When it comes to pregnancy and childbirth, expectant mothers have more choices than ever before. From hospital births to home deliveries, and from obstetricians to midwives, the variety of options can feel overwhelming. Among the most common questions women ask when exploring their maternity care options is: What’s the difference between a Certified Nurse Midwife and a Traditional Midwife? Understanding this distinction is essential to making an informed decision about who will guide you through pregnancy, labor, and birth. In this Certified Nurse Midwife Comparison, we’ll explore the differences in education, licensing, care approach, and scope of practice so you can choose the provider that best aligns with your values and needs.

Understanding Midwifery in Modern Healthcare 

Midwives have supported women in childbirth for centuries. Historically, they were experienced community members who learned the art of childbirth through practice rather than formal education. Over time, as healthcare evolved, so did the midwifery profession. Today, midwives in the United States fall into two main categories: Certified Nurse Midwives (CNMs) and Traditional Midwives (which may include Certified Professional Midwives, or CPMs, and direct-entry midwives). 

Both types of midwives share a common goal — to provide safe, compassionate, and empowering care for women during pregnancy and birth. However, their training, credentials, and practice environments can differ significantly.

What Is a Certified Nurse Midwife (CNM)? 

A Certified Nurse Midwife is a healthcare professional who combines the clinical training of a nurse with the specialized expertise of a midwife. CNMs are Advanced Practice Registered Nurses (APRNs) who have completed a master’s or doctoral degree in nurse-midwifery and have passed national certification through the American Midwifery Certification Board (AMCB). 

Because of this rigorous medical training, CNMs are licensed to practice in all 50 states and the District of Columbia. Their scope of practice is broad — they can prescribe medications, order diagnostic tests, and provide care in hospitals, birth centers, or even at home. 

In addition to attending births, CNMs offer a full range of women’s healthcare services, including: 

This combination of medical expertise and holistic philosophy allows Certified Nurse Midwives to provide comprehensive, evidence-based care throughout a woman’s life

What Is a Traditional Midwife? 

The term Traditional Midwife refers to professionals who are trained in midwifery but are not necessarily registered nurses. Within this group, there are a few distinct designations: 

Traditional midwives primarily focus on low-risk pregnancies and emphasize natural, non-interventionist birth practices. Their care is deeply personal and centered around the mother’s preferences, with strong attention to emotional and spiritual well-being.

Education and Certification: The Key Difference 

When comparing Certified Nurse Midwives and Traditional Midwives, education and certification stand out as the primary differences. 

In short, CNMs have a more standardized medical education and broader legal authority, while traditional midwives tend to have specialized, experience-based training focused on natural birth.

Where They Practice 

Certified Nurse Midwives have the flexibility to practice in multiple settings, including hospitals, private clinics, birth centers, and homes. They are often part of interdisciplinary healthcare teams, working alongside obstetricians, anesthesiologists, and pediatricians. This collaborative environment ensures that if complications arise, medical intervention is immediately available. 

Traditional Midwives, on the other hand, primarily practice in out-of-hospital settings such as homes and freestanding birth centers. Their practice environments are typically more relaxed and home-like, promoting comfort and a sense of autonomy for the birthing mother. However, they may not have immediate access to hospital-based technology or surgical support if complications occur.

Scope of Practice and Medical Authority 

Another important distinction lies in the scope of practice and medical authority each provider holds. 

The Philosophy of Care 

Despite differences in training and licensing, both CNMs and Traditional Midwives share a philosophy centered on respect for the natural process of birth. They emphasize patient education, informed choice, and emotional support. 

However, their approaches can differ in focus: 

Choosing between them often depends on your comfort level with medical technology and your preferences for birth setting and intervention.

Safety and Outcomes 

Safety is a key consideration for any expectant parent. Research shows that both Certified Nurse Midwives and Traditional Midwives provide safe, effective care — when matched appropriately to the patient’s risk level. 

For low-risk pregnancies, midwifery care (in any form) is associated with lower rates of cesarean births, fewer interventions, and higher satisfaction. For pregnancies with medical complications or higher risk factors, a Certified Nurse Midwife working in a hospital or collaborative setting is typically the safer option. 

Ultimately, safety depends on the provider’s training, the birth environment, and clear communication between midwife and medical teams.

Conclusion: Empowering Choices for Every Family 

Both Certified Nurse Midwives and Traditional Midwives bring unique strengths to the childbirth experience. CNMs offer a combination of medical knowledge and compassionate care, making them ideal for women who want the reassurance of advanced training and access to hospital support. Traditional Midwives provide deeply personalized, home-centered care that celebrates the natural beauty of birth.