Last Updated: May 2025 | Reviewed by Abbie Jacobs
Understand the differences between CNMs, CMs, CPMs, doulas, and OB/GYNs—including training, scope of care, licensing, and practice settings.
Although midwives have supported childbirth across cultures for centuries, modern midwifery in the United States has taken many forms and fought for its place in mainstream care. After nearly disappearing due to the rise of hospital births in the 20th century, midwifery has since reclaimed its role through credentialing, advocacy, and evidence-based practice.
Today, a variety of midwifery credentials exist, each with its training model, clinical authority, and legal standing. Whether you’re pursuing a career in midwifery or comparing provider options for maternity care, understanding these roles is key.
Quick Navigation
- Certified Nurse-Midwives (CNMs)
- Certified Midwives (CMs)
- Certified Professional Midwives (CPMs)
- Doulas
- Midwives vs. OB/GYNs
- Credential Comparison Table
- FAQs
Certified Nurse-Midwives (CNMs)
Certified Nurse-Midwives (CNMs) are advanced practice registered nurses (APRNs) with a master’s or doctoral degree in nurse-midwifery. They are certified by the American Midwifery Certification Board (AMCB) and licensed in all 50 U.S. states.
- Provide full-scope reproductive and primary care
- Attend hospital, birth center, and home births
- Hold prescriptive authority and often practice independently
- Qualified to care for women across the lifespan, including gynecologic care, family planning, and postpartum support
All accredited nurse-midwifery programs include extensive clinical experience and must meet ACME standards. CNMs are trained not only in labor and birth, but also in public health, preventive medicine, and interprofessional collaboration.
Certified Midwives (CMs)
Certified Midwives (CMs) follow the same educational path and certification exam as Certified Nurse-Midwives (CNMs), but do not hold a nursing degree. This role was created in 1997 to expand access to midwifery for individuals from non-nursing backgrounds.
- Graduate-level midwifery education is required
- Certified by the AMCB
- Authorized to practice in 12+ states, with growing recognition
- Offer full-scope women’s healthcare like CNMs
Because they meet the same competency standards as CNMs, CMs are trained for hospital, clinic, and birth center practice. However, their legal status varies by state.
Learn more about the CM credential »
Certified Professional Midwives (CPMs)
Certified Professional Midwives are direct-entry midwives certified through the North American Registry of Midwives (NARM). They specialize in out-of-hospital births and are trained through MEAC-accredited programs or the Portfolio Evaluation Process (PEP).
- Emphasize natural birth and low-intervention care
- Typically attend home births or work in freestanding birth centers
- Legal recognition in 30+ states
- Often work independently or in midwife-led teams
The Midwifery Education Accreditation Council (MEAC) oversees educational standards. CPMs are the only nationally recognized midwives required to demonstrate experience in community-based settings before certification.
See where CPMs can practice independently.»
Doulas
Doulas are non-clinical professionals trained to offer emotional, physical, and informational support before, during, and after birth. They do not perform medical tasks or make clinical decisions.
- Focus on comfort, advocacy, and continuous presence during labor
- May specialize in postpartum care, bereavement, or fertility support
- Not licensed or regulated by most states
- Often certified by national organizations such as DONA International or CAPPA
Doulas play an essential role on the birth team, often working alongside midwives, OB/GYNs, and nurses to improve outcomes and satisfaction.
Midwives vs. OB/GYNs
While midwives and OB/GYNs may collaborate in maternity care, their philosophies, training, and scopes of practice differ significantly. Choosing between them depends on your health status, birth preferences, and need for specialized medical interventions.
- Midwives: Holistic, client-centered approach for low-risk pregnancies
- OB/GYNs: Medical specialists trained in surgery and high-risk obstetrics
- CNMs: Often work alongside OBs in hospitals and clinics
Many families benefit from integrated care teams that include both midwives and OB/GYNs, allowing for personalized support alongside medical safety nets when needed.
Credential Comparison Table
Midwife Credential Overview
| Credential | Education | Certification | Scope | Licensure | Practice Settings |
|---|---|---|---|---|---|
| CNM | RN + Master’s in Midwifery | AMCB | Full-scope women’s healthcare | All 50 states | Hospitals, clinics, birth centers |
| CM | Master’s in Midwifery (non-nurse) | AMCB | Same as CNM | 12+ states | Hospitals, birth centers |
| CPM | MEAC or Portfolio (PEP) | NARM | Low-risk, out-of-hospital care | 30+ states | Home births, birth centers |
| Doula | Training optional (non-medical) | DONA, CAPPA, others | Emotional and physical support | Unregulated | All settings |
“I wasn’t sure which midwifery path to follow, but learning about CNM vs. CPM roles helped me decide to pursue a master’s in nurse-midwifery. Now I’m supporting women in both hospitals and birth centers!” — Jessica R., RN, CNM Student
FAQs
Can doulas deliver babies?
No. Doulas are not licensed medical providers and do not perform clinical tasks. Their role is non-medical support before, during, and after birth.
What’s the difference between a CNM and a CM?
Both are certified by the AMCB. CNMs are also licensed registered nurses, while CMs are not. Their scope of practice is largely the same, but legal recognition varies by state.
Can midwives prescribe medication?
Yes, CNMs and CMs can prescribe in most states. CPMs do not typically have prescriptive authority, although this may vary depending on state law.
What is the focus of a CPM’s training?
CPMs are specifically trained for out-of-hospital births and low-risk maternity care in homes or birthing centers.
Conclusion
Each midwifery role serves a distinct population and philosophy of care. CNMs and CMs offer advanced clinical services across a woman’s lifespan, while CPMs bring vital community-based options to low-risk pregnancies. Doulas provide critical emotional and physical support throughout the journey. Understanding these differences empowers families and aspiring professionals to make confident, informed choices.