Laws pertaining to midwifery vary greatly by state. The most important thing to understand before you hire a midwife in the State of Michigan is that there are absolutely no laws that pertain to midwifery outside of nursing, or outside hospital walls. Therefore, if you choose a home birth or a freestanding birth center with a midwife, licensed or not, there is no defined scope of practice, no guideline for assessments, no definition for risking out, and no protocol for transfer of care.
Literally anyone can call herself, practice, and advertise as a “midwife” in the state of Michigan. There simply are no rules to follow other than those an individual midwife makes up for herself, or those defined by her employer…ie a hosptial.
For these reasons the quality of care can be downright reckless, and accountability is scarce. It’s impossible to hold a negligent midwife accountable if there are no rules by which they can be held accountable.
What kind of midwives are available in Michigan?
*Please visit Certification and Education to learn more about the educational background and training of various types of midwives.
- CNMs are licensed in every state in the US, including Michigan
- CMs are NOT licensed in Michigan
- CPMs, DEMs, and Lay Midwives are NOT licensed in Michigan. (The licensing status for CPMs, DEMs, and lay midwives varies widely by state. Even if these midwives are “licensed” in a given state, the rules to which they are expected to practice vary widely too.)
In the State of Michigan, CNMs are the only kind of licensed midwife. When a care provider such as a CNM is licensed through the state, they have a defined scope of practice defined by nursing that is written into the Public Health Code, and governed by a state-appointed board. In the case of a CNM, the Board of Nursing establishes rules that govern practices, and provides a body of oversight to a limited degree. The rules are non-specific to midwifery and do not specify practices particular to out-of-hospital birth.
In Michigan, we have CNMs who practice in hospitals or hospital-affiliated birth centers, andCNMs who practice in the home birth setting or freestanding birth centers. While certification of CNMs regardless of place of practice is the same, the philosophies and scope of practice of CNMs who practice in different settings can be vastly different. Often this is because midwives who practice in the hospital setting, or in a hospital-affiliated birth center are governed by the rules, practices, and safety precautions of the hospital. These midwives are working within a fully collaborative, integrated network with safety parameters and scope of practice built within the very structure of their work environment. For example, midwives practicing in a hospital or hospital-affiliated birth center carry malpractice insurance, while almost always a midwife practicing outside a hospital does not.
Regardless of setting for intended place of birth, it is important to always Verify A License of any care provider before hiring.