There are two main divisions of modern midwifery in the United States, nurse midwives and non-nurse midwives.
Nurse Midwives In the United States, nurse midwives are registered nurses with a bachelors degree in nursing who return to college for two additional years to specialize in midwifery and gynecological care of normal women. Most nurse midwives also have a masters Degree in nursing. Nurse midwives practice in hospitals and medical clinics, and may also deliver babies in birth centers and assist with home births. They are able to prescribe medications and provide care to women from puberty through menopause, not only during childbearing. Nurse-midwives work closely with an obstetrician, who provides consultation and assistance to patients who develop complications. Often, women with high risk pregnancies can receive the benefits of midwifery care from a nurse midwife in collaboration with a physician. Currently 2% of nurse midwives are men.
Non-Nurse Midwives Midwives who are not registered nurses vary greatly in their training, certification and methods. Some are graduates of colleges or schools of midwifery which offer degree and certification programs of different lengths. The American College of Nurse-Midwives (ACNM) certification council provides accreditation to non-nurse midwife programs as well as colleges which graduate nurse midwives. All midwives certified by ACNM must pass the same certifying exam. Other midwives are trained through apprenticeships; they assist a practicing midwife for a period of time to learn the trade.
Midwives deliver children in any number of settings. While the majority of nurse midwives perform deliveries in hospitals, some nurse midwives and many non-nurse midwives often perform home deliveries. In many states midwives perform deliveries at birthing centers where a group of midwives work together. Laws regarding who can practice midwifery and in what circumstances vary from state to state, and some midwives practice outside of the law.
Someone needs to write about the history of midwifery, the competition between mostly rural & female midwives and mostly urban & all male early medical doctors in the 18th and 19th centurys, and modern midwifery in countries other than the US
In the United Kingdom midwives are practitioners in their own right, and take responsibility for the antenatal,intrapartum and postnatal care of women. One may become a registered midwife by completing an eighteen month course (leading to a degree qualification) following completion of nurse training, or by undertaking a 3 year degree in midwifery. All practising midwives must be registered with the UKCC and the ENB and are subject to the local supervising authority. Most midwives work within the National Health Service providing both hospital and community care, but a significant proportion work independently, providing total care for their clients within a community setting. To be a midwife is to be responsible for the woman for whom you are caring at all times, to know when to refer complications to medical staff, but also to act as the woman's advocate, to ensure that she retains some choice and control over her childbirth experience. Many midwives are opposed to the so-called 'medicalisation' of childbirth, preferring a more normal and natural option, to ensure a more satisfactory outcome for mother and baby.