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 In Ask an Expert, Midwifery, OB/GYN & Women's Health, Pulse Blog

Q: What’s the difference between a certified nurse midwife and other midwives?

Many moms-to-be want to work with a midwife because of their belief in the body’s natural birthing abilities and the support they offer women throughout labor. However, not all people who use the title of midwife have the same training or experience.

At Vancouver Clinic, all of our midwives are certified nurse midwives (CNMs). CNMs have more medical education and training than any other type of midwife. CNMs are registered nurses who went on to graduate from an accredited nurse midwifery education program and pass a national certification examination from the American College of Nurse-Midwives (ACNM). Here at the clinic, all of our CNMs hold a master of science in nursing or midwifery.

Certified midwives (CMs) have a background in a health-related field other than nursing. They have graduated from an accredited midwifery education program. They take the same national certification examination as CNMs but receive the professional designation of CM. The vast majority of midwives certified by the ACNM are CNMs; there are very few CMs.

Certified practical midwives (CPMs) are also known as “lay or direct-entry midwives.” They are not required to earn an academic degree. Instead, they generally participate in an apprenticeship. They cannot receive certification from the ACNM. They earn certification from the North American Registry of Midwives by demonstrating certain skills and knowledge.

Beyond their training, one of the big differences between nurse midwives and practical midwives is where they deliver. CNMs deliver babies in a variety of settings including hospitals, birth centers, and homes. At Vancouver Clinic, our midwives deliver babies only at area hospitals. CPMs typically deliver babies in homes or birth centers. Another distinction? Unlike practical midwives, nurse midwives may write prescriptions.

In the eyes of Medicare administrators, giving birth with a CNM is similar to giving birth with a physician. Medicare and most Medicaid programs reimburse CNMs and CMs at 100 percent of physician rates. The majority of states also mandate private insurance reimbursement for midwifery services. This is not true for practical midwives.

Deciding which care provider to work with on the journey toward parenthood is an important and personal choice for a woman. The knowledge and training providers offer are key factors in achieving a safe and comfortable delivery. Learn more about Vancouver Clinic midwives at

Patricia Kartchner earned a master of science in nursing with a specialty in midwifery from Oregon Health & Science University. She enjoys being a trusted guide for women during pregnancy and childbirth.

Patricia Kartchner, CNM.