Midwives Vs. Nurse-Midwives - What’s the Difference?

Have you ever wondered about the difference between midwives and nurse-midwives?

The terms “midwife” and “nurse-midwife” are often used interchangeably, but they are not the same. While all midwives are trained to provide the same level of care throughout pregnancy, birth, and postpartum, their paths to practice do differ in some areas.

Breakdown of Midwives vs Nurse-Midwives vs Professional Midwives

There are three main types of midwives - Certified Nurse-Midwives (CNMs), Certified Midwives (CMs), and Certified Professional Midwives (CPMs). Below is a breakdown of their key differences:

Midwife Type	Education & Training	Certification & Regulation	Scope of Practice	Birth Settings	Legal Status in Ohio
Certified Nurse-Midwife (CNM)	Registered Nurse (RN) + Graduate Degree in Midwifery (Master’s or Doctorate)	Certified by the American Midwifery Certification Board (AMCB); Licensed in all 50 states	Full-scope maternity care, including prenatal, birth, postpartum, gynecological, and primary care; Can prescribe medications	Hospitals, Birth Centers, Home Births (where legally permitted)	Legal and licensed as Advanced Practice Registered Nurses (APRNs), but require a collaborative agreement with a physician to prescribe medications
Certified Midwife (CM)	Graduate Degree in Midwifery, but without a nursing background	Certified by AMCB; Licensed in some states, but not all	Provides the same care as a CNM but without a nursing degree; Cannot prescribe in some states	Hospitals, Birth Centers, Home Births (depending on state regulations)	Not recognized in Ohio—CMs cannot legally practice in the state
Certified Professional Midwife (CPM)	Training through an accredited midwifery program or apprenticeship; Focused on out-of-hospital birth	Certified by the North American Registry of Midwives (NARM); Licensure varies by state	Specializes in home birth and birth center care for low-risk pregnancies; Does not provide hospital-based care or general women’s healthcare	Birth Centers, Home Births	Not licensed in Ohio—CPMs operate in a legal gray area

Regulatory Recognition and Practice in Ohio

Ohio has specific regulations governing midwifery practice, affecting CNMs, CPMs, and CMs differently. Below is an overview of how each type of midwife is recognized and regulated in the state.

Certified Nurse-Midwives (CNMs) in Ohio

Legal Status: Recognized and licensed as Advanced Practice Registered Nurses (APRNs).
Regulatory Body: Ohio Board of Nursing (OBN).
Scope of Practice: CNMs can provide full-scope midwifery care, including prenatal, birth, postpartum, gynecological, and primary care.
Prescriptive Authority: CNMs in Ohio can prescribe medications but must have a Standard Care Arrangement with a collaborating physician to do so.
Birth Settings: CNMs can legally practice in hospitals, birth centers, and home birth settings.
Practice Limitations: While CNMs are licensed in Ohio, the requirement for physician collaboration can limit their ability to practice independently.

Certified Midwives (CMs) in Ohio

Legal Status: Not recognized or licensed in Ohio.
Regulatory Body: No regulatory oversight in Ohio.
Scope of Practice: CMs are trained to provide the same midwifery care as CNMs, but because they do not have a nursing background, they are not legally permitted to practice in Ohio.
Prescriptive Authority: Not applicable in Ohio, as CMs are not recognized.
Birth Settings: CMs cannot legally attend births in Ohio.
Practice Limitations: Without state recognition, CMs are unable to obtain licensure or legally offer midwifery care in Ohio.

Certified Professional Midwives (CPMs) in Ohio

Legal Status: Not licensed or regulated by the state of Ohio.
Regulatory Body: No state oversight—CPMs are not recognized by the Ohio Board of Nursing or the Ohio Medical Board.
Scope of Practice: CPMs specialize in home birth and birth center care for low-risk pregnancies
Prescriptive Authority: CPMs cannot prescribe medications in Ohio.
Birth Settings: CPMs primarily attend home births and birth center births
Practice Limitations: Because Ohio does not regulate CPMs, they cannot access hospital privileges, order laboratory tests, or provide prescriptions.

Advocacy efforts continue to push for CPM licensure in Ohio to expand midwifery care access, particularly for families seeking out-of-hospital birth options. Regulatory changes could provide greater legal clarity, improved safety measures, and increased options for midwifery care statewide.

Which Type of Midwife Is Right for You?

Choosing between a CNM, CPM, or other type of midwife depends on factors such as birth preferences, desired setting, and state regulations. Those seeking a hospital birth or a midwife with prescriptive authority may opt for a CNM, while those planning an out-of-hospital birth may prefer a CPM or another midwife trained in home birth settings.

Regardless of the chosen provider, midwifery care has been proven to improve birth outcomes, lower intervention rates, and provide a more personalized approach to maternity care.