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Not all midwives are created equally and this holds true, especially through the varied ways they receive their training. The two most frequently heard terms with midwives is lay midwife and certified-nurse midwife. They are both unique in what they offer pregnant women.
A lay midwife, also called direct-entry midwife in some places, typically does not have a nursing degree and acquires training through an apprenticeship with another midwife. How long it takes to become a lay midwife depends on how many births are available for attendance and if any formal textbook learning is needed.
Lay midwives do mostly homebirths though some are able to work in free-standing birth centers. The ideology behind homebirth is a non-interventive approach so someone with no medical training is the preferred route to go.
Lay midwives also do not have formal physician backup in some cases, though this may vary with each state. And only some states in the country consider lay midwives legal, though where they are deemed illegal, they often still practice but with more discretion.
Herbal remedies are more likely to be used to treat pregnancy-acquired conditions with a lay midwife. Their non-interventive approach treats pregnancy as normal and not requiring medical attention.
A certified-nurse midwife needs to obtain a nursing degree as a registered nurse prior to entrance in any program. Job experience as an R.N. is also necessary before the rigors of nurse-midwifery education begins. Once that is completed another couple years is required and usually a masters degree as well before being able to take state boards to become a C.N.M.
Nurse-midwives are more likely to deliver babies in hospitals though some have free-standing birth centers and do attend homebirths. They also are more likely to have formalized physician backup though this varies a lot with each practice.
Nurse-midwives are able to prescribe medications and order pertinent laboratory tests that may not be available to lay midwives. But if a lay midwife has good backup arrangement the appropriate tests can be arranged with ease.
A nurse-midwife is more likely to be bound by arrangements with the physician and the protocol of that particular office. This may decrease flexibility and increase likely interventions depending on how much independence the midwife has.
If a nurse-midwife shares her practice it may more resemble a physician practice in that you will get whoever is on call when you are in labor. A midwife in a solo practice is always on call and that isn't as big of a concern.
Either option of midwife has its pros and cons and which you choose really depends on the birth experience you are seeking.
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