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 | ||||||
