If you are exploring your options for pregnancy and birth care, particularly if you are interested in giving birth outside a hospital, you may have come across the credential "CPM." Certified Professional Midwives represent a distinct branch of midwifery with a deep focus on physiologic birth in community settings.

Here is what you should know about who CPMs are, how they are trained, what they can do, and how to find out whether CPM care is available where you live.

What Does CPM Stand For?

CPM stands for Certified Professional Midwife. CPMs are midwives who specialize in providing care during pregnancy, birth, and the postpartum period, primarily in out-of-hospital settings like homes and freestanding birth centers.

The CPM credential was established in 1994 by the North American Registry of Midwives (NARM) to create a national standard for midwives practicing outside the hospital system. It is the only midwifery credential that specifically requires training in out-of-hospital birth.

How CPMs Are Trained

One of the most distinctive things about CPMs is their education pathway. Unlike Certified Nurse-Midwives (CNMs), who follow a nursing-to-graduate-school route, CPMs can reach their credential through multiple pathways:

Pathway 1: MEAC-Accredited Midwifery Program

Some CPMs attend a midwifery school accredited by the Midwifery Education Accreditation Council (MEAC). These are standalone midwifery programs (not housed within nursing schools) that focus specifically on the art and science of midwifery. Programs include both classroom learning and clinical training, with required hours attending births under supervision.

Pathway 2: Apprenticeship (Portfolio Evaluation Process)

The apprenticeship pathway, also known as the Portfolio Evaluation Process (PEP), allows aspiring midwives to learn under the direct mentorship of an experienced midwife. This is a structured, documented process that includes:

  • Specific didactic study requirements
  • A minimum number of prenatal visits, births attended, and postpartum visits
  • Skills verification by qualified preceptors
  • Completion of required clinical benchmarks

This pathway honors the centuries-old tradition of learning midwifery through hands-on mentorship, while holding apprentices to measurable, verifiable standards.

The NARM Exam

Regardless of which educational pathway they follow, all CPM candidates must pass the same comprehensive exam administered by NARM. This written examination covers:

  • Antepartum (prenatal) care
  • Intrapartum (labor and birth) care
  • Postpartum care
  • Newborn care
  • Professional issues and standards
  • Emergency management

CPMs must also demonstrate competency through a skills assessment and maintain their certification through ongoing continuing education.

What CPMs Do: Scope of Practice

CPMs provide a focused scope of care centered on healthy, low-risk pregnancy and birth. Their practice typically includes:

Prenatal Care

  • Comprehensive health history and risk assessment
  • Physical exams, including fundal height measurement and fetal heart rate monitoring
  • Ordering and interpreting routine lab work (blood type, CBC, urinalysis, glucose screening, GBS cultures)
  • Nutritional counseling and lifestyle support
  • Emotional and psychosocial support
  • Referrals for ultrasound and other diagnostic imaging

Labor and Birth Support

  • Continuous one-on-one care during labor (a hallmark of CPM practice)
  • Skilled assessment of labor progress
  • Fetal heart rate monitoring with Doppler
  • Comfort measures, positioning support, and hydrotherapy
  • Management of the second stage (pushing) and the third stage (placenta delivery)
  • Newborn assessment and resuscitation if needed

Postpartum Care

  • Home visits in the early days after birth (often within 24 to 48 hours)
  • Breastfeeding support and troubleshooting
  • Newborn screening and assessment
  • Maternal recovery monitoring, including uterine involution and emotional wellbeing
  • Referrals for postpartum mood disorders or complications

What CPMs Generally Do Not Do

CPMs typically do not:

  • Prescribe medications (though this varies by state)
  • Perform surgery
  • Attend births in hospitals
  • Manage high-risk pregnancies independently

This is by design, not by limitation. CPM practice is built around supporting the physiologic process of birth for healthy people with uncomplicated pregnancies. When situations fall outside their scope, CPMs refer to or co-manage with physicians and CNMs.

The Philosophy Behind CPM Care

CPM care is rooted in what is often called the "midwives model of care," which holds that:

  • Pregnancy and birth are normal life events, not inherently medical ones
  • The birthing person is the primary decision-maker in their own care
  • Emotional, psychological, and spiritual wellbeing are inseparable from physical health
  • Intervention should be used only when clearly indicated, not as routine
  • The home or birth center environment can be a safe and empowering place to give birth for low-risk individuals

Research published in the Journal of Midwifery & Women's Health has found that planned home births attended by CPMs for low-risk pregnancies are associated with low rates of intervention and comparable safety outcomes when appropriate screening, risk assessment, and transfer protocols are in place.

State Licensure: The Patchwork Reality

Here is where things get complicated. Unlike CNMs, who are recognized in all 50 states, CPM licensure varies dramatically from state to state:

  • Licensed and regulated states. Many states (including Oregon, Colorado, Minnesota, New Mexico, and others) offer licensure or certification for CPMs, with clear legal frameworks for their practice.
  • Legally authorized but not licensed. In some states, CPMs can practice legally but without formal licensure or state oversight.
  • Legal gray areas. A few states neither explicitly license nor prohibit CPM practice, creating uncertainty for both midwives and families.
  • Illegal or effectively prohibited. A small number of states effectively prevent CPMs from practicing through laws that restrict midwifery to nurses or physicians.

If you are considering working with a CPM, one of the first things to do is find out the legal status in your state. The Big Push for Midwives and NARM both maintain current information about state-by-state CPM regulation.

Why Does This Matter?

In states where CPMs are licensed, you benefit from:

  • Regulatory oversight and accountability
  • Required continuing education
  • Clear standards for practice, including transfer protocols
  • Potential insurance coverage (Medicaid covers CPM services in some licensed states)

In states without licensure, finding a CPM may be more challenging, and you may need to pay out of pocket.

The CPM and the Broader Midwifery Landscape

It helps to understand where CPMs fit alongside other types of midwives:

  • CNMs (Certified Nurse-Midwives) are nursing-trained, practice in all settings including hospitals, and have prescriptive authority. They are licensed in all 50 states.
  • CPMs (Certified Professional Midwives) are trained specifically for out-of-hospital birth and hold NARM certification. Their legal status varies by state.
  • CMs (Certified Midwives) have the same graduate-level midwifery training as CNMs but without the nursing degree. They are currently licensed in only a handful of states.
  • Traditional or lay midwives may have extensive experience but do not hold a national credential.

These are not rankings of quality. They represent different pathways to midwifery, each with its own strengths, philosophies, and regulatory contexts.

Who Might Choose a CPM?

CPM care may be a good fit if:

  • You are planning a home birth or birth center birth
  • You want a provider whose entire training is focused on out-of-hospital care
  • You value continuity of care, meaning a deep, ongoing relationship with your midwife throughout pregnancy
  • You want continuous one-on-one support during labor
  • You are drawn to a practice philosophy that treats birth as a normal life event
  • You want your prenatal and postpartum care to happen in your own home or a home-like setting

That said, CPM care is not appropriate for everyone. If you have significant health complications, a history of preterm birth, or other risk factors, a CNM or OB-GYN (or a combination) may be a better primary provider for your pregnancy.

Finding a CPM

If a Certified Professional Midwife sounds like the right fit for your birth experience, start by checking your state's licensure status, then look for providers in your area. BAABY can help you connect with CPMs near you, learn about their training and approach, and begin the conversation about whether their care aligns with your vision for pregnancy and birth.