CNM vs CPM vs CM: types of midwives explained

There are three national midwife credentials in the US, and the letters after a midwife's name tell you a lot about where they can work and what they can do.

• CNM (certified nurse-midwife): a registered nurse with a graduate degree in midwifery and a national board exam. Licensed in every state. Most work in hospitals.
• CM (certified midwife): the same graduate midwifery education and exam as a CNM, without the nursing degree. Licensed in only about a dozen states.
• CPM (certified professional midwife): certified by a separate national body, trained specifically for home and birth center births. Licensed in some states, not others.

If you want a midwife at a hospital birth, you're looking for a CNM, or a CM in states that license them. If you're planning a home birth, you'll mostly be choosing among CPMs, state-licensed midwives and CNMs who attend home births.

CNM vs CM vs CPM at a glance

Certified nurse-midwife (CNM)

CNMs and CMs attend nearly 9 in 10 midwife-attended births in the US ^[5]. To sit for the American Midwifery Certification Board (AMCB) exam, a CNM candidate needs an active registered nurse license and a graduate degree from an accredited nurse-midwifery program ^[1]. A master's degree is the minimum, and some hold doctorates ^[1].

Scope. AMCB describes CNM clinical skills as including primary care for women across the lifespan, reproductive health care, pregnancy and birth ^[1]. So a CNM can also handle your annual exam, birth control and menopause care, not only pregnancy.

Prescribing. CNMs are advanced practice registered nurses (APRNs). The Bureau of Labor Statistics notes that in most states, APRNs can prescribe medications, order medical tests and diagnose health problems ^[6]. Nurse-midwives deliver babies and manage emergency situations during labor ^[6].

Where they work. In 2023, CNMs and CMs attended 408,214 US births, about 11% of all births. Roughly 94% of those births happened in hospitals ^[5]. Many CNMs have hospital privileges and work in practices alongside obstetricians. Some also attend births in birth centers and homes.

Certified midwife (CM)

A CM has the same midwifery education and passes the same AMCB exam as a CNM. The difference is that a CM came to midwifery without a nursing background ^[1]. CMs need a graduate degree and certain science courses before admission ^[1], and they recertify on the same five-year cycle as CNMs ^[2].

The catch is legal status. AMCB lists CM licensure in about a dozen states plus DC, including New York, New Jersey, Maryland and Rhode Island ^[1]. If you live elsewhere, you likely won't find CMs practicing.

Certified professional midwife (CPM)

The CPM credential comes from the North American Registry of Midwives (NARM). It's built for midwives who practice "predominately in out-of-hospital settings," and NARM says it is the only nationally accredited midwifery credential that requires out-of-hospital experience ^[3].

Training. There are two main routes. A candidate either graduates from a program accredited by the Midwifery Education Accreditation Council (MEAC), or completes NARM's Portfolio Evaluation Process, where qualified preceptors verify their skills ^[3]. Either way, they must pass NARM's written exam ^[3]. There's no minimum college degree ^[1], and AMCB notes that about half of CPMs came through the portfolio route ^[1]. CPMs recertify every three years ^[3].

Licensing. As of October 2024, CPMs had a path to licensure in 37 states and DC ^[4]. Rules keep changing: Massachusetts formally established CPM licensure in September 2026 ^[11]. A few states take other approaches. Kansas and Missouri don't license midwives, but independent practice is protected by a court ruling and statute ^[9].

Prescribing. CPMs and other community midwives don't have the broad prescribing authority of nurse-midwives. A 2021 legal review found that limited access to medications and devices is a barrier for CPMs and state-licensed midwives, and that what they can carry depends on each state's law ^[7]. Ask any home birth midwife which medications they carry for bleeding after birth, and how they handle newborn eye ointment, vitamin K and other routine newborn care.

Lay and traditional midwives

You may hear "lay midwife" or "traditional midwife" for someone who attends births without a national credential or a state license. Some have long experience. But without a credential or license, there's no exam, licensing board or public record to check their training against.

AMCB warns that midwives practicing in states without midwifery regulation "have no legal, regulatory protection" unless they hold AMCB certification ^[1]. If you're considering an uncredentialed midwife, ask about training, how many births they've attended, their emergency transfer plan, and which hospital they would transfer you to.

Where each type attends births

Birth certificate data shows how differently these groups practice ^[5]:

"Other midwives" on birth certificates means midwives without the CNM or CM credential, a group that includes CPMs.

If you're thinking about a home birth, know where the major medical groups stand. ACOG believes hospitals and accredited birth centers are the safest settings for birth, while recognizing each woman's right to make a medically informed decision ^[10]. It lists factors critical to good home birth outcomes: careful selection of who is a candidate, a CNM, CM or midwife whose education and licensure meet international standards, ready access to consultation, and fast transport to a nearby hospital ^[10]. ACOG considers a baby in a non-head-down position, twins or more, or a prior cesarean an absolute reason not to plan a home birth ^[10]. Home and birth center births are for low-risk pregnancies only. Our guide to birth center vs hospital covers who qualifies.

Insurance and Medicaid by midwife type

CNMs. Federal Medicaid rules require states to cover certified nurse-midwives ^[8]. With private insurance, check that the CNM and the hospital or birth center are both in your network, the same as you would for an OB.

CPMs and CMs. Medicaid coverage is optional for states. As of July 2026, 22 states and DC covered CPMs and/or CMs, and 10 states and DC paid them the same rate as physicians for a vaginal birth ^[8]. Most covering states let these midwives bill for births at birth centers or at home ^[8].

Private insurance coverage for CPM care and home birth varies by plan and state. Get it in writing before you commit. Our guides to whether insurance covers midwives and what a midwife costs go deeper.

How to check a midwife's credentials

1. Ask which credential they hold. CNM, CM, CPM or none.
2. Check your state's license lookup. Depending on the state, midwives are licensed by a board of nursing, medicine or midwifery, or by the health department ^[1].
3. Ask about backup and transfer. Who covers when they're unavailable, which physicians they consult, and which hospital they use.
4. Confirm coverage. Call your insurer or Medicaid plan with the midwife's name and credential.

Ready to look? Browse midwives by state in our directory.