There are two types of midwives in the U.S., Direct-Entry Midwives and Nurse-Midwives. Direct-Entry Midwives train through apprenticeship and midwifery school or self-study while Nurse-Midwives train as nurses first and then as midwives. Both types of midwives practice legally and independently in the state of Oregon. Training, education, certification, and license status vary widely among Direct-Entry Midwives and we encourage pregnant mothers and families to ask prospective midwives questions about these and other qualifications before choosing a midwife. A comprehensive list of interview questions can be found here.
Licensed Direct-Entry Midwife (LDM)
LDMs are licensed in the state of Oregon to provide prenatal, birth and postpartum care and they work in home and birth center settings. The CPM credential and additional clinical experience are part of the requirements for licensure as an LDM in Oregon.
Oregon LDMs are trained in and authorized to use oxygen, IV therapy, anti-hemorrhagic medications, local anesthetics for suturing and vitamin K and ophthalmic antibiotics for newborns. Oregon LDMs can order lab work, obstetric ultrasound and newborn metabolic screening.
Certified Professional Midwife (CPM)
The CPM is a North American credential that recognizes multiple routes of education. CPMs have met clinical requirements and passed skills evaluation and a written exam. CPMs provide prenatal, birth, postpartum, and well-woman care. Many states, including Oregon, include the CPM in their licensure requirements. Out-of-Hospital birth experience is required for certification as a CPM.
Midwifery licensure is voluntary in Oregon and there are a number of qualified and experienced midwives who do not carry a license. Unlicensed midwives may or may not be CPMs. For those unlicensed midwives who are not CPMs, there is no external body that can verify training or education, and pregnant women and families must assess qualifications for themselves. Unlicensed midwives do not use oxygen, IV therapy, or anti-hemorrhagic medications and do not suture.
Certified Nurse-Midwife (CNM)
CNMs are trained in both nursing and midwifery, primarily in the hospital setting. CNMs are Advanced Practice Nurses and have a Master’s degree from a university-affiliated Nurse-Midwifery program accredited by the American College of Nurse-Midwives. CNMs provide prenatal, birth, and postpartum care primarily in the hospital setting, though some CNMs practice in home or birth center settings as well. Outside of the childbearing year, CNMs also provide well-woman care throughout the life cycle.
The Certified Midwife (CM) is a newer credential from the ACNM that does not require a nursing degree but is otherwise similar to the CNM credential. As of 2007, the CM is legally recognized in three states: New York, Massachusetts, and New Jersey.