I have already written extensively on the differences between CNMs/ CMs and CPMs, about how there is a national divide between these qualifications which may prove very hard to bridge, and about how the lack of a unified standard of midwifery in the US continues to divide and destabilize our profession. Part of the problem is that laws vary so greatly between state to state. In some states, Certified Professional Midwives (CPMs) are legal, in other states they are not recognized at all and must practice illegally and under the radar, even though they have studied and and been credentialed by a national certification board (NARM, the North American Registry of Midwives). It’s rather infuriating, given that the only thing stopping them from legal recognition and practice are the state to state differences in law. I’m not really going to go through the differences between CPMs/ CNMs/ CMs (read the link above), but instead focus on the fact that some very exciting legislation has recently been introduced by Congresswoman Chellie Pingree in an attempt to gain federal recognition of CPMs (thus eliminating the state-by-state discrepancies) as well as allowing them to be medicaid providers. The rational behind this is that once Medicaid recognizes a specific type of clinician as a medicaid provider, all of the other insurance companies usually follow Medicaid’s lead. You can read the full text of the the proposed legislation here: H.R. 1054. The driving force behind this legislation is the MAMA campaign, spearheaded by the Midwives Alliance of North America (MANA) and Citizens for Midwifery (CfM).
In New York State, CNMs/ CMs practice legally but CPMs do not. I personally know of several friends who have had lovely, safe, wonderful births attended by CPMs in this state, but unfortunately these midwives did so illegally, with no back-up and no recourse if something went wrong. Being charged with practicing medicine without a license is very serious, and especially tragic given that CPMs do have certifications, but are unable to obtain licences in various states depending on state legislation. How wonderful it would be if CPMs were federally recognized the same way CNMs are (although the bitter politician in me wonders if the ACNM is going to welcome this legislation with open arms). In any case, check out the MAMA campaign, and let’s keep our fingers crossed!