Their ladies-in-waiting were flanked by midwives, usually older, experienced women who had attended many births over their years and assisted in deliveries. Midwives took with them into the birthing chambers a special aura of knowledge and comfort (though in some cases, the difference between a midwife and pre-modern notions of a village which were somewhat interchangeable). They were the medical experts of the time, the closest thing to nurses at the birthing bedside that women had.

Incredibly, it wasn’t until the early 20th century in England that midwives were required to have certification, or until the 1920s in the United States that nurse-midwives (of necessity schooled in formal medical training) were introduced. Today, both midwives and nurses in the hospital setting have carved out niches, both of which, though their focuses differ, are aimed to bring the mother through her delivery and produce a healthy new baby.

Today, the modern midwife must be certified, no doubt in part due to the campaign doctors took up against them throughout the 20th century, citing larger amounts of child and mother deaths at their hands. A Certified Professional Midwife (CPM) now studies midwifery on her own, through apprenticeship, in a private midwifery school or in a university or college-based program, which is distinct from nursing and then goes on to receive certification from the North American Registry of Midwives (NARM). A midwife can and often does assist the mother in a hospital setting, but she is also the primary caregiver during a home birth and will stay with her patient after delivery to ensure that all is well and no further attention is necessary (that of a medical sort must be provided in a hospital). Midwives appeal to mothers who want a more natural birth, the way women did it long before organized hospitals and IVs with painkillers.

Nurses, on the other hand, follow the traditional educational route, with nursing school or a variety of nursing degrees, like the Bachelor of Science in Nursing, the RN to BSN (Resident Nurse to Bachelor of Science Nursing), even master’s and doctoral programs. Resident nurses, in fact, have a multitude of educational opportunities available if they wish to continue their studies; a graduate degree is a way of obtaining a higher salary, and nurses can get something like an RN to MSN online.

Nurses, of course, work specifically in hospitals and are not necessarily confined to the labor and delivery department, though some may particularly prefer it. Nurses also don’t perform the actual deliveries – that job is in the hands of an obstetrician.

The certified nurse-midwife is an amalgam of the two professions and one which might be very appealing to expectant mothers. A certified nurse-midwife has both the education of a traditionally trained nurse (most have graduate degrees, as the profession is considered that of an advanced practice nurse) and the certification of a midwife, allowing them to work in both hospital and home settings. She provides for her patient the thorough medical background of a nurse with the focus and expertise of a midwife and can be an all-around reassuring presence for a woman in labor.

Midwives do not come cheap. The average salary for a midwife is currently well over $60,000 annually, and some make over $100,000. In comparison, the average nurse salary can range anywhere from $40,000 to $70,000, but of course, graduate levels of education, plus years of experience may skew the amount higher. Certified nurse-midwives can expect salaries comparable to that of nurses, though privately practicing can provide a higher salary range.

So before you get your RN BSN degree or pursue your future as a midwife, take some time and contrast and compare these very different, but very similar vocations. Each has a rich history and a bright future.

The author of this post is Michelle Gavins, who is studying to become an obstetrician.  Michelle loves children and can’t wait to finish her degree.