87505 
(505) 476-8908

The Texas Department of State Health Services has approved Maternidad La Luz as both a Midwifery Education Program and as a Licensed Birth Center. If someone has a complaint regarding Maternidad La Luz, please contact the address below:
Texas Department of State Health Services 
1100 W. 49th Street 
Austin, Texas 78756-3199 
Phone: 512-834-4523
The Legalities of Midwifery

Adapted from the Midwives Alliance of North America website.