In addition to the Benefits of Accreditation discussed in this video and in this tool kit provided by the Council for Higher Education Accreditation, visitors can find answers to the questions often asked by prospective students, midwifery schools, midwives, and consumers below.


What is accreditation?

The practice of accreditation is a means of conducting non-governmental, peer evaluation of educational institutions and programs in order to ensure a basic level of quality. Private educational associations, such as MEAC, adopt criteria reflecting the qualities of a sound educational program and develop procedures for evaluating institutions and programs to determine whether they are operating at basic levels of quality.

What are the benefits of accreditation?

There are benefits of accreditation for schools, students, the midwifery profession, and the public.  There are a few videos that may be helpful to you.

MEAC and its schools talk about the benefits here.

The Association of Specialized and Professional Accreditors (ASPA) discuss the benefits here.

What are the standards for MEAC accreditation?

Each institution or program accredited by MEAC:

  1. Measures student success with respect to the school’s mission;
  2. Bases its course of education on nationally recognized standards;
  3. Utilizes qualified faculty for its didactic and clinical education;
  4. Maintains appropriate facilities, equipment, supplies and other resources;
  5. Practices sound financial management;
  6. Provides appropriate student services;
  7. Establishes policies and procedures regarding student affairs;
  8. Includes minimum lengths of didactic and clinical education;
  9. Has a mechanism for responding to complaints; and
  10. Is in compliance with Title IV of the Higher Education Act, if it chooses to participate.


What are the steps to earn accreditation?

To become accredited, each program or institution must:

  1. Submit an application;
  2. Conduct a self-evaluation study of its program based on MEAC standards;
  3. Submit this study for review by an outside committee of peers and experts in midwifery education;
  4. Open its doors to a thorough inspection; and then
  5. Repeat the process every three to five years.

The applicant program or institution voluntarily elects to apply for accreditation and it voluntarily agrees to comply with all MEAC standards. The burden of proof in demonstrating compliance with standards rests with the institution or program, not with MEAC. The institution must prove to MEAC that it meets or exceeds the standards. MEAC considers information about an applicant institution from any source in reaching its conclusions.

You can learn more about the process of MEAC accreditation in this 5 minute overview: http://youtu.be/cN1XAXfhlEw

What is “institutional” accreditation?

Institutional accreditation refers to the review and approval of an entire institution, including all of its financial and management aspects. MEAC institutional accreditation is limited to independent or freestanding educational entities that primarily provide midwifery education.

If the institution also offers other educational programs beyond the scope of midwifery expertise, the institution must be accredited by another agency recognized by the USED and the midwifery educational program can then apply for MEAC programmatic accreditation.

What is “programmatic” accreditation?

Programmatic accreditation refers to the review and approval of a midwifery program that legally functions as part of an accredited institution with a scope larger than midwifery. In order to apply for program accreditation, the program must be housed within an institution already accredited by an agency recognized by the US Department of Education.

What is the difference between accreditation and pre-accreditation?

To apply for accreditation, institutions or programs must have graduated at least four students — the majority of whom are licensed or certified midwives or are working in midwifery or a related field. Institutions or programs that do not meet these criteria may apply for pre-accreditation, but must otherwise meet the same standards as those set for institutions or programs seeking accreditation.

Where can I find definitions of terms in MEAC Standards or the website?

Please see [link to glossary] for more information about terms that you find on this site.


Why would a school want to become accredited?

MEAC accreditation—

  1. Verifies that an institution or program meets established standards.
  2. Enhances its national reputation and represents peer recognition.
  3. Provides communication to institutions about issues, changes, and updates within the midwifery community that affect accreditation standards and procedures.
  4. Is an advocacy process that helps midwifery programs evaluate themselves according to their own goals.
  5. Provides technical assistance to the applicant schools to achieve a high quality program that meets MEAC standards.
  6. Provides an opportunity for the school to receive feedback on program content , operation, and direction.
  7. Provides a reliable basis for inter- and intra-institutional cooperative practices, including admissions and transfer of credit.
  8. Promotes ongoing self-evaluation and continuous improvement and provides an effective system for accountability.
  9. Serves as a short- and long-term planning tool.
  10. Aids staff, board, and administration in establishing priorities and developing action plans.
  11. Offers a unique professional development opportunity for school staff and faculty to evaluate their own institutions or programs.
  12. Is helpful to midwifery programs located within larger institutions that need support to maintin the necessary courses, qualified faculty, and adequate administrative and financial support.
  13. Assists institutions in determining the acceptability of transfer credits.
  14. Is a recruiting tool to attract the brightest and best faculty and students.
  15. Protects an institution or program against harmful internal and external pressure.
  16. Helps to identify institutions and programs for the investment of public and private funds.
  17. Establishes one of several considerations used as a basis for determining eligibility for Federal student financial aid programs.


