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Direct-Entry Midwife — CPM/LM/CM
Some details on this page are not yet confirmed against an official source. See sources below or contact the licensing board to verify.
Licensed
Legal Status
No
CPM Required
Not Required
Physician Collab.
Allowed
Home Birth
Varies
CE Hours
Varies
Total Initial Fees
Direct-Entry Midwifery Legal Status
VerifiedLicensed State
Direct-entry midwives may practice with state authorization
State License Title
Licensed Midwife
Additional Notes
Florida has its own midwifery licensing program under Chapter 467 Florida Statutes.
Approximately 35 states license or regulate direct-entry midwives in some form. About 10-12 states prohibit or have no legal pathway for non-nurse midwifery practice. Several states occupy a legal gray area where practice is not explicitly illegal but is also not authorized or regulated. The legal landscape is actively evolving with ongoing legislative efforts in many states. This is distinct from Certified Nurse-Midwives (CNMs), who are licensed in all 50 states.
Midwifery Education & Clinical Training
VerifiedMEAC Program
Not Required
Apprenticeship Route
Not Accepted
Portfolio Evaluation (PEP)
Not Accepted
Direct-entry midwives enter the profession through non-nursing pathways. MEAC (Midwifery Education Accreditation Council) accredits midwifery education programs. Some states also accept apprenticeship routes or the NARM Portfolio Evaluation Process (PEP). Clinical training typically requires attending a minimum of 40 births (20 as primary midwife) including prenatal, birth, and postpartum care. This credential is distinct from the Certified Nurse-Midwife (CNM), which requires a nursing degree.
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National Certification Requirements
VerifiedCPM Not Required
Certified Professional Midwife (NARM)
CM Not Accepted
Certified Midwife (AMCB)
Required Certifications
CPR and NRP certifications typically required
Three main credentials exist for direct-entry midwives: CPM (Certified Professional Midwife) issued by NARM through the CPE examination, CM (Certified Midwife) issued by AMCB requiring a master's-level midwifery program, and LM (Licensed Midwife) which is a state-level designation. Most states require the CPM credential. A few states (notably New York, New Jersey, Delaware, Rhode Island) also accept the CM credential. All licensed midwives must maintain current NRP and CPR certifications.
NARM CPE & State Examinations
VerifiedNARM CPE Not Required
Certified Professional Examination
State Jurisprudence Exam
State Exam Required
The NARM (North American Registry of Midwives) CPE (Certified Professional Examination) is the primary qualifying exam for the CPM credential. It consists of a written examination covering midwifery knowledge, skills, and clinical judgment. Most states that license direct-entry midwives require passage of the NARM CPE. Some states additionally require a state-specific jurisprudence examination covering local laws, regulations, and practice standards. NRP (Neonatal Resuscitation Program) and CPR certifications are universally required.
Overall licensing difficulty: 19/100
Study recommendation: 1–2 weeks of focused review is usually sufficient
Rating based on limited data
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Difficulty rating based on education, exam, and experience requirements. Individual experience may vary.
NARM CPM Examination
Format
Written examination and skills assessment
How long should you study? Most candidates study 2–4 weeks before taking the NARM CPM Examination.
Study Materials & Exam Prep — CPM NARM Exam
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Practice Settings & Scope
VerifiedHome Birth
Allowed
Birth Center
Allowed
VBAC
N/A
Physician Collaboration
Not Required
Prescriptive Authority
None
Scope Details
Consistent with Chapter 467 F.S. and DOH structure
Direct-entry midwives primarily attend births in home and birth center settings for low-risk pregnancies. Scope varies enormously by state: some allow VBAC (Vaginal Birth After Cesarean), some restrict it. Some states require written physician collaboration agreements, while others grant significant autonomy. Very few states grant any prescriptive authority (limited to emergency medications). Midwives are responsible for prenatal care, labor and delivery, and postpartum care within their defined scope.
| Fee | Amount |
|---|---|
Total Initial Fees Contact Florida Department of Health, Council of Licensed Midwifery for complete fee schedule | Varies |
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Renewal & CE Requirements
Verified2 years
Renewal Period
—
CE Hours Required
—
Renewal Fee
Regulatory Board
Direct-entry midwife licenses must be renewed on schedule with the state licensing authority. Most states require 20-50 continuing education contact hours per renewal cycle (typically 2-3 years). CE topics must include midwifery clinical skills, pharmacology, neonatal resuscitation, risk assessment, cultural competency, and professional ethics. NRP and CPR recertification is required at every renewal.
Out-of-State Reciprocity
VerifiedEndorsement Available
Yes
Comity Available
Varies
Reciprocity Requirements
Most states that license direct-entry midwives offer reciprocity or endorsement for midwives licensed in other states. Requirements typically include verification of current CPM certification through NARM, active license in good standing in another state, current NRP and CPR certifications, and completion of any state-specific requirements such as a jurisprudence exam or physician collaboration agreement.
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See how requirements, costs, and timelines differ across all 50 states.
Florida has a unique direct-entry midwifery licensing program that does not require CPM certification. Florida uses its own approved programs and state examination rather than the NARM pathway used by most states. Licenses renew every 2 years. Neighboring states include Alabama, Georgia, each with their own midwife requirements. Florida maintains a detailed scope of practice for licensed midwives that includes protocols for handling emergencies during out-of-hospital births.
Florida has its own midwifery licensing program under Chapter 467 Florida Statutes.
The Council of Licensed Midwifery oversees the profession.
Must graduate from an approved midwifery program and pass an examination.
Licenses renewed biennially by December 31.
Background screening with fingerprint retention required ($43.25 fee).
Applications expire one year from date received.
Florida's midwifery licensing distinguishes between Licensed Midwives (LMs) who practice direct-entry midwifery and Certified Nurse-Midwives (CNMs) who are regulated as advanced practice registered nurses under the Board of Nursing.
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Florida licenses direct-entry midwives under the Licensed Midwife designation. All licensing is managed through the Florida Department of Health, Council of Licensed Midwifery.
Requirements vary by state and change frequently. Always verify current requirements with your state licensing authority. This page covers direct-entry midwives only, not Certified Nurse-Midwives (CNMs).