The Legality of Midwifery

Well... I suppose I should clarify the statement about midwifery being illegal... Midwifery itself isn't banned outright, it has to do with the type of midwife training that the midwife has. Direct-entry midwives are illegal in 11 states, and are legal but unregulated in 16 states.

There are two types of midwives, nurse-midwives and direct-entry midwives. Nurse-midwives (as one might guess by the title) are trained in both nursing and midwifery, and since they are nurses, there generally is no question that these women are trained medical professionals and they're licensed as such.

Direct-entry is an alternative path into the profession that doesn't involve going to nursing school. Direct-entry midwives learn midwifery through self-study, apprenticeship, a midwifery school, or a college- or university-based program distinct from the discipline of nursing. The issue is that some states don't recognize this as a legitimate way to become a midwife and don't want to license midwives as medical professionals.

The Midwives Alliance of North America has published Direct-Entry Midwifery State-by-State Legal Status chart. In some states direct-entry midwives are regulated by licenses or certifications, in others direct-entry midwifery is legal but not regulated, and in 11 states (well... 10 states and one district) it's outright prohibited. The states that direct-entry midwives are prohibited from practicing in are Alabama, Washington DC, Illinois, Indiana, Iowa, Kentucky, Maryland, Missouri, North Carolina, South Dakota, and Wyoming.

In the states where direct-entry midwives are legal but unregulated, you run into the problem that they're not considered medical professionals. Which means that insurance likely will not cover expenses.... and you can also run into other problems. I read a blog of someone online who lived in a state where direct-entry midwives were legal but unregulated and she had decided that she wasn't going to do all the ultrasounds and usual medical things that most women do, she was just going to be measured by her midwife. All went well until she had her baby and the government refused to give her newborn son a SSN. Since her midwife wasn't a licensed medical professional, and due to some changes thanks to the Department of Homeland Security, her midwife was not authorized to sign the paperwork confirming that the child actually was born. It turned out that she had seen a chiropractor during her pregnancy and since he was licensed as a medical professional, he could sign off on the paperwork... but it was a real headache to get the government to admit the child actually existed because she had decided to go an alternate path from what's commonly done in this country.