Safeguarding modern midwifery

About the Site

Centered on CNM/CM best practice and the liability exposures inherent in contemporary clinical work.

About the Author

Why midwives & counsel read

These articles translate CNM/CM standards, legal doctrine, and hospital culture into actionable guidance so clinicians and counsel can navigate modern liability without sacrificing care.

Legal risks in everyday practice

Responsible CNM/CM care and informed legal strategy demand clarity on designations, standards, and how hospital expectations shift from unit to unit.

We outline how negative assumptions, corporate metrics, and knowledge gaps erode public trust and distort courtroom narratives.

Hospital systems & representation

Content focuses on CNM/CM hospital work—where role creep, policy churn, and inconsistent onboarding create hidden exposure.

Attorneys and administrators get primers that distinguish licensure pathways, scope boundaries, and why those differences matter in discovery.

Who this serves

  • CNMs/CMs reconciling bedside realities with evolving standards of care.
  • Hospital leaders repairing cultures of care and aligning policy with safe practice.
  • Attorneys, risk teams, and patients who need a grounded view of each midwifery designation.

September 24, 2024

AMERICAN COLLEGE OF NURSE-MIDWIVES

Updated November 5, 2025

DEFINITION OF MIDWIFERY AND SCOPE OF PRACTICE FOR CERTIFIED NURSE-MIDWIVES AND CERTIFIED MIDWIVES

Olivia Ann Snyder                                 unsplash-image
Photo by Olivia Ann Snyder on Unsplash

Midwifery as practiced by certified nurse-midwives (CNMs) and certified midwives (CMs) encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide care for all individuals who seek midwifery care, inclusive of gender identities and sexual orientations. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. They conduct physical examinations; independently prescribe medications, including but not limited to, controlled substances, treatment of substance use disorder, and expedited partner therapy; admit, manage, and discharge patients; order and interpret laboratory and diagnostic tests; and order medical devices, durable medical equipment, and home health services. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. These services are provided in partnership with individuals and families in diverse settings such as ambulatory care clinics, private offices, telehealth and other methods of remote care delivery, community and public health systems, homes, hospitals, and birth centers. CNMs and CMs are educated in graduate-level midwifery programs accredited by the Accreditation Commission for Midwifery Education (ACME). CNMs and CMs pass a national certification exam administered by the American Midwifery Certification Board (AMCB) to receive the professional designation of CNM (if they have an active registered nurse [RN] credential at the time of the certification exam) or CM.

Andrea Buccelli                 unsplash-image
Photo by Andrea Buccelli on Unsplash

CNMs and CMs must demonstrate that they meet the Core Competencies for Basic Midwifery Practice1 of the American College of Nurse-Midwives (ACNM) upon completion of their midwifery education programs and must practice in accordance with ACNM Standards for the Practice of Midwifery.2 ACNM competencies and standards are consistent with or exceed the global competencies and standards for the practice of midwifery as defined by the International Confederation of Midwives.3 To maintain the designation of CNM or CM, midwives must be recertified every 5 years through AMCB and must meet specific continuing education requirements.

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| 1 REFERENCES: 1. American College of Nurse-Midwives. ACNM core competencies for basic midwifery practice. Published March 20, 2020. Accessed April 13, 2021. https://www.midwife.org/acnm/files/acnmlibrarydata/uploadfilename/000000000050/A CNMCoreCompetenciesMar2020_final.pdf

2. American College of Nurse-Midwives. Standards for the practice of midwifery. Published 2011. Accessed April 13, 2021. http://www.midwife.org/acnm/files/acnmlibrarydata/uploadfilename/000000000051/sta ndards_for_practice_of_midwifery_sept_2011.pdf

3. International Confederation of Midwives. Essential Competencies for Midwifery Practice: 2019 Update. Published October 2019. Accessed April 13, 2021. https://www.internationalmidwives.org/assets/files/general-files/2019/10/icmcompetencies-en-print-october-2019_final_18-oct-5db05248843e8.pdf

Source: Scope of Practice Taskforce Approved: ACNM Board of Directors, Dec. 2011. Updated: Feb. 2012, Dec. 2021 8403 Colesville Road, Suite 1230, Silver Spring, MD 20910-6374 • ph. 240.485.1800 • fax: 240.485.1818 • www.midwife.org | 2