Certified Professional Midwives Frequently Asked Questions

Q: Who are Certified Professional Midwives (CPMs)?

A: Certified Professional Midwives (CPMs) are nationally credentialed midwives who provide primary maternity care to childbearing people. CPMs are:

  • Trained to provide health-promoting and preventive care that is evidence-based, incorporates

    best practices and avoids overuse of drugs and interventions

  • The only maternity care providers specifically trained to attend births outside the hospital

  • Independent practitioners who have met the standards for certification set by the North

    American Registry of Midwives (NARM)

  • Currently licensed to practice in 31 states

  • A rapidly-growing segment of the midwifery profession in the U.S. today

Q: What kind of care is provided by Certified Professional Midwives?

A: CPMs provide thorough care throughout the prenatal, delivery and postnatal stages of childbearing to people who are healthy and experiencing a normal pregnancy. The CPM:

  • Monitors the physical, psychological and social well-being of the birthing parent throughout

    the childbearing cycle

  • Provides the mother with individualized education and counseling that emphasizes health

    promotion and the 

    prevention of pregnancy problems

  • Provides continuous care during labor and delivery, and postpartum period

  • Identifies and refers the few women who need obstetrical attention 

  • This kind of care results in healthy outcomes for childbearing people, babies and families, with high rates of full-term, full- birth-weight babies and breastfeeding. 

Q: What are the tangible advantages of Certified Professional Midwife services?

A: Midwife-attended births at home and in birth centers have excellent outcomes and cost approximately one-third less than hospital deliveries, the latter of which account for $110 billion a year of U.S. healthcare costs. Advantages include:

  • Excellent outcomes at lower cost: much lower rates of expensive medical interventions,

    high rates of successful physiologic birth, without an increase in adverse outcomes, in a study

    published in 2014 of 16,924 home births, 73% of which were attended by CPMs

  • Healthier babies: fewer babies compromised by preterm deliveries (6% vs. 12% for hospital

    births) and low birthweight (4% vs. 8% for hospital births), according to the latest data from the Centers for Disease Control and Prevention (CDC), not to mention the effects of overused medical interventions, such as induction and cesarean section, that can lead to costly stays in Neonatal Intensive Care Units and future health challenges

  • Medicaid savings: Each childbearing person on Medicaid who chooses an out-of-hospital birth with a CPM will lower Medicaid costs, since Medicaid would otherwise be paying for a hospital birth at greater cost and with much greater likelihood of cesarean section. Savings to state Medicaid programs: Washington State Medicaid saved almost $500,000 in cesarean section reductions alone over a two-year budget cycle with licensed midwives attending just 2% of the births, according to an analysis by the Washington State Department of Health.

  • Overcoming disparities: CPMs have provided care that effectively overcame expected disparities in childbirth outcomes, according to the Washington State DOH analysis 

Georgia Moms Deserve Midwives Support ____________

Q: Is the Certified Professional Midwife Credential nationally recognized?

A: Yes. The CPM credential was established in 1994 and is accredited by the National Commission for Certifying Agencies (NCCA), the same agency that accredits the Certified Nurse-Midwife (CNM) credential. The NCCA is the accrediting body of the Institute for Credentialing Excellence (ICE), formerly the National Organization for Competency Assurance (NOCA).

Q: How are Certified Professional Midwives trained and credentialed?

A: CPMs are credentialed by the North American Registry of Midwives (NARM) after evaluation of their knowledge, skills and abilities by qualified instructors, completion of specific clinical requirements under the supervision of qualified preceptors, and successfully passing the national examination. CPM training generally takes 3 to 5 years to complete and must include specific instruction and experience attending out-of-hospital births. Applicants for NARM certification establish their qualifications by completing a midwifery program accredited by the Midwifery Education Accreditation Council, an agency recognized by the U.S. Department of Education, or by submitting their portfolio of training to NARM for review in a portfolio evaluation process.

Q: What are the differences between Certified Professional Midwives and Certified Nurse Midwives?

A: CPMs are nationally credentialed and enter the profession directly through midwifery training. The scope of practice includes care for women in pregnancy, childbirth and the postpartum period, and care of the newborn. CPMs are qualified to practice in all settings, with specific training and expertise in providing services in homes and free-standing birth centers. CNMs are nationally credentialed and enter the profession through nursing, with additional training in midwifery. CNMs have prescriptive authority in all 50 states, and are defined as primary care providers under federal law. While CNMs are qualified to practice in all birth settings, the majority of CNMs attend births in hospitals.

Q: Do CPMs and CNMs work together?

A: Yes. The National Association of Certified Professional Midwives and the American College of Nurse-Midwives have endorsed the International Confederation of Midwives Global Standards for Midwifery Education, Regulation and Association. Since 2011, they have been engaged in the US MERA collaborative process with other national midwifery groups to explore how the global standards can be applied in the U.S. This has resulted in the adoption of core agreements, including Principles for Model Midwifery Legislation and Regulation in the U.S. In practice settings, including freestanding birth centers, many CPMs work alongside CNMs, while others maintain referral relationships with hospital-based nurse- midwifery practices.

Q: What is the status of Medicaid coverage of Certified Professional Midwife services?

A: CPM services are not currently recognized under Medicaid at the federal level. However, 14 states, recognizing the benefits of CPM care, have opted, through a state plan amendment, to cover CPM services. CPMs and childbearing people who want access to their services are seeking federal recognition to secure Medicaid coverage in all states in which CPMs are licensed and meet certain educational requirements.

Additional Information: 1. Cheyney, M., Bovbjerg, M., Everson, C., Gordon, W., Hannibal, D. and Vedam, S. (2014), Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009. Journal of Midwifery& Women’s Health, 59: 17–27. doi: 10.1111/jmwh.12172 2. “Milbank Report: Evidence-Based Maternity Care,” available at: http://www.milbank.org/wp-content/uploads/2016/04/0809MaternityCare.pdf 3. “MidwiferyLicensureandDisciplinePrograminWashingtonState:EconomicCostsandBenefits,”availableat: http://www.washingtonmidwives.org/assets/Midwifery_Cost_Study_10 -31-07.pdf. 4. TrendsinOut-of-HospitalBirthsintheUnitedStates,1990–2012.CDCNCHSDataBrief,availableat: http://www.cdc.gov/nchs/data/databriefs/db144.htm