A look under “Midwifery” in your local yellow pages will make it obvious that midwives are licensed and credentialed (or not) in different ways, and have various letters after their names to indicate this.  The goal of this page is to help you make sense of this alphabet soup and understand the education/training/certification and standards behind midwifery credentials.

According to the International Confederation of Midwives, a midwife is a person who has successfully completed a midwifery education programme that is recognised in the country where it is located and that is based on the ICM Essential Competencies for Basic Midwifery Practice and the framework of the ICM Global Standards for Midwifery Education; who has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery and use the title ‘midwife’; and who demonstrates competency in the practice of midwifery.

Note: Definitions in italics are taken directly from the documents of the organizations cited.  Statements not in italics are extracted or summarized from these documents or other sources. Listings are arranged alphabetically. Clicking on the name will take you to the webpages of the organizations listed.


Accreditation Commission for Midwifery Education (ACME):  The Accreditation Commission for Midwifery Education (ACME)* has been recognized by the U.S. Department of Education (under ‘Health Care’) as a programmatic accrediting agency for nurse-midwifery education programs since 1982. In 1994, ACME approved criteria to accredit direct-entry midwifery education programs; the first program was preaccredited in April 1996.  ACME currently accredits programs offering nurse-midwifery and midwifery programs.

ACME is administratively and financially autonomous from the American College of Nurse-Midwives.

American College of Nurse-Midwives (ACNM):  The American College of Nurse-Midwives is the professional organization representing certified nurse-midwives (CNMs) and certified midwives (CMs).  It is responsible for a wide array of programs to further education, research, and  clinical practice for midwives; and for the promotion of legislative, regulatory, and organizational policies that support midwifery in the United States and abroad.  The College has four volunteer divisions: Research, Education, Global Health, and Standards and Practice.

ACNM works to establish midwifery as the standard of care for women. We lead the profession through education, clinical practice, research, and advocacy.

American Midwifery Certification Board (AMCB):

Our mission: To protect and serve the public by leading the certification standards in midwifery
The American Midwifery Certification Board (AMCB) is the national certifying body for candidates in nurse-midwifery and midwifery who have received their graduate level education in programs accredited by the Accreditation Commission for Midwifery Education (ACME).  Certification by the AMCB is considered the gold-standard in midwifery certification and is recognized in all 50 states.  Certification protects the public by ensuring that certified individuals have met predetermined criteria for safety in practice. While state licensure provides the legal basis for practice, most states require AMCB certification for licensure, and many institutions require AMCB certification to grant practice privileges.

Certified Midwife (CM):  A certified midwife (CM) is an individual educated in the discipline of midwifery, who possesses evidence of certifications according to the requirements of the American College of Nurse-Midwives (ACNM, 1997). At the present time, there are only a few CMs in clinical practice; most of these graduated from the State University of New York at Downstate program and practice in New York State. 

Certified Nurse-Midwife (CNM):  A certified nurse-midwife (CNM) is an individual educated in the two disciplines of nursing and midwifery, who possesses evidence of certification according to the requirements of the American College of Nurse-Midwives (ACNM, 1992, revised 1997).  CNMs attend births primarily in the hospital (96%); although they may also practice in birth centers (3%) or in the home (1%).  According to the American Midwifery Certification Board, there are 13,071 CNMs and 84 CMs.1 The vast majority of midwives in the United States are CNMs.  In 2011, CNMs/CMs attended 309,514 births—a slight decline in total births, but a stable percentage of all US births and a slight increase in percentage of vaginal births compared to 2010. In 2011, CNMs/CMs attended 92.2% of all midwife-attended births, 11.7% of all vaginal births, and 7.8% of total US births.2 (2011 is the most recent year for which final birth data are available from the National Center for Health Statistics.)

Certified Professional Midwife (CPM):  A Certified Professional Midwife (CPM) is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the Midwives Model of Care. The CPM is the only midwifery credential that requires knowledge about and experience in out-of-hospital settings.  The NARM certification process recognizes multiple routes of entry into midwifery and includes verification of knowledge and skills and the successful completion of both a written examination and a skills assessment.  The CPM credential requires training in out-of-hospital births (MANA).

Direct-entry Midwife (DEM):  A direct-entry midwife is an independent practitioner educated in the discipline of midwifery through self-study, apprenticeship, a midwifery school, or a college or university-based program distinct from the discipline of nursing.  A direct-entry midwife is trained to provide the Midwifery Model of Care to healthy women and newborns throughout the childbearing cycle primary in out-of-hospital settings (MANA).  

