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How does direct-entry midwifery differ from nurse-midwifery?
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midwifery
Midwives assisting a birth while astrologers consult sky charts; woodcut relief print from Jakob Rueff's De conceptu et generatione hominis (1554; The Expert Midwife).
The primary difference between direct-entry midwifery and nurse-midwifery lies in the practitioner's educational pathway and professional background.
- Nurse-Midwifery: These professionals are registered nurses who pursue additional, postgraduate training in midwifery. This education can be completed at the certificate or masterās level.12
- Direct-Entry Midwifery: These practitioners receive formal training specifically in midwifery and enter the healthcare field directly as midwives, rather than transitioning from another health profession. In the United States, they may hold designations such as certified midwife (CM) or certified professional midwife (CPM).2
While both types of midwives are considered skilled birth attendants who provide care in homes, birth centers, and hospital settings, their paths to licensure differ. It is important to distinguish both from "lay" or informally trained midwives; the World Health Organization classifies lay midwives as unskilled birth attendants due to their lack of formal training in emergency techniques, which is associated with higher risks to maternal and infant health.2