Understanding the Types of Midwives
Before you begin interviewing midwives, it helps to understand the different credential types and what they mean for your care. A Certified Nurse-Midwife (CNM) holds a nursing degree followed by a graduate-level midwifery education accredited by the Accreditation Commission for Midwifery Education. CNMs are licensed in all fifty states and can practice in hospitals, birth centers, and homes. They can prescribe medications and order diagnostic tests, and they are typically eligible for insurance reimbursement.
A Certified Professional Midwife (CPM) is credentialed through the North American Registry of Midwives and specializes in out-of-hospital birth. CPMs complete rigorous clinical training that emphasizes physiologic birth and may learn through accredited programs, apprenticeships, or portfolio evaluation pathways. CPM licensure varies by state, with some states offering full licensure and others having no regulatory framework at all. A Certified Midwife (CM) completes the same graduate-level education as a CNM but enters from a non-nursing background. CMs are currently licensed in a limited number of states. Understanding these distinctions helps you assess which type of midwife is available in your area and covered by your insurance.
Credentials and Experience to Verify
Once you have identified midwives in your area, take time to verify their credentials. Ask to see their current license and any national certifications. You can verify CNM credentials through the American Midwifery Certification Board and CPM credentials through the North American Registry of Midwives. Beyond paperwork, ask about clinical experience: how many births they have attended, how long they have been practicing, and what types of births they have managed, including breech presentations, twins, or VBACs (vaginal birth after cesarean).
It is also wise to ask about their transfer rate and outcomes. A midwife who is transparent about the percentage of clients who transfer to hospital care during labor, as well as outcomes such as cesarean rates among transferred clients, is demonstrating both honesty and competence. Ask about their training in neonatal resuscitation, hemorrhage management, and other emergencies. Every practicing midwife should hold current certification in neonatal resuscitation (NRP) and carry appropriate emergency equipment and medications to every birth.
Questions to Ask During Your Consultation
Most midwives offer a free or low-cost initial consultation, and this meeting is your opportunity to gather essential information. Start with practical questions: What does your fee include, and are there additional costs for labs, ultrasounds, or birth pool rental? What is your availability around my due date, and who serves as your backup if you are unavailable? How do you handle after-hours communication? Then move into clinical territory: What is your approach to managing prolonged labor? Under what circumstances do you recommend transfer? Do you have a collaborative relationship with a local OB or hospital?
Do not overlook the personal and cultural dimensions. Ask about their experience serving families from your community and whether they have specific training in culturally responsive care. For Black families, this is especially important given the well-documented disparities in maternal health outcomes. A midwife who understands the historical and systemic context of Black maternal health and who actively works to create a safe, affirming environment can make a meaningful difference in your birth experience.
Finding the Right Philosophy Fit
Midwifery philosophy can vary considerably from one practitioner to another. Some midwives lean heavily toward a hands-off, physiologic approach, trusting the birthing body to do its work with minimal intervention. Others are more clinical in style, preferring frequent monitoring and a structured approach to labor management. Neither approach is inherently better, but it matters that your midwife's philosophy aligns with your own values and comfort level.
Discuss specific scenarios to gauge alignment. How does your midwife feel about eating and drinking during labor? What is their stance on induction techniques if you go past your due date? How do they approach pain management, and what non-pharmacological tools do they offer? What is their position on newborn procedures such as vitamin K, eye ointment, and the hepatitis B vaccine? A midwife who listens to your preferences without judgment and supports your informed decision-making, even when your choices differ from what she might personally recommend, is a strong indicator of a good fit.
Trust Your Instincts
After you have done your research, checked credentials, and asked all the right questions, pay attention to how you feel. Birth is one of the most vulnerable experiences of your life, and the person supporting you through it needs to be someone you trust deeply. Notice whether you feel heard and respected during your consultation. Does this midwife make space for your questions, or do you feel rushed? Does she validate your concerns, or does she dismiss them? Do you feel a sense of ease and safety in her presence?
It is entirely reasonable to consult with more than one midwife before making your decision. This is a significant relationship, and taking the time to find the right match is an investment in the quality of your birth experience. If something feels off during a consultation, trust that feeling, even if you cannot articulate exactly why. Your intuition about who should be in your birth space is a powerful guide, and the right midwife will honor that instinct rather than pressure you into a commitment before you are ready.