Midwives and Birth in the United States
■ The American College of Nurse-Midwives(ACNM) is the
professional association representing certified nurse- midwives
(CNMs) and certified midwives (CMs) in the United States.
According to the American Midwifery Certification Board, as
of February 2022, there were 13,524 CNMs and CMs. Most
midwives in the United States are CNMs.1
■ In 2019, CNMs/CMs attended 372,991 births—a 10% increase
compared to 2019. In 2019, CNMs/CMs attended 92% of all
midwife-attended births and 10.3% of total US births.2 (2020 is
the most recent year for which birth data are available from the
National Center for Health Statistics.)
Percentage of Births Attended by
Certified Nurse-Midwives and Certified Midwives, 2017–2020
United States Department of Health and Human Services (US DHHS), Centers for Disease
Control and Prevention (CDC), National Center for Health Statistics (NCHS), Division of Vital
Statistics, Natality public-use data 2007-2020, on CDC WONDER Online Database, October
- Accessed at http://wonder.cdc.gov/natality-current.html on Apr. 20, 2022
■ CNMs are licensed, independent health care providers with
prescriptive authority in all 50 states, the District of
Columbia, American Samoa, Guam, Puerto Rico and USVI.
CNMs are defined as primary care providers under federal
law. CMs are licensed, independent health care providers
who have completed the same midwifery education as
■ CMs are authorized to practice in Delaware, Hawaii, Maine,
Maryland, New Jersey, New York, Rhode Island, Virginia,
and the District of Columbia. CMs have prescriptive
authority in New York, Maine, Maryland, Rhode Island,
Virginia, and the District of Columbia. The first accredited
CM education program began in 1996.
■ *While midwives are well-known for attending births, 76% of
CNMs/CMs identify reproductive care and 49% identify
primary care as responsibilitiesin their full-time positions.
Examples include annual exams, writing prescriptions, basic
nutrition counseling, parenting education, patient education,
and reproductive health visits.
■ * In 2019, 89% of CNM/CMs attended births in hospitals, 9%in
freestanding birth centers, and 8% occurred in homes.
■ *More than 43% of CNMs/CMs list physician/midwife
practices or hospitals/medical centers as their principal
■ Medicaid reimbursement for CNM care is mandatory in all
states. Most Medicaid programs reimburse CNMs/CMs at
100% of physician rates. Medicare reimburses CNMs at 100%.
Most states also mandate private insurance reimbursement for
■ Standards for education and certification in midwifery are
identical for CNMs and CMs.
■ The Accreditation Commission for Midwifery Education
(ACME) is the official accrediting body for CNM/CM
education programs. There are 40 ACME-accredited
midwifery education programsin the United States.5
■ * Approximately 84% of CNMs have a master’s degree.
of 2010, a graduate degree is required for entry to midwifery
practice as a CNM/CM.6
■ *20% of CNM/CMs have doctoral degrees.