Practitioner and Practice Characteristics of Certified Professional Midwives in the United States: Results of the 2011 North American Registry of Midwives Survey

IntroductionNo data describing certified professional midwives (CPMs) currently exist in the literature, although CPMs attend the majority of home births in the United States. This study addresses this gap by assessing the demographics, education levels, routes to certification, and practice characteristics of currently practicing CPMs. MethodsData were collected from a survey of CPMs conducted by the North American Registry of Midwives (NARM) between July and October 2011. In order to assess generalization to the entire population of practicing CPMs, we also completed a nonresponse bias analysis. We examined midwives' demographic, education, certification, and practice characteristics using descriptive and nonparametric, bivariable statistics. ResultsMore than 90% of the 568 respondents attended at least some college, and 47.1% hold a bachelor's degree or greater. CPMs spent a median of 3 years (interquartile range, 2-5 years) in training before attending births as a primary midwife. However, 38.9% of currently practicing CPMs had less than 3 years of training. Regarding pathways to certification, 48.5% utilized the portfolio evaluation process (PEP); 36.9% graduated from a Midwifery Education and Accreditation Council (MEAC)-accredited school; 14.5% were already licensed by a state as a direct-entry midwife; and 0.7% were already a certified nurse-midwife or certified midwife, although many CPMs reported a blended education pathway. One-fifth (21%) of respondents identified as midwives of color. Whereas nearly one-third (31.8%) of CPM respondents reported that 95% or more of their clients were white, 5.2% serve populations that are 90% or more nonwhite. CPMs of color are significantly more likely to serve clients of color (P < .001). DiscussionTraining and nonmidwifery education levels of most CPMs practicing in the United States align with the Global Standards for Midwifery Education established by the International Confederation of Midwives, although there are still clear areas for improvement. (C) 2015 by the American College of Nurse-Midwives.