If you’re exploring home birth or out-of-hospital maternity support in Pennsylvania, it’s critical to understand what the law actually says—and what it doesn’t.
Direct entry midwives—those who enter the work through apprenticeship, certification, or calling rather than nursing school—have served Pennsylvania families for generations. Pennsylvania licenses nurse-midwives and, as of Act 14 of 2026, certified midwives. Cardinal Birth is not in those licensed categories. Traditional midwives are not licensed by Pennsylvania, and families who hire them are choosing this model with that disclosed.
WHAT IS A DIRECT ENTRY MIDWIFE?
Direct entry midwives do not become nurses first. They often train through community-based pathways or national certification bodies, or through faith-based mentorship. Examples include:
Certified Professional Midwives (CPMs) – credentialed by the North American Registry of Midwives (NARM)
Traditional midwives – trained by elders, usually through apprenticeship
Religious or faith-based birth keepers – who serve based on spiritual calling, not medical training
Holistic birth workers – sometimes combining herbalism, bodywork, or ancestral knowledge
Student/apprentice midwives – who are learning in the field, not in a nursing program
These midwives may be highly trained, deeply experienced, and spiritually called—but traditional midwives are not licensed by Pennsylvania.
THE LEGAL REALITY IN PENNSYLVANIA
Pennsylvania licenses nurse-midwives and, as of Act 14 of 2026, certified midwives. Cardinal Birth is not in those licensed categories. Other traditional midwives are not licensed by Pennsylvania.
This legal distinction matters to families choosing out-of-hospital care. Families should understand the disclosed model, ask questions, and make their own informed decisions.
WHAT DIRECT ENTRY MIDWIVES CAN SAFELY OFFER (AND WHAT THEY RISK)
Traditional midwives serve families under a disclosed, unlicensed model. The legal environment can create uncertainty and families should understand the responsibilities and risks of their choices.
Even when families give full, informed consent, families should seek clear disclosure about the midwife’s training, model, and emergency planning.
SO WHAT CAN BE DONE?
While Pennsylvania does not provide a licensure pathway for traditional midwives, families still have the right to:
Choose their own support system
Learn from traditional birth knowledge
Invite trusted individuals into their birth space
Practice their faith and traditions in pregnancy and birth
Take full responsibility for their decisions outside the system
AT CARDINAL BIRTH
These are traditional midwifery services, not state-licensed medical care. Pennsylvania does not license traditional midwives. Cardinal Birth is not a licensed medical provider. Families who hire us are choosing this model with that disclosed.