A Certified Professional Midwife (CPM) is a trained, credentialed professional who offers primary maternity care to women and families. CPMs have completed a program of midwifery education approved by the North American Registry of Midwives, including both didactic and clinical experience, the sum of which, on average, takes three to five years to complete. CPMs are often called “direct-entry” midwives, because they trained exclusively for midwifery without attending nursing school. The CPM credential is unique among maternity care providers in the United States as it requires training and experience in out-of hospital birth.
The number of CPMs is growing rapidly, from 500 in early 2000 to more than 1,400 in 2008. Today, at least one in nine of all nationally-certified midwives in the United States is a CPM.
Learn more from an issue brief that explains the conception, formation, promotion and maintenance of the Certified Professional Midwife (CPM) credential: 
A "licensed midwife" is an individual who has been issued a license to practice midwifery by the state in which she lives or works. In Minnesota, the Board of Medical Practice issues license for midwives, along with physicians and other allied health professionals. In Wisconsin, the Department of Regulation & Licensing issues licenses. The practice of midwifery authorizes the licensee to attend cases of normal childbirth, in a home or birthing clinic environment.
Licensed midwives must pass the North American Registry of Midwives (NARM) comprehensive examination. After successful completion of this examination, prospective applicants are designated as a "Certified Professional Midwife" and are eligible to submit an application for state midwifery licensure.
For women with low-risk pregnancies, birth outside of the hospital with a trained professional has been shown to be as safe—or safer than—hospital birth. Most pregnancies and births (about 90%) are low risk and can be expected to go smoothly. Low-risk is defined by a healthy woman with no serious medical problems, reaching full-term (37-42 weeks), with a single baby in a head-down presentation, who has no serious medical problems.
Midwives are skilled professionals, trained to identify complications in pregnancy and birth. We understand the true parameters of “normal” and “healthy,” and are required to transfer care of women who don’t meet these guidelines. The state gives us clear rules and regulations in which to work. Indeed, this is what keeps homebirth safe—and far more natural than hospital birth.
In our country, we are conditioned to expect birth to be difficult and dangerous, and typical hospital polices are designed to enforce that belief. Routine hospital interventions, such as continuous fetal monitoring, restriction of food and water, and birthing on our backs, clearly interfere with the natural process of birth. These interventions present unnecessary risks to mom and baby, and saddle our country with a cesarean rate of more than 30% and a ranking of 29th in the world for infant mortality, the worst of the industrialized world.
In European nations, where midwifery care is the norm and out-of-hospital birth is common, home is where babies are born. Not coincidentally, our European cousins have far better outcomes than the U.S.
The most comprehensive study on the safety of homebirth involved the study of over 5,000 CPM-attended homebirths. It showed that “planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States.”
Interested in learning more? Check out my resources page for links to other studies supporting the safety of out-of-hospital birth and midwifery care.
Midwives are qualified to manage both simple and serious complications that may arise during a birth, and have clear guidelines on when to transfer a woman or baby to a hospital for more specialized care or an emergency situation. My care for you and baby--right from the beginning--focuses on keeping you both safe, healthy, and within the parameters of normal. I am keenly aware of where the edges of normal pregnancy and birth begin and end, and invest much effort in keeping you in that generous safety zone.
It’s reassuring to know that we carry oxygen for mom and baby, medications for hemorrhage, sutures and lidocaine for perineal repairs, and IV equipment as allowed. We’re also trained in the American Heart Association’s neonatal resuscitation and adult CPR.
I’m happy to say that true emergencies are very rare. Transfer of care, instead, is almost always a deliberate decision to get additional help that will offer the safest birth in a given situation.
If you’re unfamiliar with midwifery care in an out-of-hospital setting, you probably have many questions about emergency situations. I’m happy to answer your questions, and guide you to literature and studies that will help you understand my comfort in helping women give birth at home.
I’m able to provide all your routine care, tests and screens, as outlined by the American College of Obstetricians and Gynecologists, and even more in terms of one-on-one care. Some women, however, choose to maintain their relationship with a physician during pregnancy. In situations where your pregnancy or birth requires additional medical care, having access to a caregiver with whom you have established a relationship can be reassuring. I am always pleased to work with any caregiver of your choice.