What types of programs and institutions are eligible for accreditation?

MEAC welcomes all direct-entry midwifery education programs in the United States to participate in the process of accreditation. MEAC has developed accreditation processes that honor a diversity of educational models including: structured apprenticeships, distance education, correspondence education, self-paced programs, programs within large institutions, and free-standing schools or colleges, offering certificates or degrees in midwifery.

What is the accreditation process?

You can gain a 5 minute overview of the process by watching this introductory video: http://youtu.be/cN1XAXfhlEw

Is it difficult to attain accreditation?

Accreditation is a self-evaluation process which helps educational entities evaluate their own programs according to their own goals, and to educate midwives according to basic standards set by Midwives Alliance of North America (MANA), and North American Registry of Midwives (NARM). The process includes support and guidance from MEAC for program clarification, development, and improvement. Programs that do not initially meet all MEAC standards are given technical assistance and opportunities to correct weaknesses.

Do all MEAC schools use a single version of midwifery curriculum?

No. Accreditation provides an opportunity for each program/institution to develop its unique perspective and design in midwifery education. There is no formula for midwifery education imposed, other than that graduates have mastered the essential competencies outlined in the MEAC Curriculum Checklist. This Checklist integrates the core competencies developed by MANA, the Knowledge, Skills and Abilities as required by NARM for certification as well as the International Confederation of Midwives Essential Competencies. Each program will implement these requirements within its unique educational environment to best suit the needs of its students.

Can students at MEAC-accredited schools apply for federal financial aid?

In order for students to have access to educational grants and loans from the federal government, the program or institution they attend must be approved in two steps:

  1. The program/institution must be accredited by a federally recognized accrediting agency and,
  2. The program must submit an application directly to the U.S. Department of Education to be approved to participate in Title IV student financial aid programs.

After both of these steps have been successfully completed by the institution or program, its students can then apply for financial aid.

What are actual and potential costs associated with accreditation?

Direct Cost Calculator:

Initial Accreditation Cost:

Number of Students:
Application Fee: $300 $0
Base Rate: $1735 $0
Accredited Program: $6/Student
Accredited Institution: $13/Student
Fee at a program or institution that offers distance or correspondence education: $6/StudentFee at a degree-granting program or institution: $6/StudentFee per student in a program or institution that participates in Title IV: $6/Student
Site Visit Fee (Due 8 weeks in advance of Site Visit): $0

Sustaining Fees:

Number of Students:
Base Rate: $5738 $0
Accredited Program: $75/Student
Accredited Institution: $127/Student
Fee at a program or institution that offers distance or correspondence education: $21/StudentFee at a degree-granting program or institution: $77/StudentFee per student in a program or
institution that participates in Title IV: $52/Student

Indirect Costs:


Required as part of MEAC standards
Annual Audit or financial review required by MEAC
The financial state of the institution is assessed annually by an independent accountant.

  1. If the institution has annual gross revenue that exceeds $150,000, an audit is required every other year and an external financial review is required in the intermediary year.
  2. If the institution has annual gross revenue that is less than $150,000, external financial reviews are required every year.

The school needs to provide a copy of the completed audits and/or external financial reviews including management letters, for the previous two years.

Financial Audits are not required if a program (within an institution) is accredited.

Cost ranges from $1500 to $8000.Financial Reviews generally cost less than full financial audits.
State Licensure fee/state authorization Depends on State e.g Maine (50/year),
Utah ($5000, but not required ),
Oregon ( $14,000 every two years)
Potential Operational Costs
Additional personnel Staffing and AdministrativeExpenses
Estimated personnel hours for example school:
Re-Accreditation Application: 10 hrs
Annual Report:
10 hrs
meetings 40 hrs, writing SER 60 hrs
20 hrs

Student FAQ

What personal qualities does one need to be an excellent midwife?

