Becoming a licensed midwife in Kentucky requires navigating distinct regulatory and educational pathways, as the state recognizes two different types of professionals who provide prenatal, labor, and postpartum care. Individuals aspiring to this profession must adhere closely to Kentucky’s specific statutes and administrative regulations to ensure their practice is both lawful and clinically competent. Understanding the difference between the two recognized routes is the first step toward a career focused on supporting women and newborns through the childbirth continuum.
Types of Midwives Recognized in Kentucky
Kentucky legally recognizes two midwifery professions, each with its own educational requirements and scope of practice. The first is the Certified Nurse Midwife (CNM), whose practice is rooted in the nursing model of care. CNMs are licensed as Advanced Practice Registered Nurses (APRNs) within the state’s healthcare system. The second is the Licensed Certified Professional Midwife (LCPM), who follows a non-nursing, direct-entry path. LCPMs focus primarily on out-of-hospital birth settings, while the CNM path dictates a different educational trajectory and employment setting.
The Certified Nurse Midwife Pathway
The Certified Nurse Midwife path is an academic route beginning with obtaining an active Registered Nurse (RN) license. This requires completing an accredited nursing program and passing the national licensure exam. The RN background is followed by graduate-level education, requiring a master’s or doctoral degree from a nurse-midwifery program accredited by the Accreditation Commission for Midwifery Education (ACME). These programs include coursework and clinical training covering women’s health, obstetrics, gynecology, and primary care. Candidates must then pass the national certification examination administered by the American Midwifery Certification Board (AMCB), which awards the CNM credential necessary for state licensure as an APRN.
The Certified Professional Midwife Pathway
The Certified Professional Midwife path is a non-nursing route focusing on the out-of-hospital model of care for low-risk pregnancy and birth. LCPM candidates complete their education through either a program accredited by the Midwifery Education Accreditation Council (MEAC) or the Portfolio Evaluation Process (PEP). The MEAC curriculum emphasizes the natural process of birth and monitoring maternal and fetal well-being in non-hospital environments. The PEP pathway is a clinical apprenticeship route demonstrating competency through documented experience under qualified preceptors. All candidates must pass the national certification examination administered by the North American Registry of Midwives (NARM), which is mandatory before applying for Kentucky licensure as an LCPM.
Kentucky State Licensing Requirements
Both CNMs and LCPMs must secure licensure from the Kentucky Board of Nursing (KBN) to practice legally. Certified Nurse Midwives apply to the KBN for licensure as an Advanced Practice Registered Nurse (APRN) under Kentucky Revised Statutes (KRS) Chapter 314. This process includes obtaining the APRN license with the CNM designation and applying for prescriptive authority. CNMs must adhere to annual renewal requirements, including completing at least five contact hours of pharmacology continuing education yearly.
The Licensed Certified Professional Midwife (LCPM) applies for licensure directly through the KBN, which has regulated LCPMs since 2020 under KRS 314.400. The application requires proof of current NARM certification and several other certifications and courses:
- Current certification in Neonatal Resuscitation Program (NRP).
- Current certification in American Heart Association Basic Life Support (BLS).
- State-required courses on Domestic Violence.
- State-required courses on Pediatric Abusive Head Trauma.
LCPM licenses are renewed annually between September 15th and October 31st, requiring the maintenance of the NARM, NRP, and BLS certifications.
Scope of Practice and Employment Settings
The scope of practice for midwives is defined by their credential, with CNMs having a broader range of clinical permissions. CNMs, as APRNs, are licensed independent providers managing a woman’s health across the lifespan, including gynecologic, primary care, and maternity services. They can attend births in all settings, though most CNMs practice within hospital systems. Kentucky law allows CNMs to practice without physician supervision, often collaborating with obstetricians and specialists.
Licensed Certified Professional Midwives (LCPMs) are legally permitted to provide care for individuals with low-risk pregnancies, including prenatal care, childbirth attendance, postpartum care, and care of the normal newborn. LCPMs are statutorily limited to practicing in out-of-hospital settings, such as licensed birth centers or the client’s home. Their practice requires established guidelines for consultation and referral if a client develops risk factors that exceed the LCPM’s defined scope of practice.
Career Outlook for Midwives in Kentucky
The career outlook for midwives depends on the chosen credential. Certified Nurse Midwives command a higher salary range due to their advanced practice status and employment in hospital systems, with average annual salaries between $98,000 and $110,000. However, the CNM job market in Kentucky is smaller compared to other states, and the number of practicing CNMs has seen a slight decline in recent years.
The outlook for Licensed Certified Professional Midwives (LCPMs) is focused on the growing demand for out-of-hospital birth options. Although LCPMs are a newer, smaller population of licensed providers, the demand for home birth and birth center services is increasing. LCPM salaries average closer to $55,000 annually, reflecting their operation in a private practice or birth center model. Professional growth for both CNMs and LCPMs is tied to the expansion of women’s health services.