by Hadassah Ryan

Created on: April 14, 2009

There are vital differences between a Nurse-Midwife and a Lay Midwife that a woman making the decision for the care of her pregnancy needs to be aware of.

The Lay Midwife has been around since the dawn of humanity; ever since there were women present to attend to each other's births. A Lay Midwife is simply a woman who has learned the skills of attending to a lady in labour through apprenticeship, workshops and possibly private midwifery schools. She is very experienced, intuitive and often naturally predisposed to the art of child-bearing. Lay Midwives commonly practice not because of the lucrative money to be made (there isn't), but with a sense of urgency born through strong conviction that women need the option of birthing in the most natural way possible.

The most famous Lay Midwife of recent times is Ina May Gaskin of "The Farm". This community of naturally living, "back to the earth" families operated at its peak through the 1970's and early 1980's (and is still in existence now). Ina May, an inspirational and charismatic campaigner for the art of Midwifery, wrote a classic book about birthing called "Spiritual Midwifery". It's a must read for any woman considering using a midwife or homebirthing, but is even quite valuable for a woman turning to the mainstream medical establishment for her birthing experience.

The Lay Midwife faces fierce opposition however. In the U.S., eleven states outlaw Lay Midwifery including Maryland, Alabama, Arkansas, Virginia, Illinois and Georgia. Lay Midwives are often forced to practice secretly and are not comfortable signing birth certificates. They are often found living close to the borders of States that allow Lay Midwifery to best offer their services to those who desire to birth without the oversight of a doctor. Lay Midwives can be and are regularly arrested and charged with practicing Midwifery. Fortunately, community service is more often the penalty as opposed to jail time.

The Certified-Nurse Midwife is, as the name implies, a health practitioner (not always a woman) who has completed nursing school with a Midwifery component. They are registered by the State or Province and can be found practicing in a hospital or Midwifery Practice environment. Many consider a CNM to be the best of both worlds: a balance between the skill and apparent safety the medical establishment has to offer and the age-old practice of traditional Midwifery.

There are those however, who see the CNM as a paltry peace offering; an opportunity recognized by the State to exert influence over this growing movement of women to take back control of their births. The financial implications cannot be overlooked. CNM's can also find themselves facing subtle discrimination once their licensing is complete, when finding a doctor to supervise them as the State requires proves difficult due to lingering beliefs about the competency of Midwives. It can be a no-win situation for a woman who feels called to the art of Midwifery.

The differences between Certified Nurse-Midwives and Lay Midwives are the heart of a nearly thirty year controversy that continues to rage. Future parents who educate themselves thoroughly on their options for birthing will prove to be the weights that will someday swing the balance to one side or the other.

Which side will you join?

Learn more about this author, Hadassah Ryan.
Click here to send this author comments or questions.