ACNM Frequently Asked Questions
What is a
nurse-midwife?
Certified nurse-midwives (CNMs) are licensed health care practitioners educated in the two disciplines of
nursing and midwifery. They provide primary care to women of childbearing age including: prenatal care,
labor and delivery care, care after birth, gynecological exams, newborn care, assistance with family
planning decisions, preconception care, menopausal management and counseling in health maintenance and
disease prevention.
Where do nurse-midwives practice?
Nurse-midwifery care is available in all 50 states, the District of Columbia and some U.S. territories. Most
CNMs are employed by a hospital or a physician practice. While some CNMs attend home births, most of
the births they attend occur in hospitals or birth centers California has the largest number of CNMs,
followed by New York, Florida, Pennsylvania, Illinois and Massachusetts.
In the U.S., CNMs are required to pass a national examination for certification administered by the ACNM
Certification Council (ACC). To be eligible for examination, a midwifery student must graduate from an
educational program accredited by the American College of Nurse-Midwives (ACNM). These
requirements ensure that U.S. nurse-midwifery education is standardized, and that CNMs meet national
requirements. In addition, some states (not including Massachusetts) have further requirements for the practice of nurse-midwifery.
TACC Certified Midwives (CMs) are relatively new professionals to the health care field, but their education
closely mirrors the education for certified nurse-midwives. They have or receive a background in a health
related field other than nursing and graduate from a midwifery education program accredited by the
ACNM Division of Accreditation. CMs take the same national certification examination as CNMs but
receive the professional designation certified midwife.
There are a number of midwives in the U.S. who practice without the same nationally recognized
certification as CNMs and CMs. These midwives are known as "lay" midwives. Some midwives have
received extensive apprenticeship training as well as formal education not focusing on midwifery.
How safe is nurse-midwifery practice?
Numerous studies have uniformly concluded that nurse-midwifery care has outcomes that are equal to that
of physicians with the same type of patients. CNMs are particularly adept at providing care that helps
women prevent complications and communicate with their health care providers. Moreover, ACNM
Standards for the Practice of Nurse-Midwifery recognize that nurse-midwives must "demonstrate a safe
mechanism for obtaining medical consultation, collaboration and referral" when questions or problems arise.
Nurse-midwifery care is woman-centered and based on the philosophy that health care should be safe and
satisfying. CNMs make every effort to respect the human dignity and cultural diversity of their clients.
They are committed to promoting self-determination, the right to obtain complete information about the care
and enhancing the normal process of pregnancy and birth through education and supportive intervention.
While CNMs are qualified to administer drugs, perform medical procedures and provide their clients with
other technological interventions, they rely on technology only when it is medically necessary. As a result,
women who are under the care of a CNM are less likely to have a cesarean section or an episiotomy and
are more likely to experience a vaginal birth after a previous cesarean section.
What kinds of questions should I ask when I'm choosing a nurse-midwife?
In choosing a nurse-midwife the following questions might be helpful:
How long have you been practicing and in what kind of setting?
What is your philosophy of care?
What are the eligibility requirements for your services?
What arrangements do you have if complications occur?
What are your fees and will my insurance cover them?
Can my family be present during labor and birth? I find a nurse-midwife?
