Direct-Entry Midwifery, LM, CPM

Midwifery is the practice of helping women through pregnancy, labor, and delivery of a healthy baby. Midwives have historically been women who have gained knowledge and practice of delivering babies before obstetricians began to take on the role. Midwives today go through training to become certified and often work alongside physicians and obstetricians, collaborating for the best care for patients. A direct-entry midwife is someone who has trained in midwifery without a background in nursing.

Although direct-entry midwives do not attend nursing schools for training, many go through formal training at a college or in a university program to become licensed to practice, while others learn skills through private courses. Many direct-entry midwifery programs are approximately three years in length and require classroom study as well as clinical practice as a student.


After completing a program to become a direct-entry midwife, you may become a licensed midwife or you may take further certification. A licensed midwife (LM) is a person who is trained to perform the care tasks needed for a healthy pregnancy, labor, and delivery and is typically trained to work only within the state of licensure. Not all states recognize LMs, and you may need to take a test to become further certified to practice.

A certified professional midwife (CPM) is someone who has completed a midwifery program and has taken an exam for certification through the North American Registry of Midwives (NARM). This organization requires a test that assesses the midwife’s skills and experience assisting with births. The development of the role of the CPM was in response to the numbers of midwives who assist with births outside of the hospital setting and is meant to set standards of care for those practicing this profession.

Midwives are somewhat different from many obstetricians in that they generally provide care for low-risk pregnancies and may strive to provide a natural birth. This often involves assisting in a delivery without making many interventions and allowing the birth to be free from excess intrusions from the medical provider. Many mothers choose care from a direct-entry midwife to provide a natural birth experience and to gain support for pregnancy and a healthy baby.