Since America’s colonization, midwives have been caring for pregnant women and attending births in the United States. Today, certified nurse-midwives can run their own practices, perform clinical exams, and even prescribe medicine—not just during pregnancy, but at all stages of a woman’s life. However, most states require that a midwife practice have a physician backup or supervisor.

The profession of nurse-midwifery was established in the 1920s, in response to the alarming rate of infant and maternal mortality in the United States. A group of obstetricians, nurses, and mothers formed the Maternity Center Association (MCA) in New York City to address the problem. The MCA looked at foreign countries with outstanding maternal and child health records, and saw that the most prominent figure in the birth cycle was the nurse-midwife.

The first nurse-midwives in America came from England. They joined the Frontier Nursing Service, which was established in Kentucky to send nurses on horseback to isolated areas in the Appalachian Mountains. The first nurse-midwifery school was established a few years later. Today there are more than 7,000 certified nurse-midwives, and members of the profession attend about 8 percent of US births each year. They no longer care only for isolated or poor women and children; plenty of affluent customers today appreciate the personalized, holistic health care that nurse-midwives provide.

Certified nurse-midwives are registered nurses who have completed graduate-level training in midwifery and passed a national certification exam. They can practice in homes, birth centers, clinics, and hospitals and can prescribe medication, and their services are often reimbursed by insurance. Many patients visit their midwives for annual checkups and for guidance on women’s health issues such as birth control, breast cancer, and menopause.

Most states license nurse-midwives, but only for care of healthy patients, not for treatment of disease or complications of delivery.

Other types of non-nurse-midwives, including certified midwives and direct-entry midwives, have different rights to practice depending on state laws. Another type of midwife figure is the doula—a woman whose role is to provide physical and emotional support to women and their partners during labor and birth, but not to diagnose medical conditions or give medical advice. A doula is not usually licensed or certified to have had specific training.

ADDITIONAL FACTS

  1. Practitioners of midwifery are known as midwives, whether they are women or men. The word comes from the roots mid, meaning “with,” and wif, meaning “woman.”
  2. In many areas of the world, traditional midwives, renamed traditional birth attendants by the World Health Organization and other groups, are the only available providers for childbearing women. They are usually local women with some experience but little or no specific training, much as midwives were in America before licensing was required.