Types of Midwives in New York and Connecticut

Why the word midwife can mean different things

You may be choosing prenatal care in Westchester, Greenwich or Manhattan and see letters like CNM, CM, CPM or LM after a name. They are not the same thing. Some are national credentials from a certifying board. Others are state licenses. And the rules change when you cross from New York into Connecticut.

You will often see three national credentials. According to the American College of Nurse-Midwives (ACNM), a certified nurse-midwife (CNM) is a registered nurse with graduate midwifery education who passed the exam of the American Midwifery Certification Board (AMCB). A certified midwife (CM) has the same graduate education and AMCB exam without the nursing part. A certified professional midwife (CPM) is certified by a different body, the North American Registry of Midwives (NARM), based on shown skills, and one path to it is an apprenticeship.

ACNM notes that most CNMs and CMs attend births in hospitals, and most CPMs attend births in homes or birth centers. A national credential alone does not let someone practice here. What matters is whether the person holds a license in the state where you get care.

How New York licenses midwives

In New York, the State Education Department's Office of the Professions licenses midwives. Its rule is short: any use of the title "midwife" in New York State requires a license, and only a licensed or legally exempt person may practice midwifery. New York's consumer page adds that the training may build on a nursing background or follow a program for people without one.

• Education and exam: a master's or higher degree from a registered or accredited midwifery program, plus passing the AMCB exam.
• Scope: state law defines midwifery as managing normal pregnancies, childbirth and postpartum care for essentially healthy women, including newborn evaluation, resuscitation and referral.
• Physician relationships: a midwife must have collaborative relationships with a board-certified OB-GYN, a physician with obstetric privileges, or a hospital, and must make information about them available to patients.
• Prescribing: licensed midwives may prescribe and order tests within midwifery after completing required pharmacology training.
• Titles: only someone licensed as both a midwife and a nurse may use the title "nurse-midwife" in New York.
• Renewal: midwives reregister every three years and must display a current New York registration certificate.

How Connecticut licenses midwives

Connecticut works differently. The Department of Public Health (DPH) licenses nurse-midwives. To qualify, a person must be eligible for a Connecticut registered nurse license, hold current AMCB certification and complete thirty hours of pharmacology education for nurse-midwifery. State law reserves the titles "licensed nurse-midwife," L.N.M. and C.N.M. for people with this license.

Under Connecticut law, nurse-midwives practice within a health care system or a birth center, and they keep clinical relationships with OB-GYNs for consultation, collaborative management or referral as a patient's health requires. The law also lets a small group of midwives who held a Connecticut midwife license on June 30, 1983 keep renewing it.

Connecticut is still studying other kinds of midwives. A 2023 law, Public Act 23-147, asked DPH to form a midwifery working group to study community birth (planned home birth or birth center birth) and the role of direct-entry midwives, a group that includes certified midwives and certified professional midwives. If you are weighing a CPM or CM in Connecticut, check the current DPH midwife pages for updates.

Where midwives attend births

New York's Office of the Professions says licensed midwives practice and assist births in hospitals, birth centers, clients' homes and professional offices. In both states, many families meet a midwife through an OB-GYN practice that includes midwives, and others choose a midwife-led practice or birth center.

The setting shapes what the day looks like, so it helps to decide the setting and the provider together. Our guide to hospital, birth center and home birth in NY and CT compares the three settings and what each state requires of birth centers.

How a doula is different, and how the two work together

A midwife is a licensed medical provider. She examines you, orders tests, catches the baby and makes clinical decisions with you. A doula does none of that. A doula is a non-medical support person who offers comfort, information and emotional support, and who helps you and your partner ask questions and stay part of each decision. Our short post on doula vs midwife vs OB-GYN covers the basic split.

Many families with a midwife still choose a doula because the jobs fit together. Your midwife watches the health of you and your baby. A doula focuses on you: breathing through contractions, finding positions, keeping your partner fed and steady, and reminding you of the questions you wanted to ask. At Northeast Doulas, our labor doulas come "with no agenda" and offer "judgement free educational, physical and emotional support," whoever your provider is.

How to check a midwife before you choose

A license check takes a few minutes online. Then a short conversation tells you how the practice works day to day, and who you will actually see in labor.

• New York: search the name on the Office of the Professions online license verification and ask to see the current registration certificate.
• Connecticut: use the DPH eLicense look-up and choose the license type Licensed Nurse Midwife.
• Ask which physician or hospital the midwife collaborates with, and which hospital you would go to if plans change.
• Ask where she attends births: hospital, birth center, home or more than one.
• Ask who covers when she is off call, and whether you can meet the other midwives.
• Ask your insurance plan whether the midwife and the birth setting are covered. New York's licensing office says to check with your insurer, since plans may limit which midwives they reimburse.