What a Certified Midwife Is and What They Do
A Certified Midwife (CM) is a healthcare provider trained to manage pregnancy, labor, and birth, and to care for newborns and postpartum people. Certified Midwives are not the same as Certified Nurse Midwives (CNMs), though both attend births. The key difference: a CM has completed midwifery training but does not hold a nursing license, while a CNM is a registered nurse who completed additional midwifery education.
Certified Midwives can order lab tests, prescribe some medications, and manage uncomplicated pregnancies and births in hospitals, birth centers, or home settings—depending on state law and the midwife's credentials. They work alongside doctors in some settings and independently in others. What they cannot do varies by state: some states do not recognize the CM credential at all, while others allow CMs to practice only in hospitals or only in birth centers.
If you are pregnant or planning pregnancy and want midwifery care, understanding whether your state licenses CMs and what scope of practice they have will shape where you can receive care and what your insurance will cover.
Key Takeaways
- Certified Midwives are recognized in only about half of U.S. states; your state's medical board website shows whether CMs are licensed where you live.
- A CM's scope of practice—what they are legally allowed to do—depends on state law, so the same credential means different things in different places.
- Finding a CM near you requires checking birth centers, midwifery practices, and hospitals in your area, since there is no single national registry.
- Insurance coverage for CM services varies by plan and state; calling your insurer to ask whether they cover midwifery care is the fastest way to know.
- If your state does not license CMs, you may still find midwives practicing under other credentials or as unlicensed practitioners, which carries different legal and safety considerations.
How to Search for Certified Midwives in Your State
Start by confirming that your state recognizes the CM credential. Visit your state's medical board or health department website and search for "Certified Midwife" or "midwifery licensure." Some states call the credential by a different name or do not license CMs at all. If your state does license CMs, the board usually maintains a searchable directory of licensed practitioners.
If a directory exists, search by your county or city. If no directory is available, contact the board directly by phone or email and ask for a list of licensed CMs in your area. Many state boards can provide names and contact information in one business day.
Beyond the state board, search for birth centers and midwifery practices in your area by name. Birth centers almost always employ or contract with CMs or CNMs. Hospitals with midwifery programs also employ CMs or CNMs. Call these facilities and ask whether they have Certified Midwives on staff and whether those midwives are taking new patients.
The American College of Midwives (ACNM) website has a "Find a Midwife" tool, but it includes both CNMs and CMs and does not cover all states equally. Use it as a starting point, but verify credentials and location through your state board.
What to Check Before Scheduling an Appointment
Once you have found a midwife, confirm three things: their credential, their license status, and their scope of practice in your state. Ask directly: "Are you a Certified Midwife, a Certified Nurse Midwife, or a Licensed Midwife?" Do not assume the title tells you everything. Then ask what setting they practice in—hospital, birth center, or home—because that determines what equipment and backup care are available during labor.
Ask whether they have hospital privileges or a transfer agreement with a nearby hospital. This matters because if complications arise during labor, you need to know whether the midwife can transfer you to a hospital and continue your care there, or whether you will be handed off to an obstetrician. Some midwives have full hospital privileges; others can only refer you.
Confirm that they accept your insurance or understand your out-of-pocket costs. Call your insurance company separately and ask whether they cover midwifery care, what the copay or coinsurance is, and whether the midwife is in-network. Insurance coverage for CM services is less standardized than coverage for CNMs, so this step is essential.
Insurance Coverage and Out-of-Pocket Costs
Coverage for Certified Midwife services depends on your insurance plan, your state, and whether the midwife is in-network. Many commercial insurance plans cover CNM services but not CM services, or they cover CMs only in certain settings. Medicaid coverage for midwifery varies widely by state: some states cover both CNMs and CMs, others cover only CNMs, and a few cover neither.
The cost of midwifery care without insurance ranges widely depending on setting and location. A home birth with a CM may cost between $2,000 and $5,000 out of pocket; a birth center birth may cost $3,000 to $6,000. Hospital births attended by midwives are usually billed through the hospital and may be covered by insurance even if the midwife is not in-network.
Before committing to a midwife, ask for a written estimate of their fees and what is included: prenatal visits, labor and delivery, postpartum care, and newborn care. Ask whether they offer payment plans. Some midwives reduce fees for uninsured patients or offer sliding scale pricing.