Women who give birth at home actually have far more options for coping with pain than those at a hospital! At home, you’re free to move, to eat what you like, to enjoy a quiet nap, to stand in a dark shower, to get in the warm birth tub, to be as loud as you like, to turn out all the lights, to be alone, to walk around the block, to do whatever you feel will help you birth your baby.
Leave a woman to her own devices, and she’ll find her way to all sorts of positions--standing, on all fours, lying on her side, sitting. Most of the positions she chooses are vertical, which makes good sense, as it allows the baby's weight to assist the birth process and keeps baby from pressing against her lower back and pelvis.
You’re with friends and held in a loving place during your birth. This is your birth, and you are firmly in control. You can surround yourself with people who love you, know you well, who will be with you throughout your labor and delivery.
The pain of birth is multiplied by fear. Holding the fear in our bodies slows us down, and prevents labor from proceeding easily. It’s true that is painful for most women, and a time of great vulnerability. Addressing fear prior to labor is a tremendous benefit. Midwifery care and homebirth offer a safe environment for dealing with the fears we all carry as we face labor, as well as the fears related to the enormous change this new baby will bring to our lives.
Lastly, you’ll be attended with a midwife and assistants who have helped hundreds of women give birth with the soothing touch of hands, gentle voices, and tender guidance. Indeed, we’re specialists!
It sure seems like it ought to be! In reality, it’s a fairly tidy business. We give you a list of supplies to have ready for your birth, including large absorbent pads for underneath you and a plastic lining for the bed. No need to worry about carpets, mattresses and so forth. We’re skilled in keeping your house as it should be. In the end, we usually have one full garbage bag and a load of laundry to wash up—that’s it! Even better, before we leave, we make sure your birthing area is tidied up and the house in order.
The experience of birth is an amazing gift to give your older children. Preparing them for birth, with conversation and birth movies, lays the way for a life-changing day. In my experience, children generally take on the attitude of the adults in the room. If we’re calm and happy, they will be, too. I love to have their hands helping me welcome the new baby. Truly, I have never seen a child “traumatized” by being near a birth. To the contrary, they are kind, loving, encouraging, and quite amazing.
Younger children often sleep right through a labor and delivery. When they wake, the new baby has arrived! Some families choose to have a family member or friend come to the house to care specifically for young children.
Other moms know right off that they won’t be able to focus if kids are in the house, and send them off to Grandma’s or the neighbor’s house for the night.
It’s your choice, and we’ll decide what’s best for your family as your care progresses.
This is a common dilemma, even in the most natural-minded of families. You have intuition, information from friends, and lots of research on your side. Most men simply feel a strong need to protect their family, and this is an appropriate biological response for a man to have! To him, safety probably means a hospital--that’s what he’s learned from our culture.
Initial consultations with me are always free, and I am pleased to spend an hour answering questions, sharing from my lending library of books and movies, and talking about the work I do. Please ask your partner to come with you to this important meeting. (I can tell him how my partner initially responded when I pursued a homebirth in 1996!
Ask him to talk with the fathers of a few homebirthed babies. I’ll be happy to provide you with some names and numbers. If you are absolutely clear that you want a homebirth and you let your husband know of your intent, and if you make sure he has the factual information he needs to help him address his fears, most couples will find themselves working toward the same goals.
As with everything to do with pregnancy and birth, there are plenty of voices telling you what’s right. There are strong feelings on both sides of the Natural Birth/Hospital Birth debate, and voices on both sides sound like there is no alternative to their way of thinking. You’ll probably hear plenty of opinions, and have to decide between conflicting views on what is right.
Like every big decision in life, you ultimately have to listen to your own voice. In the end, you must choose what’s best for you and this baby. For some people, that means a midwife, for others, and obstetrician. All these choices are okay. I’m simply thrilled that we have these choices to offer!
Just the way that you’ll know how to care for this baby, and how to raise this child, you know how it’s best to bring your child into this world. I believe in your knowledge of what’s best for you and your baby.