Midwives require a diverse set of skills and qualities for their practices. Not only do they need excellent interpersonal skills in order to give care in a nurturing way, but they also need to be able to think critically and respond quickly to situations that need immediate action. A short list of ideal midwife qualities would include the following:

  1. Good interpersonal and counseling skills;
  2. Confidence;
  3. Has good hands-on skills;
  4. High ethical standards;
  5. Is not squeamish;
  6. Has a passion for natural birth;
  7. Has physical and emotional stamina;
  8. Is a quick learner;
  9. Handles stressful situations well;
  10. Self-motivated and resourceful;
  11. Has a supportive partner and/or family;
  12. Models a healthy lifestyle.


How does one become a midwife? What education is required?

There are many different paths to becoming a midwife. You will want to learn about the requirements for practicing as a midwife in the state where you would like to work because each state makes its own laws. Depending on the local requirements, you may:

  1. Attend a direct-entry midwifery program or school;
  2. Apprentice with a qualified midwife, completing the Portfolio Evaluation Process (PEP) through NARM;
  3. Complete your coursework through a distance educational program and/or at a local college while completing your clinical requirements with a midwife who is a qualified faculty member of your school;
  4. Become a registered nurse and then attend graduate school to become a Certified NurseMidwife (CNM);
  5. Receive your education in another country and then try to transfer your credentials. You may have to attend continuing education in the United States. (Contact NARM or ACNM about foreign-trained midwives.)
  6. Comparison Chart of different types of midwives:

Most direct-entry midwifery education programs are approximately 3 years in length, although the time period may be shorter or longer depending on the clinical opportunities available and the time a person has to devote to their education.

Why would a student choose a MEAC-accredited school?

For students, accreditation—

  1. Serves a consumer protection purpose by providing assurance that the school or program has been evaluated and has met accepted standards established by and with the profession.
  2. Assists prospective students in identifying acceptable programs or institutions.
  3. Assures students that the school does what it promises on its website and promotional materials.
  4. Ensures that the education the student receives is well-rounded and comprehensive for entrylevel midwifery practice.
  5. Determines that a midwifery education program has set objectives for students who enroll, has provided services that enable these students to meet those objectives, and can in fact show that students have benefited from the learning experiences provided.
  6. Facilitates the process of becoming a Certified Professional Midwife (CPM) through the North American Registry of Midwives. Allows students to participate in federally-funded financial aid programs at participating schools.
  7. Assures students that the school continually undergoes quality-improvement process that includes both self-evaluation and feedback from peers, including other midwifery educators and school administrators.
  8. Improves the chance that a graduate will be able to transfer credits or degrees to another institution for further education or graduate education.
  9. Enhances employment opportunities for graduates in states that base eligibility for licensure upon graduation from an accredited school or program or within midwifery practices that want to see the MEAC “seal of approval.”

To learn more about the importance of accreditation to midwifery students, please watch this helpful video: http://youtu.be/2zBdyBNwwmo

What is midwifery school like?

MEAC accredits many models of midwifery education. From living on site at an intensive immersionstyle school to a self-paced, distance education done in your hometown, there are many pathways to becoming an excellent midwife graduate from a MEAC school. You can get a feel for student life by watching this video: [INSERT MEAC VIDEO LINK HERE AFTER IT IS COMPLETED]

If I enroll in a school that is seeking MEAC accreditation, will I be a graduate of a MEAC-accredited school?

Accreditation is a status that a school earns after demonstrating that it has met MEAC standards and criteria. The accreditation process can take over two years and is not guaranteed. Someone who graduates from a school that is not accredited, but is in process, does not qualify as a MEAC graduate.

If I attend an accredited school, will I also be accredited?

MEAC accreditation is a process for midwifery education programs or institutions, not for individual midwives. Certification, licensure, or registration are the processes which credential individual midwives.

Can students at MEAC-accredited schools apply for federal financial aid?

In order for students to have access to educational grants and loans from the federal government, the program or institution they attend must be approved in two steps:

  1. The program/institution must be accredited by a federally recognized accrediting agency and,
  2. The program must submit an application directly to the U.S. Department of Education to be approved to participate in Title IV student financial aid programs.

After both of these steps have been successfully completed by the institution or program, its students can then apply for financial aid.

What if I live outside the United States?

Every country has its own form of midwifery education but if you are interested in getting a midwifery education in the United States, please see our list of accredited midwifery schools (those that provide distance education are noted). If you choose distance education, you will need to find a licensed or certified midwife to act as your preceptor as part of the clinical experience in these programs. For financial aid information, you need to consult the individual school or institution with which you wish to study.

What if I have already been trained as a midwife in another country?

