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Direct-Entry Midwife — CPM/LM/CM
Total cost: $200
Governing Authority
Montana Alternative Health Care Board (Board of Alternative Health Care)
Official website →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
$200
Total Initial Fees
Direct-Entry Midwifery Legal Status
VerifiedLicensed State
Direct-entry midwives may practice with state authorization
State License Title
Licensed Direct-Entry Midwife
Additional Notes
Governed by Board of Alternative Health Care.
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
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)
NARM Certification
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 Required
Certified Professional Examination
State Jurisprudence Exam
No State Exam
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: 12/100
Study recommendation: 1–2 weeks of focused review is usually sufficient
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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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Study guides for midwifery certification exams.
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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
Montana licenses direct-entry midwives through the Board of Alternative Health Care. Must be at least 21, have high school diploma, good moral character, and pass NARM exam (score 75+). Extensive practical experience required: 100 prenatal exams, observation of 40 births, 25 births as primary attendant (15 with continuous care).
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 |
|---|---|
Application Fee | $200 |
Renewal Fee | $100 |
Total Initial Fees Contact Montana Board of Alternative Health Care for complete fee schedule | $200 |
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Renewal & CE Requirements
Verified1 year
Renewal Period
—
CE Hours Required
$100
Renewal Fee
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.
Moving to another state? Use our Transfer Tool to see what you need →
Compare Montana with other states →
See how requirements, costs, and timelines differ across all 50 states.
Montana requires one of the most extensive practical experience requirements for midwifery licensure: 100 prenatal exams, 40 birth observations, and 25 births as primary attendant. Licensed through the unique Board of Alternative Health Care.
Governed by Board of Alternative Health Care.
Apprentice application fee is $200, renewal $100.
Must be at least 21 years of age.
Must pass NARM exam with score of 75 or better.
Extensive practical requirements: 100 prenatal exams, 40 birth observations, 25 births as primary (15 with continuous care).
Renewal period March 1 through April 30 for apprentices.
Midwife requirements in nearby states
| State | Total Cost | Timeline | |
|---|---|---|---|
| Montana (you) | $200 | 112–176 wks | |
| Idaho | — | 112–176 wks | → |
| North Dakota | — | 112–176 wks | → |
| South Dakota | $1000 | 112–176 wks | → |
| Wyoming | — | 112–176 wks | → |
See how Montana compares: Midwife License Fees by State — Cheapest to Most Expensive →
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Midwife Schools in Montana
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Moving to Montana? Use our free Transfer Tool to see what you need →
Already licensed elsewhere? See how to transfer your Midwife license to Montana →
Transfer your Midwife license from Montana to: Idaho → | North Dakota → | South Dakota → | Wyoming →
Montana licenses direct-entry midwives under the Licensed Direct-Entry Midwife designation. All licensing is managed through the Montana Alternative Health Care Board (Board of Alternative Health Care).
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).