States Where Certified Midwives Are Not Licensed
About half of U.S. states do not license or recognize Certified Midwives. In these states, you may still find midwives practicing under other credentials—such as Licensed Midwife (LM), Licensed Direct-Entry Midwife (LDEM), or Certified Professional Midwife (CPM)—or as unlicensed practitioners. Each credential has different training standards and legal standing.
If you live in a state without CM licensure and want midwifery care, research what credentials are available in your state. Licensed Midwives and Certified Professional Midwives are recognized in some non-CM states and have their own credentialing bodies and standards. Unlicensed midwives are legal in some states and illegal in others; check your state's laws before hiring one.
The safest path in a non-CM state is to work with a Certified Nurse Midwife, who is licensed as a nurse in all 50 states and can practice midwifery in all states. If you prefer a direct-entry midwife (someone trained in midwifery but not nursing), verify their credential and check your state's laws about whether that credential is legal and what scope of practice it allows.
Questions to Ask a Midwife Before Hiring Them
Beyond credentials and insurance, ask about their experience and philosophy. How many births have they attended? What is their transfer rate to hospital care, and under what circumstances do they transfer? What is their cesarean rate for their clients? These numbers tell you whether the midwife practices conservatively (transferring early for complications) or more expectantly (waiting longer before transferring).
Ask about their backup physician or obstetrician. If complications arise, who will you see at the hospital? Is that person someone the midwife works with regularly, or will you be handed off to whoever is on call? Ask about their policies on pain management, continuous fetal monitoring, and episiotomy. Ask what happens if you go past your due date or if labor stalls.
Ask about their availability. Will the same midwife attend your birth, or might you meet a different midwife on the day you labor? Some practices have one midwife; others have a team. Ask about their cancellation policy and what happens if they become unavailable during your pregnancy.
When Midwifery Care May Not Be an Option
If you have a high-risk pregnancy—such as gestational diabetes, preeclampsia, a multiple pregnancy, or a history of complications—some midwives will not take you on as a client, or they will co-manage your care with an obstetrician. This is not a judgment; it reflects the midwife's scope of practice and training. Ask upfront whether the midwife manages high-risk pregnancies or whether you would need to see an obstetrician for your primary care.
If your state does not license CMs and does not recognize any midwifery credential, your only option for midwifery-model care may be a Certified Nurse Midwife working in a hospital or birth center. If you want a home birth in such a state, you would need to hire an unlicensed midwife, which carries legal and safety risks you should understand fully before proceeding.
Frequently Asked Questions
Is a Certified Midwife the same as a Certified Nurse Midwife?
No. A Certified Midwife (CM) has completed midwifery training but is not a registered nurse. A Certified Nurse Midwife (CNM) is a registered nurse who completed additional midwifery education. Both can attend births, but CNMs are licensed in all 50 states, while CMs are licensed in only about half. CNMs often have broader scope of practice and better insurance coverage.
Can I use a Certified Midwife if my state does not license them?
No, not legally. If your state does not license CMs, you cannot hire a CM to attend your birth. You can hire a Certified Nurse Midwife, a Licensed Midwife (if your state recognizes that credential), or an unlicensed midwife—but unlicensed practice is illegal in some states. Check your state's midwifery laws before hiring anyone.
Will my insurance cover a Certified Midwife?
It depends on your plan and state. Many plans cover Certified Nurse Midwives but not Certified Midwives. Medicaid coverage varies by state. Call your insurance company and ask specifically whether they cover CM services, what the copay is, and whether the midwife you want to hire is in-network.
What should I do if I cannot find a Certified Midwife near me?
First, confirm whether your state licenses CMs—if not, you will not find one legally practicing there. If your state does license CMs but you cannot find one nearby, contact your state medical board and ask for referrals. You can also ask your obstetrician or local hospital whether they know of midwives in your area or can recommend one.
What is the difference between a home birth midwife and a hospital midwife?
The setting determines what equipment and backup care are available. A home birth midwife carries portable equipment and relies on transfer to a hospital if complications arise. A hospital midwife has access to all hospital resources and can call for when ready physician backup. Both can be Certified Midwives, but their scope of practice and risk management differ based on setting.