Midwife, Direct Entry

License required by 28 states

4th most burdensome licensing requirements.

33rd most widely and onerously licensed occupation.

Direct-entry midwives, or lay midwives, are non-nurses who provide prenatal care and childbirth assistance.

Twenty-eight states license direct-entry midwives. (In nine states, the occupation is or appears to be prohibited.) On average, licensed states require $1,383 in fees, more than three years (1,152 days) of education and experience, and around one exam—the fourth most burdensome requirements of the 102 occupations studied. However, because direct-entry midwives are licensed by just over half of states, the occupation is the 33rd most widely and onerously licensed.

License requirements are fairly uniform across states: 20 states require three years of education, all require one or two exams, and 24 require a high school diploma. However, there is some variation. For example, Indiana requires over seven years of education and experience (about 2,695 days, or three years of midwife school plus observation of or participation in 80 births), while Texas requires only one year of education. Fees also vary greatly, from $822 in New York to $2,600 in Wyoming.

States With Licenses

Burden Rank State States Licensed Fees Estimated Calendar Days Lost Education Experience Exams Minimum Grade Minimum Age
1 Indiana 28 $1,000 2695 3 years 80 births 1 12 21
2 New York 28 $822 2190 6 years 1 0 21
3 Montana 28 $1,400 1295 3 years 10 births 1 12 21
4 Colorado 28 $2,100 1195 3 years 5 births 1 12 19
5 Washington 28 $1,674 1095 3 years 2 12 21
6 Louisiana 28 $1,488 1095 3 years 2 12 21
7 Arizona 28 $1,150 1095 3 years 2 12 21
8 Maryland 28 $1,920 1095 3 years 1 12 21
9 Wyoming 28 $2,600 1095 3 years 1 12 0
10 Oregon 28 $1,650 1095 3 years 2 12 0
11 Florida 28 $1,605 1095 3 years and 1 clock hours 1 12 21
12 Delaware 28 $1,253 1095 3 years 1 12 21
13 New Hampshire 28 $1,210 1095 3 years 2 12 0
14 South Carolina 28 $1,200 1095 3 years 2 12 0
15 Tennessee 28 $2,043 1095 3 years 1 12 0
16 New Mexico 28 $1,120 1095 3 years 2 12 0
17 Idaho 28 $2,000 1095 3 years 1 12 0
18 Virginia 28 $1,277 1095 3 years 1 12 0
19 Minnesota 28 $1,200 1095 3 years 1 12 0
20 Utah 28 $1,100 1095 3 years 1 12 0
20 Vermont 28 $1,100 1095 3 years 1 12 0
22 South Dakota 28 $1,043 1095 3 years 1 12 0
23 New Jersey 28 $1,210 1095 3 years 1 0 18
24 California 28 $1,249 1095 3 years 1 0 0
25 Rhode Island 28 $1,080 1095 3 years 1 0 0
26 Arkansas 28 $900 800 40 births 2 12 0
27 Wisconsin 28 $1,085 730 2 years 1 12 0
28 Texas 28 $1,235 365 1 years 2 12 0
N/A Alabama 28 Prohibited or appears to be prohibited
N/A Georgia 28 Prohibited or appears to be prohibited
N/A Illinois 28 Prohibited or appears to be prohibited
N/A Iowa 28 Prohibited or appears to be prohibited
N/A Kentucky 28 Prohibited or appears to be prohibited
N/A Nebraska 28 Prohibited or appears to be prohibited
N/A Nevada 28 Prohibited or appears to be prohibited
N/A North Carolina 28 Prohibited or appears to be prohibited
N/A North Dakota 28 Prohibited or appears to be prohibited

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