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Direct-Entry Midwife — CPM/LM/CM
Direct-entry midwife licensing varies dramatically by state — from full licensure to outright prohibition. CPM certification through NARM, scope of practice, VBAC policies, physician collaboration requirements, and continuing education differ across jurisdictions. This is distinct from the Certified Nurse-Midwife (CNM) credential, which requires a nursing degree.
51
Total States
35
License/Regulate
33
Require CPM
22.2 hrs
Avg CE Hours
Direct-entry midwives enter the profession through non-nursing pathways, including MEAC-accredited programs and apprenticeships. Licensing requirements and legal status vary enormously across states.
The Certified Professional Midwife (CPM) credential is issued by NARM (North American Registry of Midwives) after passing the CPE (Certified Professional Examination). Most states that license direct-entry midwives require CPM certification. Education pathways include MEAC-accredited programs, apprenticeships, and the Portfolio Evaluation Process (PEP).
Approximately 35 states license or regulate direct-entry midwives. About 10-12 states prohibit practice or have no legal pathway. Several states exist in a gray area where practice is not explicitly illegal but is unregulated. This is a rapidly evolving area with active legislative battles in many states.
Direct-entry midwives primarily attend home births and birth center births for low-risk pregnancies. Scope varies by state: VBAC policies, physician collaboration requirements, and prescriptive authority differ significantly. Some states grant broad autonomy while others require detailed physician supervision agreements.
Side-by-side fees, hours, exams, and timelines across all 50 states. Sort by cost, hours, or any column.
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Click any column header to sort. Click a state to view full requirements.
| State | Legal Status | CPM Req. | Phys. Collab. | CE Hours | Total Fees | Confidence | Verified |
|---|---|---|---|---|---|---|---|
| Alabama(AL) | Licensed | Yes | Yes | — | — | high | March 2026 |
| Alaska(AK) | Licensed | Yes | No | — | $250 | high | March 2026 |
| Arizona(AZ) | Licensed | Yes | No | — | — | high | March 2026 |
| Arkansas(AR) | Licensed | Yes | No | — | — | high | March 2026 |
| California(CA) | Licensed | No | No | 36 | — | high | March 2026 |
| Colorado(CO) | registered | Yes | No | — | — | high | March 2026 |
| Connecticut(CT) | Unregulated | No | No | — | — | high | March 2026 |
| Delaware(DE) | Licensed | Yes | No | — | — | high | March 2026 |
| District of Columbia(DC) | Licensed | Yes | No | — | — | high | March 2026 |
| Florida(FL) | Licensed | No | No | — | — | high | March 2026 |
| Georgia(GA) | Unregulated | No | No | — | — | high | March 2026 |
| Hawaii(HI) | Licensed | Yes | No | — | $50 | high | March 2026 |
| Idaho(ID) | Licensed | Yes | No | 10 | — | high | March 2026 |
| Illinois(IL) | Licensed | Yes | No | 20 | — | high | March 2026 |
| Indiana(IN) | Licensed | Yes | No | — | $50 | high | March 2026 |
| Iowa(IA) | Licensed | Yes | No | — | — | high | March 2026 |
| Kansas(KS) | Unregulated | No | No | — | — | high | March 2026 |
| Kentucky(KY) | Licensed | Yes | No | — | $165 | high | March 2026 |
| Louisiana(LA) | Licensed | Yes | Yes | — | $200 | high | March 2026 |
| Maine(ME) | Licensed | Yes | No | — | — | high | March 2026 |
| Maryland(MD) | Licensed | Yes | No | — | — | high | March 2026 |
| Massachusetts(MA) | legal-unregulated for CPMs; CPM practice is not prohibited but is entirely unregulated by any Massachusetts statute or board | No | No | — | — | high | March 2026 |
| Michigan(MI) | Licensed | Yes | No | 30 | $650 | high | March 2026 |
| Minnesota(MN) | Licensed | Yes | No | — | $233 | high | March 2026 |
| Mississippi(MS) | Unregulated | No | No | — | — | high | March 2026 |
| Missouri(MO) | Unregulated | No | No | — | — | high | March 2026 |
| Montana(MT) | Licensed | No | No | — | $200 | high | March 2026 |
| Nebraska(NE) | Unregulated | No | No | — | — | high | March 2026 |
| Nevada(NV) | Unregulated | No | No | — | — | high | March 2026 |
| New Hampshire(NH) | certified | Yes | No | — | — | high | March 2026 |
| New Jersey(NJ) | Licensed | Yes | Yes | — | — | high | March 2026 |
| New Mexico(NM) | Licensed | No | No | — | — | high | March 2026 |
| New York(NY) | Licensed | No | Yes | No CE hours required | $322 | high | March 2026 |
| North Carolina(NC) | prohibited / unlicensed — CPM practice is not authorized under current NC law. NC GS Chapter 90 Article 10A governs only CNMs. No licensure pathway exists for CPMs under current enacted law. | No | No | — | — | high | March 2026 |
| North Dakota(ND) | Unregulated | No | No | null (N/A — no licensing system) | — | high | March 2026 |
| Ohio(OH) | Unregulated | No | No | — | — | high | March 2026 |
| Oklahoma(OK) | Licensed | Yes | No | — | — | high | March 2026 |
| Oregon(OR) | Licensed | Yes | No | 35 | — | high | March 2026 |
| Pennsylvania(PA) | legal-unregulated (direct-entry/lay midwifery is neither licensed nor explicitly prohibited under Pennsylvania law) | No | No | — | — | high | March 2026 |
| Rhode Island(RI) | Licensed | Yes | No | — | — | high | March 2026 |
| South Carolina(SC) | Licensed | Yes | No | — | $50 | high | March 2026 |
| South Dakota(SD) | Licensed | Yes | No | — | $1000 | high | March 2026 |
| Tennessee(TN) | certified | Yes | No | — | — | high | March 2026 |
| Texas(TX) | Licensed | Yes | No | — | $195 | high | March 2026 |
| Utah(UT) | Licensed | Yes | No | 2 | — | high | March 2026 |
| Vermont(VT) | Licensed | Yes | No | — | — | high | March 2026 |
| Virginia(VA) | Licensed | Yes | No | — | — | high | March 2026 |
| Washington(WA) | Licensed | Yes | No | — | — | high | March 2026 |
| West Virginia(WV) | Unregulated | No | No | — | — | high | March 2026 |
| Wisconsin(WI) | Licensed | Yes | No | — | $10 | high | March 2026 |
| Wyoming(WY) | Licensed | Yes | No | — | — | high | March 2026 |
Direct-entry midwives work alongside other healthcare professionals. Explore related licensing requirements.
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