Midwives in California


There are two pathways for practicing midwifery in California: Nurse Midwife (NMW) and Licensed Midwife (LM). The Nurse Midwife is recognized as a CNM nationally while the Licensed Midwife is recognized as a CPM nationally.


 

Nurse Midwife (NMW)

Licensed Midwife (LM)

 

Scope of Practice

Both NMWs and LMs are independent midwifery practitioners who can provide necessary support and care during pregnancy, childbirth, and the postpartum period, in addition to care of the normal newborn during the first 28 days of life. Midwives promote a healthy pregnancy and birth, provide health counseling and education, continually monitor progress throughout the childbearing cycle, recommend appropriate management if complications arise, and collaborate with other healthcare providers when needed. 

Midwifery care by NMWs includes a full range of primary health care services from adolescence to beyond menopause. In addition to providing care during pregnancy, childbirth, and the postpartum period, care includes independent provision of primary care, gynecologic and family planning services, preconception care, and treatment of male partners for sexually transmitted infections. NNWs also have prescriptive authority and can provide abortion services, including prescription of medical abortion medication and aspiration abortion in some states. NMWs can be licensed in all 50 states, plus D.C. and U.S territories, and are able to practice in all settings (hospitals, birth centers, homes, clinics). 

Midwifery care by LMs include comprehensive care for people throughout the pregnancy, childbirth, and postpartum periods. LMs are knowledgeable on the management of the childbearing cycle in out of hospital settings, typically homes, birth centers, and offices. LMs can be licensed in 34 states, plus D.C., and do not have prescriptive authority, however, they can obtain and administer certain medications in select states. LMs also are likely to receive education on homeopathy modalities, such as herbal medicine or Traditional Chinese Medicine.

Practice Settings

Nurse Midwifes are trained in both nursing and midwifery. Their training is hospital-based, and the majority of NMWs practice in clinics and hospitals, although some do attend home births and practice in birth centers. 

The LM education and clinical training focuses on providing midwifery model care in homes and freestanding birth centers. In some states, LMs may also practice in clinics and doctors’ offices, providing well woman and maternity care.

School/Program Accreditation

The Accreditation Commission for Midwifery Education (ACME) agency provides accreditation for basic certificate, basic graduate nurse midwifery, direct entry midwifery, and pre-certification nurse-midwifery education programs. CNM programs are typically a university affiliated program.

Some programs are accredited by the Midwifery Education and Accreditation Council (MEAC).

Licensure Exam

The CNM certification examination is administered by the American Midwifery Certification Board (AMCB) to receive the professional designation of CNM.

The NARM exam must be administered to receive the nationally recognized title of CPM. For those intending to practice in California, they must apply to the Medical Board of California (MBC) to receive the Licensed Midwife designation in CA.

Note: The NARM organization provides a “national” credential of Certified Professional Midwife (CPM) when you pass the NARM exam, however, this is not meaningful in all states. In some states, graduation from a MEAC accredited school, passing the NARM exam, and receiving the CPM certification is the requirement for licensure in that state. In other states, you need to obtain the CPM designation and complete additional state requirements to earn licensure.