Certified nurse midwife - delineation of privileges - Kaleida Health 2025

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In some states, statute specifies whether a nurse midwife must complete a transition to practice period before practicing or prescribing independently. In other states, certified nurse midwives have full independent practice and prescriptive authority, meaning they practice independently with no physician oversight.
During a normal hospital labor and birth, a CNM and CM can admit a pregnant person to the hospital, write medical orders, including prescribing medications, manage labor and birth, deliver the baby, and provide postpartum care independently within the scope of the CNM and CMs education and training.
Several states maintain that hospitals not discriminate against midwives seeking hospital privileges, while several others expressly limit admitting privileges to physicians. In most states there is no regulation concerning who may admit.
The license for midwifery is the same, not more comprehensive at all. CNMs just also have nursing experience. CPMs are the only ones trained specifically for out of hospital birth.
Midwives who work for hospitals, obstetrics clinics and birthing centers might get a range of additional benefits, including 401(k), paid time off and health insurance. They can increase their pay by earning additional certifications, completing a nursing degree or taking on leadership roles.
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If you have a health condition, or have had a difficult delivery in the past, a midwife may not be the best choice for you. Additionally, they are not typically able to manage multiple births (twins, triplets, or more). They cannot perform cesarean sections or intervene in the event of a medical emergency when needed.

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