Nursemidwives

Nurse-midwives, commonly referred to as certified nurse-midwives (CNMs) in the United States, are advanced practice registered nurses who have completed graduate education in midwifery and are nationally certified to provide reproductive, obstetric, and neonatal care. They specialize in normal pregnancy, labor, birth, and the postpartum period, and often also offer gynecologic and well-woman services. Depending on the jurisdiction, nurse-midwives may practice independently or as part of a healthcare team in hospitals, birth centers, or home-like settings.

Core services include prenatal care that emphasizes screening, education, and risk assessment; management of labor and birth with fetal monitoring and pain relief when appropriate; and postpartum and newborn care. They also provide gynecologic care such as routine exams, contraception, and counseling on reproductive options. Nurse-midwives are trained to manage normal pregnancies and births and to recognize complications, coordinating with obstetricians or other specialists when higher-risk care is needed.

Training and certification involve first becoming a licensed registered nurse, completing a graduate program in nurse-midwifery (master’s or doctoral level), and achieving certification from the American Midwifery Certification Board (AMCB). Certification and licensure requirements vary by country and state. In the United States, many CNMs have prescribing authority and work under state practice provisions that may allow autonomous practice or require collaboration with physicians.

Historically rooted in community and hospital settings, nurse-midwifery expanded with professionalization in the 20th century. Evidence indicates that care led by CNMs for appropriate patients is associated with outcomes comparable to physician-led care and can be linked to lower cesarean rates and high patient satisfaction, highlighting the role of nurse-midwives in improving access to maternity care.