If you are a practicing midwife in another country, there are some resources you will need to consult in order to practice in the United States of America. We have two agencies which govern the certification of midwives: NARM (North American Registry of Midwives) for CPM (Certified Professional Midwife) certification; and ACNM (American College of Nurse Midwives) for CNM (Certified Nurse-Midwife) certification. Information can be found on their websites. Additional information about midwifery practice in the USA can be obtained from Midwives Alliance of North America (MANA) and Citizens for Midwifery (CFM).


Why is accreditation good for the midwifery profession?

For midwives, accreditation—

  1. Advances the profession by promoting standards of practice and advocating rigorous preparation;
  2. Provides assurance to existing midwifery practices that new midwives entering the group will be trained in the essential knowledge and skills needed to be a competent partner midwife;
  3. Ensures consistency of skills among midwives;
  4. Recognition of profession within health care profession (accreditation is a piece of contemporary American professionalism);
  5. Fosters accountability and therefore, credibility;
  6. Fosters cohesion within the profession (no us vs. them);
  7. Access to financial aid opportunities to increase the numbers of practicing midwives; and
  8. Acts as scaffolding for the next generation – helps the profession to come together to share resources, develop standards, education then means that students are being trained in a forward-thinking system.

In a nutshell, what does a midwife do?

Midwives provide comprehensive care and education for women and their newborns during the childbearing year. This model of care encompasses women’s physical and emotional needs and fosters self-determination throughout the childbearing cycle. Midwives specialize in normal birth and generally refer high-risk women to obstetricians or other medical specialists.

Prior to pregnancy, midwives may offer family planning, well-woman gynecology services, and/or education and assistance with fertility issues.

During pregnancy, she provides comprehensive prenatal care that includes nutritional counseling and discussion of lifestyle issues, with plenty of time to answer any questions and discuss any concerns the family may have. The time spent prenatally establishes a trusting and intimate relationship with the woman and her family. Midwives view their relationship with each client as a partnership. The best way to have a healthy baby is to be a healthy mother. Midwife and mother work together to achieve this– it is a shared responsibility.

A midwife also attends the woman in labor, birth, and the immediate postpartum period, and provides care to the mother and her newborn up to 6 weeks postpartum. They must be able to recognize the warning signs of abnormal conditions requiring referral to a doctor and to carry out emergency measures when no additional help is available. They may attend births in homes, birth centers, or in the case of Certified Nurse Midwives (CNM’s), in hospitals as well.

Midwives consult with or refer to other health care providers when appropriate. They are responsible for keeping accurate records, informing clients of current medical practice in obstetrical care and state laws relating to childbirth, and filing birth certificates.

Where do midwives practice?

Direct-entry midwives usually work in clinics or have offices in their homes and attend births at the client’s home or in a birth center. They work in both urban areas (many home birth clients are welleducated, young professionals living in the city) and in rural areas. Some rural communities, such as the Amish, have a strong preference for midwives and most women birth at home. Certified nurse-midwives usually work in hospitals, although a few have home birth or birth center practices.

What is the average starting salary of a midwife?

Generally, direct-entry midwives do not receive a ‘salary’ that is predictable and dependable. Most direct-entry midwives have private practices, so their income depends on the volume of births that they attend and other services that they provide. A busy homebirth solo practice (one midwife practice) would attend 2-4 births per month. Midwives charge anywhere from $2,000-4,000 per birth, depending on their location. How busy your practice is depends on your location, how established you are in your community, and how well you promote your services.

Most CNMs are employees of practices and therefore receive a salary similar to that of a nursepractitioner in their geographic area.

Are there different kinds of midwives?

Yes, there are different types of midwives in the United States. The two main categories of midwives are:

  1. Direct-entry midwives are educated or trained as midwives without having to become nurses first. They may be Certified Professional Midwives (CPMs), Licensed Midwives (LM) or Registered Midwives (RM), Certified Midwives (CMs) or unregulated lay midwives. The legal status and requirements for direct-entry (non-nurse) midwives vary from state. The Midwives Alliance of North America tracks the laws and regulations in each state for direct-entry midwives.
  2. Nurse-midwives are educated and licensed as nurses first, and then complete additional education in midwifery. They are known as Certified Nurse-Midwives (CNMs). CNMs are licensed to practice in all 50 states. They are usually also licensed in individual states as Nurse Practitioners (NPs). Most CNMs practice in hospitals or birth centers under the supervision of a doctor and must abide by the policies and procedures of the facility.

There are more CNMs than direct-entry midwives practicing in the United States, although direct-entry midwives attend the majority of normal births in hospitals and other settings in many western European countries and are utilized within the Canadian healthcare system.

