Homebirth Midwife in Reno, NV
Sage Springs Midwifery

Amanda Macdonald
Licensed and Certified Professional Midwife
Types of Midwives in Nevada
Did you know that there are several types of midwives in Nevada?
Nevada is one of the handful of states that does not require a license, certification, or formal education to legally practice midwifery.

Certified Professional Midwife (CPM)
Certified Professional Midwives (CPM for short) are midwives certified through the North American Registry of Midwives. CPMs are the only type of midwife with required out of hospital clinical training requirements. CPMs specialize in low risk pregnancy and birth in the home or birth center setting.
CPMs do not need to be a registered nurse and are able to gain certification typically through one of two routes:
- MEAC route (Midwifery Education Accreditation Council)
- PEP route (Portfolio Evaluation Process).
The MEAC route meets the International Confederation of Midwives Global Education Standards, while the PEP route requires additional classes. If route of education is important to you, you have to ask your CPM as there is no public database.
Most states in the US offer licensure for CPMs and their scope of practice is regulated at the state level. Nevada is not one of those states so CPMs can practice without regulation. In Northern Nevada, those of us who have the designation "LM" (Licensed Midwife) after our name have a midwifery license in California. Though uncommon, not all California Licensed Midwives are CPMs. The public is able to check the status of our California licenses at any time using this link and searching by last name. It will tell you whether a license is in good standing, or if there are disciplinary actions.
Certified Nurse Midwife (CNM)
Certified Nurse Midwives (CNM for short) are midwives who usually train and work in the hospital setting, but some work in the home or birth center setting. They are certified through the American Midwifery Certification Board. When working in the hospital setting, hospital-based CNMs can often safely care for patients that may have risk factors considered too great for a CPM or CNM practicing at home or in a birth center.
CNMs first become a Registered Nurse (RN). Many CNM programs require that a RN gain some experience before applying for a Masters in Midwifery program accredited by Accreditation Commission for Midwifery Education. After completing their Masters degree in Midwifery, they then take the national CNM exam. CNMs meet the ICM Global Educational Standards without additional course work necessary.

CNMs are legally recognized in all 50 states. Their scope of practice is regulated at the state level. You can verify the status of a Nevada CNM's license HERE.

Other Types of Midwives
It is said that Nevada is one of the few states remaining in the country with complete "birth freedom". This means that anyone may legally practice midwifery without regulation of route or length of training, and no requirement for graduation, certification or licensure. In Nevada, non-nurse midwives may serve any family without any rules on the federal, state, or local government levels.
If a Nevada midwife does not have the letters CNM or CPM after their name, the midwife and the family have complete autonomy regarding scope of practice and levels of acceptable risk in the out of hospital setting. This provides the greatest level of freedom in birth choices. These midwives are trained through apprenticeship. They bring with them centuries of traditional knowledge passed down through the generations, holding an important place in our history. Their practices typically utilize alternative options to pharmaceuticals and other common obstetric technology.
Above are examples of some of the titles used by midwives who are not CNMs or CPMs. Direct Entry Midwife (DEM), Traditional Midwife or just plain Midwife are the most common. Because there is no regulation, it is not uncommon for some midwifery students to begin to use these titles as they progress through the second half of their apprenticeships, so it is important to ask about experience and training to differentiate who is a student and who is a qualified midwife. Because there are no databases to track these other types of midwives, you will need to rely on your own research.