International Confederation of Midwives (ICM):  

The International Confederation of Midwives (ICM) supports, represents and works to strengthen professional associations of midwives throughout the world. There are currently 108 national Midwives Associations, representing 95 countries across every continent. ICM is organised into four regions: Africa, the Americas, Asia Pacific and Europe. Together these associations represent more than 300,000 midwives globally. 

ICM is an accredited non-governmental organisation and represents midwives and midwifery to organisations worldwide to achieve common goals in the care of mothers and children. These organisations include the WHO and other UN Agencies, global professional health care organisations including the International Federation of Gynaecology and Obstetrics (FIGO), the International Paediatric Association (IPA), the International Council of Nurses (ICN), non-governmental organisations, bilateral and civil society groups.

Lay Midwife:   A lay midwife is one who obtained her knowledge and skills informally, either through self-study or an apprenticeship program without formal educational requirements and other standards; and who practices outside the established health care system.  Presently, many midwives consider this to be a pejorative term, and use it only in a historical context.  Other midwives are proud to describe themselves as lay midwives, and believe that formal education necessarily leads to co-opting by the medical mainstream and loss of autonomy for midwives. Other terms with similar connotations are traditional midwife, granny midwife, and independent midwife. 

Licensed Midwife (LM):  A licensed midwife is a midwife who is licensed to practice in the jurisdiction in which she holds a license. In Washington State, this term refers specifically to direct-entry midwives who have met certain prerequisites for licensure. 

Midwifery Education Accreditation Council (MEAC): 

The Midwifery Education Accreditation Council’s mission is to promote excellence in midwifery education through accreditation. It creates standards and criteria for the education of midwives. MEAC standards incorporate the nationally recognized core competencies and guiding principles set by the Midwives Alliance of North America (MANA), The International Confederation of Midwives (ICM),  and the requirements for national certification of the North American Registry of Midwives (NARM).  MEAC’s accreditation criteria for midwifery education programs reflect the unique components and philosophy of the Midwives Model of Care. 

The purpose of MEAC is to establish standards for the education of competent midwives, and to provide a process for self-evaluation and peer evaluation for diverse educational programs. MEAC is a non-profit organization approved by the U.S. Secretary of Education as a nationally recognized accrediting agency.

Midwives’ Alliance of North America (MANA): The Midwives Alliance of North America (MANA), established in 1982, is a professional membership organization that promotes excellence in midwifery practice, endorses diversity in educational backgrounds and practice styles, and is dedicated to unifying and strengthening the profession, thereby increasing access to quality health care and improving outcomes for women, babies, families, and communities.

MANA’s vision is that midwifery is an essential maternity care option that must be fully integrated into the U.S. health care system. MANA asserts that investing in midwives and midwife-led care is fundamental to delivering high quality maternity care. MANA is unique and innovative in that it is the only professional midwifery organization in the U.S. that is inclusive of all midwives regardless of their educational route to midwifery. MANA supports the diversity in educational backgrounds and practice styles within the profession as a means of making midwifery available to more women and their families. If you are a midwife, MANA can provide you with a forum for professional dialog with your peers about practice and political issues you face daily.

Midwives Model of Care:

The Midwives Model of Care™ is a fundamentally different approach to pregnancy and childbirth than contemporary obstetrics. Midwifery care is uniquely nurturing, hands-on care before, during, and after birth. Midwives are health care professionals specializing in pregnancy and childbirth who develop a trusting relationship with their clients, which results in confident, supported labor and birth. While there are different types of midwives practicing in various settings, all midwives are trained to provide comprehensive prenatal care and education, guide labor and birth, address complications, and care for newborns. The Midwives Model of Care™ is based on the fact that pregnancy and birth are normal life events. The Midwives Model of Care includes:

  • monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle
  • providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
  • minimizing technological interventions and
  • identifying and referring women who require obstetrical attention

The application of this model has been proven to reduce to incidence of birth injury, trauma, and cesarean section. 

(Midwives Model of Care definition is Copyrighted © by the Midwifery Task Force, all rights reserved)

North American Registry of Midwives (NARM):

 NARM’s mission is to provide and maintain an evaluative process for multiple routes of midwifery education and training; to develop and administer a standardized examination system leading to the credential “Certified Professional Midwife” (CPM); to identify best practices that reflect the excellence and diversity of the independent midwifery community as the basis for setting the standards for the CPM credential; to publish, distribute and/or make available materials that describe the certification and examination process and requirements for application; to maintain a registry of those individuals who have received certification and/or passed the examination; to manage the process of re-certification; and to work in multiple arenas to promote and improve the role of CPMs in the delivery of maternity care to women and their newborns.

Traditional Birth Attendant (TBA):  A traditional birth attendant is a person who assists the mother at childbirth and initially acquired her skills by delivering babies herself or through apprenticeship to other traditional birth attendants (World Health Organization).