A person who is trained in both nursing and midwifery and, in the US, is certified by the American College of Nurse-Midwives (ACNM). In order to practice, a nurse-midwife must pass an examination for certification by a national board. Nurse-midwife training focuses on the management of women's health care, particularly pregnancy, childbirth, the postpartum period, care of the newborn, and gynecology. Nurse-midwife training promotes a noninterventional, individualized approach to normal pregnancy and childbirth, involving a certain amount of education of women — an approach that is often time-consuming.
Historically, nurse-midwives arose in the US to serve the poor and address high maternal and infant mortality among the underserved. The Frontier Nursing Service was the first nurse-midwifery program in the US. Under the leadership of Mary Breckenridge, British-trained midwives were recruited to rural Kentucky to "safeguard the lives and health of mothers and children." Their care resulted in marked reductions in maternal and infant mortality. In 1932, the Maternity Center Association opened the first American educational program for nurse-midwives; it was in Harlem. By 1944, there were 6 schools for nurse-midwives in the US, including the Catholic Maternity Institute in New Mexico, which aimed to provide maternity care for the poor Spanish-speaking population of the Santa Fe area.
Midwives in Ireland, Scotland, and England deliver more than 65% of all babies, and the proportions in Denmark, Sweden, Norway, Finland, and Germany exceed 85%. These countries have fewer obstetrical interventions than the US, as well as lower maternal, neonatal, and infant mortality rates and higher rates of breastfeeding. A nurse-midwife is said to be engaged in the practice of nurse-midwifery. If certified by the American College of Nurse-Midwives (ACNM), the nurse-midwife is a CNM (Certified Nurse-Midwife).
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