Essential Facts about Midwives
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Midwives & Birth in the United States
- The American College of Nurse-Midwives (ACNM) is the professional association representing certified nurse-midwives (CNMs)
and certified midwives (CMs) in the United States. According to the American Midwifery Certification Board, as of February
2015, there were 11,018 CNMs and 88 CMs.1 The vast majority of
midwives in the United States are CNMs.
- In 2013, CNMs/CMs attended 320,983 births—a slight increase
despite a decrease in total US births compared to 2012. In 2013,
CNMs/CMs attended 92% of all midwife-attended births, 12% of
all vaginal births, and 8.2% of total US births.2 (2013 is the most
recent year for which final birth data are available from the National
Center for Health Statistics.)
- CNMs are licensed, independent health care providers with
prescriptive authority in all 50 states, the District of Columbia,
American Samoa, Guam, and Puerto Rico. CNMs are defined as
primary care providers under federal law.
- Because CM is a newer, equivalent pathway to midwifery, it is
not yet reflected in all state legislatures. CMs are authorized
to practice in Delaware, Missouri, New Jersey, New York, and
Rhode Island. CMs have prescription-writing authority in
- While midwives are well-known for attending births, 53.3% of CNMs/CMs identify reproductive care and 33.1% identify
primary care as main responsibilities in their full-time positions.
Examples include annual exams, writing prescriptions, basic
nutrition counseling, parenting education, patient education,
and reproductive health visits.3
- In 2013, 94.6% of CNM/CM-attended births occurred in hospitals,
2.8% occurred in freestanding birth centers, and 2.6% occurred
- More than 50% of CNMs/CMs list physician practices or hospitals/
medical centers as their principal employers.4
- Medicaid reimbursement for CNM care is mandatory in all states.
Medicare and most Medicaid programs reimburse CNMs/CMs at 100% of physician rates. The majority of states also mandate
private insurance reimbursement for midwifery services.
- Standards for education and certification in midwifery are
identical for CNMs and CMs.
- The Accreditation Commission for Midwifery Education (ACME)
is the official accrediting body for CNM/CM education programs.
There are 39 ACME-accredited midwifery education programs in
the United States.5
- Approximately 82% of CNMs have a master’s degree.3 As of 2010,
a graduate degree is required for entry to midwifery practice as a
- 4.8% of CNMs have doctoral degrees, the highest proportion of
all APRN groups.7
(1) American Midwifery Certification Board
(2) Martin JA, Hamilton BE, Osterman MJK, Curtin, SC, Mathews TJ. Births: Final Data
for 2013. National Vital Statistics Reports; Vol 64, No 1. Hyattsville, MD: National
Center for Health Statistics. 2015.
(3) Fullerton J, Schuiling K, Sipe TA. Findings from the Analysis of the American
College of Nurse-Midwives’ Membership Surveys: 2006–2008. Journal of
Midwifery & Women’s Health 2010; 55: 299-307.
(4) ACNM Core Data Survey, 2010
(5) Accreditation Commission for Midwifery Education
(6) Mandatory Degree Requirements for Entry into Midwifery Practice, ACNM Position Statement, July 2009
(7) Fullerton JT, Sipe TA, and Schuiling KD, Demographic profiles of certified
nurse-midwives, certified registered nurse anesthetists and nurse practitioners:
reflections on implications for uniform education and regulation. Journal of
Professional Nursing. Vol 25, No 3 (May-June) 2009.
Updated June 2015