by Tamara Muhammad, BSN, MSN
Midwifery, meaning women assisting women during childbirth, has existed since the earliest human civilizations. The practice of midwifery is customary in many different countries today and has gained widespread popularity in America.
Midwifery is considered one of the oldest professions and is mentioned in the Bible, in the story of Exodus 1:15-21, where two midwives, Shiphrah and Puah, played a pivotal role by refusing to obey Pharaoh’s command to kill all male babies.
They saved the lives of many, including Moses. Also, during the Transatlantic Slave Trade under chattel slavery here in America, enslaved Black women were educated, skilled midwives and provided healthcare for both enslaved women and the families of their enslavers.
After emancipation, Black midwives, often known as “granny midwives,” played a vital role in our communities, providing essential healthcare using deep-rooted traditions passed down through generations.
They offered a holistic approach to birth at a time when access to hospitals was limited due to segregation and Jim Crow laws. Despite their challenges, the legacy of Black midwives was one of hope, safety, protection, and health. Their expertise helped shape cultural perceptions of Black motherhood and uplifted and empowered Black women and their husbands.
They ensured that Black women had access to quality prenatal care that made them feel safe and cared for and “granny midwives” significantly improved the social health of the entire family and our overall community health.
In the 20th century, the rise of medicalized and surgical births, established by White male OBGYNs, led to the suppression of the Black midwives’ profession.
Black midwives faced persecution through systemic racism in efforts to eradicate their profession, particularly in the United States. They were wrongly labeled as incompetent by White male obstetricians and public health officials.
Even though research shows that midwife-assisted births, including those by traditional midwives, had lower maternal and infant mortality rates than physician-attended births, this inaccurate portrayal of Black midwives was a gross misrepresentation of their knowledge, skills, and dedication. This portrayal also led to the displacement and disappearance of Black midwives from the healthcare system.
Due to America’s dark history, it’s been a long journey for Black midwives to come back into the workforce. They make up only 7 percent of all midwives and are dedicated to upholding the legacy of Black midwives.
With the increasing demand and popularity of midwives in America, the medical establishment has recognized their effectiveness and necessity. Midwives offer immeasurable benefits, such as reduced maternal and infant mortality and preterm birth rates, and lower rates of cesarean sections and inductions.
More importantly, midwives empower women to take control of their health, encouraging them to make informed decisions about their birthing plan and care, including the delivery location. The presence of midwives in the healthcare system can help to reassure women and their families by providing confidence and security.
Midwifery encompasses a variety of roles, each with its own set of credentials and practice privileges. Today, 4 types of midwives provide varying levels of care to women and newborns. Understanding this diversity can empower individuals to make informed choices about their healthcare and be knowledgeable about their options.
Certified Nurse Midwives (CNMs): CNMs completed nursing school with a bachelors degree and have also gone to graduate school and completed a degree in midwifery to obtain a master’s or doctorate.
In addition to specializing in pregnancy, birth, and postpartum care, they can also care for newborns for up to three months of age. CNMs conduct regular prenatal visits and annual exams, prescribe medication, diagnose conditions, order lab tests, and manage various reproductive health issues like menstrual irregularities, menopause symptoms, and infertility treatment.
CNMs also manage chronic conditions like diabetes and hypertension and often collaborate with physicians. CNMs are qualified to work in hospitals, homes, private practices, and birth centers. They are certified by the American Midwifery Certification Board and can practice in all 50 states.
Certified Midwives (CMs): CMs have a master’s degree in midwifery and are not nurses. CMs have an undergraduate degree in something other than nursing. They can prescribe medications, make diagnoses, and are certified by the American Midwifery Certification Board. CMs are only licensed to practice in a few states.
Certified Professional Midwives (CPMs): CPMs are not required to be nurses or have any medical background. Entry-level requirements include a high school diploma, and CPMs must complete a set number of births under apprenticeship with another CPM or CNM.
They have completed some coursework and are certified by the North American Registry of Midwives. CPMs are not licensed or legally recognized to practice in all 50 states and cannot prescribe medications; however, their expertise is pregnancy, childbirth, and postpartum care. They work in birthing centers and conduct home births.
Unlicensed or lay midwives: These midwives do not have certification or a license to practice. They are either self-taught or have received some other type of training, which could include an apprenticeship. Unlicensed midwives work exclusively in homes and are not recognized for practicing in most states.
This article is not intended to provide health care advice or recommendations. Please consult your physician to address your healthcare needs.