Washington, DC—Since 2010, the International Confederation of Midwives (ICM, www.internationalmidwives.org) has called for minimum education and training standards for midwives in all countries including the United States. ICM also recommends uniformity in how governments license and regulate midwives, robust and transparent government oversight, as well as use of a single midwife credential. Universal implementation of the ICM standards will help ensure women everywhere receive safe and high quality care.
The American College of Obstetricians and Gynecologists (ACOG) endorses the ICM education and training standards and strongly advocates the ICM criteria as a baseline for midwife licensure in the United States, through legislation and regulation. Women in every state should be guaranteed care that meets these important minimum standards.
A March 2015 consensus document, Levels of Maternal Care, developed jointly by ACOG and the Society for Maternal-Fetal Medicine, calls for systems-level improvements, including implementation of a new uniform classification system for how maternal care is delivered across the US, and specifies new regional criteria for facilities including birth centers. While Levels of Maternal Care references certified professional midwives, ACOG holds firm that all midwife providers must meet or exceed the ICM education and training standards.
Here in the US, midwifery groups have no agreed-upon definition of a midwife. There are three separate midwifery credentials — certified nurse midwives (CNMs), certified midwives (CMs), and certified professional midwives (CPMs) — with differing levels of education and training. CNMs and CMs meet and exceed ICM’s minimum education standards. However, possibly as many as two-thirds of CPMs do not meet the ICM standards.
It’s time for the US to uphold the standards for midwifery care expected by women in other nations around the world. Today, US state laws and regulations governing midwifery vary widely; few states require a common, minimum requirement for education and accredited training that every midwife must meet to practice legally.
Our health care partners and state lawmakers must work with us to ensure that no woman in the US receives midwifery care that wouldn’t meet the standards received by women in other, even less developed, nations. ACOG advocates for implementation of the ICM standards in every state to assure all women access to safe, qualified, highly skilled providers.
All midwives—whatever their title or professional designation and regardless of where they practice—should meet the ICM standards, to ensure access to safe, qualified, highly skilled midwives in all settings including birth centers.
*This policy statement is a companion document to the ACOG Policy Statement on Midwifery Education and Certification and the Obstetric Care Consensus document, Levels of Maternal Care, developed jointly by ACOG and the Society for Maternal-Fetal Medicine.
The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 58,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization. www.acog.org