What is a Certified Professional Midwife (CPM)?

Direct entry midwives are usually credentialed as Certified Professional Midwives (CPMs) by the North American Registry of Midwives (NARM). CPMs are graduates of accredited midwifery education programs or demonstrate that they have met all NARM certification requirements through equivalency, called the Portfolio Evaluation Process. CPMs have also passed the NARM national certification examination. Every three years, CPMs must renew their certification. Most CPMs are self-employed and practice in home or birth center settings. Go to NARM.org or NACPM.org for more information on the CPM.

What is a Licensed Midwife (LM) or Registered Midwife (RM)?

Some direct-entry midwives are state-licensed and in some states, national certification is optional. A midwife who holds a license but may or may not have attained the CPM credential are called licensed or registered midwives. They are legally allowed to practice without being a CPM or CM, as long as they are licensed or regulated by the state.

What is a Certified Midwife (CM)?

There is a direct-entry midwifery credential offered by the American College of Nurse Midwives (ACNM) called the Certified Midwife (CM). Certified midwives have graduated from a midwifery education program accredited by the ACNM Division of Accreditation and have passed a national certification exam administered by the American Midwifery Certification Board (AMCB). They can practice legally throughout the United States. Go to ACNM.org for more information on this option.

What is a Certified Nurse-Midwife (CNM)?

Certified Nurse Midwives (CNMs) are registered nurses who have graduated from a midwifery education program accredited by the ACNM Division of Accreditation, and have passed a national certification exam administered by the AMCB. Many CNMs have received their midwifery education as part of a Master’s Degree program. Most CNM’s work in hospitals, although some attend home births and practice in birth centers. Go to ACNM.org for more information on CNMs.

What is a Lay Midwife?

Some direct-entry midwives choose not to pursue any credential, license, or registration and complete their training through apprenticeship and self-study. Other names for a lay midwife are traditional midwives, granny midwives, traditional birth attendants or independent midwives. Occasionally, the media will use the term “lay midwife” to mean any non-nurse midwife.

What licensing or certification is required to be a direct-entry midwife?

Licensing requirements for direct-entry midwives vary from state to state. Some states require licensing, some have voluntary licensing, some states do not regulate direct-entry midwives, and others have laws prohibiting the practice of direct-entry midwifery. MANA, NARM, and CfM all maintain webpages cataloging state-by-state requirements.

Do midwives carry professional liability insurance?

Most direct-entry midwives are not covered by professional liability insurance, unless it is required for practice in their state or for participation in healthcare plans. Some midwives cannot afford or choose not to purchase professional liability insurance, and at times it has been unavailable to purchase. Instead, most midwives rely on the personal relationships they have with their clients, conscientious practice, and the informed consent and shared responsibility with women and families that they encourage in their practices.


Why is accreditation good for moms and babies?

For the public, accreditation—

  1. Promotes health, safety, and welfare by assuring that midwives are competent health professionals for the community;
  2. Uses tax dollars wisely when it is used as a bases for determining eligibility for federally-funded programs and student financial aid; and
  3. Assures families that when they hire a midwife who graduated from a MEAC-accredited school, they are ready to practice at a certain level.


How can one find out information about a specific midwife or practice?

Occasionally, it is as easy as opening the phone book. You can also check with the Department of Health in your state (or the appropriate licensing authority, or national certification agency, such as NARM) to find licensed or certified midwives. Local La Leche League meetings, parenting groups, health food stores, county health departments, or complementary medicine/alternative health practitioners may have information about midwives in your area. Once you find a midwife, ask for information about her training and credentials and request references from former clients and other health care professionals.

Does insurance cover midwives’ services?

Some health care plans and private insurance companies cover all or part of a midwife’s services if the patient has maternity care coverage; other plans do not. Some plans may only cover lab work and/or complications. In some states, midwifery care is covered by Medicaid healthcare plans and direct-entry midwives save those states millions of dollars. Midwifery services are generally much less expensive than hospital births and obstetrician care. Some midwives are participants in health care plans and bill insurance companies, but others do not.


How do I file a complaint about a MEAC accredited institution or program?

MEAC encourages parties to pursue informal grievance mediation attempts with each other, or with MEAC staff or Board members, to attempt to resolve grievances informally before commencing a formal written complaint process with MEAC. If those attempts fail, MEAC will review complaints received against an institution or program if it is in writing and complies with the guidelines set forth in the Accreditation Handbook, Section G III(P).

What is Adverse Action?