What is a Midwife?
Midwifery is an ancient profession. The scope and practice of the midwife has waxed and waned across generations, dependent upon the needs of their community, legislature, and regional/cultural values.
Today in the United States, there are many types of midwives in practice. Those midwives may differ in their training, education, scope of practice, and licensure. In the state of Washington, there are two kinds of licensed midwives: Certified Nurse-Midwives (CNM) and Licensed Midwives (LM or CPM).
CNM
LM/CPM
Full range of primary health care services for people from adolescence beyond menopause. These services can include pre-conception care, care during pregnancy, childbirth and the postpartum period, care of the normal newborn during the first 28 days of life, primary care, gynecologic and family planning services. Midwifery care also includes health promotion, disease prevention, and individualized wellness education and counseling.
Provides care, education, counseling and support to patients and their families throughout the caregiving partnership, including pregnancy, birth and the postpartum period. CPM/LMs provide on-going care throughout pregnancy and continuous, hands-on care during labor, birth and the immediate postpartum period. Maternal care continues through the 6-8 week postpartum period, and newborn care for the first 2 weeks.
Whole-person, patient-centered care
View pregnancy, labor, birth, and postpartum period as normal part of life
Prescriptive authority in all 50 states
Provides care in all settings (hospitals, homes, birth centers, and offices)
May obtain and administer certain medications in select states.
Provides care in homes, birth centers, and offices.
The two types of licensed midwives in Washington differ by their scope of practice and practice setting. Each midwifery practice determines its services within that scope and setting. However, what all midwives share in common is that they are trained to provide whole person & patient-centered care. The Midwifery Model of Care is to respect all people and truly listen to those who trust them with their healthcare.
Midwives are well known worldwide for their care of pregnant people. Midwives view pregnancy as a normal physiological stage, meaning it is a normal process in life, not a disease or disordered state. They strive to help pregnant people have a healthy pregnancy and birth through education about their changing bodies and individualized care to maximize wellness and respond to complications.
Let's focus on the Nurse-Midwife
This site is the home page for the Washington state affiliate of the American College of Nurse-Midwives.
Certified Nurse-Midwives (CNM) are Nurse Practitioners (ARNPs) who are trained to provide care across the reproductive lifespan. This means that CNMs provide wellness care (i.e. annual health exams, pap smear/HPV screening, STI screenings), reproductive health care (i.e. gynecology, birth control, abortion care), gender affirming care, menopause management, and limited primary care.
What CNMs are most well-known for though is pregnancy care. The care they provide for pregnancy includes prenatal and postpartum care, labor and delivery management, and newborn care with breastfeeding support.
Although midwifery care is focused on supporting the normal process of labor and birth, and minimizing unnecessary interventions, midwives are also trained to recognize and respond to complications that may arise. Midwives work closely with other providers including Obstetrician/Gynecologists (OB/GYN), Maternal Fetal Medicine doctors (MFM), Pediatricians, and other specialists, whom they may consult or transfer patient care to when complications are beyond the CNM’s licensed scope of practice (i.e. very high risk pregnancy).
The term "midwife" came from Old English meaning to be "with women.” So all providers are midwives, no matter their gender! There is no such thing as a "mid-husband" or "mid-non-binary-spouse," except maybe humorously.
Midwives do not only take care of women, and strive to be with their patients in a way that creates whole-person, holistic, and compassionate healthcare.