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Curricula · Hands-On Healthcare · Northern Idaho

Licensed Midwife: the Idaho Path

Idaho licenses midwives who are not nurses. A licensed midwife (L.M.) attends healthy women through pregnancy, at home or out-of-hospital births, and for six weeks after. The road runs through a national certification earned mostly by apprenticeship. It can start with observing births in the teen years. The practice that results can be sized to fit a family.

Ed. 2026–27Builds on the Hands-On Healthcare core pathChecked 2026-09-26

Why this field is on the list · as of September 2026

$104,611Idaho living wage, one earner, three children
$4,500–$6,500Reported fee per birth in the panhandle, including prenatal and postpartum care
≈ $110,000Gross from 20 births a year at about $5,500 each, before business costs

It can pass the one-income test, but only at a full caseload. BLS publishes no wage for licensed midwives, because nearly all are self-employed. Income is simply births times fee, minus costs. About 20 births a year at a typical panhandle fee reaches the three-child bar before costs. After supplies, insurance, travel, continuing education and an assistant at births, the net is lower. At 8 to 12 births a year, it is a strong second income that one spouse can fit around the family.

The work stays in human hands. A midwife palpates the baby’s position and listens to the heart with a handheld Doppler. She reads a laboring woman’s face and breathing and catches the baby. She repairs a tear and decides, sometimes in minutes, whether a transfer to the hospital is needed. It happens in bedrooms and farmhouses, often an hour or more from the nearest hospital. AI can help with scheduling and charting. It cannot sit through a 20-hour labor.

Watch for: fees vary widely. The fee range above comes from a local home-birth information page, not a survey. Before counting on any figure, ask two or three working midwives what they charge and how many births they attend each year.

01 · Two kinds of midwifeNurse or not

Many midwives attending home births around Bonners Ferry and Sandpoint are not nurses. Since July 1, 2024, those midwives must hold an Idaho license. Anyone can check a midwife’s license on the state licensing site.

Licensed midwife (L.M.) / CPM

Not a nurse. Holds the national Certified Professional Midwife (CPM) credential from the North American Registry of Midwives (NARM), plus an Idaho license.

Attends out-of-hospital births: at home, or in a freestanding birth center (Idaho does not license birth centers). Trained mostly by apprenticeship, usually in 3 to 5 years after high school.

This page covers this path.

Certified nurse-midwife (CNM)

A registered nurse with a graduate degree in midwifery, certified by the American Midwifery Certification Board. Can work in hospitals, deliver in birth centers and at home, prescribe medication and provide well-woman care.

Takes an RN (2–4 years) plus a master’s or doctorate (2–3 years). BLS publishes no Idaho wage for CNMs, because there are too few in the state. It will be covered with nursing.

Doula

Not a medical provider, and no license. A doula gives comfort, support and information during labor and after the birth. Doula training takes a few days to a few weeks.

It is a useful first step toward midwifery. It gets a young woman into births, and it teaches her how labor looks and sounds.

02 · The ladderFrom first course to an Idaho license

One NARM rule shapes the whole plan: births attended before a high school diploma (or its equivalent) do not count toward certification. The teen years are for learning, observing and deciding. The countable apprenticeship starts after graduation. Ask NARM how it wants a homeschool diploma documented before starting.

  1. CPR, neonatal resuscitation and doula training (teen years)

    An adult and infant CPR card and the Neonatal Resuscitation Program (NRP) course. Both are required for the CPM and must be kept current. A doula course is also worth taking, along with a basic childbirth-education class.

    A few hundred dollars in course fees

  2. Observing births (teen years)

    Some midwives let a mature teenager observe prenatal visits and births, with the family’s consent. This is the best way to find out whether the work suits her. It does not count toward NARM’s numbers, but it makes the later apprenticeship easier to get and easier to finish.

  3. Apprenticeship or midwifery school (after high school)

    There are two main routes to the CPM.

    Portfolio Evaluation Process (PEP): an apprenticeship under a NARM-registered preceptor, a practicing midwife who supervises and signs off each skill. This is how most panhandle midwives trained, and it can be done entirely in the area.

    A MEAC-accredited school: distance programs accredited by the Midwifery Education Accreditation Council, with clinical work done under a local preceptor. Examples include Midwives College of Utah, Mercy in Action, National Midwifery Institute and Commonsense Childbirth School of Midwifery.

    Either way, NARM requires at least 2 years of training. By the end, the student must have:

    • about 55 births: 10 observed, 20 as an assistant, 20 as the primary midwife under supervision, and 5 more with continuity of care
    • 75 prenatal exams, 20 newborn exams and 40 postpartum exams
    • current CPR and NRP certification

    Usually 3–5 years; the pace depends on how many births the preceptor attends

  4. The NARM exam: Certified Professional Midwife

    A 300-question written exam. On the PEP route, NARM’s fees total about $2,430, including the exam. MEAC graduates pay about $1,365. The CPM is renewed every 3 years ($216), with continuing education and peer review.

  5. The Idaho license: L.M.

    Idaho requires the CPM plus three extra courses from MEAC-accredited programs: pharmacology, treatment of shock and IV therapy, and suturing. The license comes from the Idaho Board of Nursing. It must be renewed every 2 years, expiring on the midwife’s birthday, and outcome data is reported at each renewal.

    The license covers Idaho only. Washington and Montana license midwives under their own laws. A Bonners Ferry midwife cannot attend a birth across the state line on an Idaho license.

    Self-employed. Income depends on caseload (see section 04).

03 · The lawWhat the Idaho license allows

Idaho rewrote its midwifery law in 2024 (Idaho Code Title 54, Chapter 55). The Board of Nursing now regulates midwives, advised by a Midwifery Advisory Committee, and biennial licensing began April 1, 2026. Earlier Idaho licensing was voluntary. Now it is required.

Who needs a license

Anyone who practices midwifery for pay must be licensed. Practicing without a license is a misdemeanor, and a second offense is a felony. The law exempts:

Who a licensed midwife may not care for

The law sets conditions that rule out a midwife-attended birth. These include:

Some other conditions require the midwife to share care with a physician: diabetes, thyroid disease, epilepsy and high blood pressure among them. The law also lists when a midwife must refer a patient or transfer her to a hospital.

Consent, records and transport

Before care begins, the midwife must give the family written disclosures, including:

Records are kept for 9 years. Physicians and EMS crews who take over care in a transfer are protected from liability for the midwife’s acts.

Medicaid

Idaho Medicaid has covered care by enrolled licensed midwives since 2012. It pays a single global fee that includes the newborn’s care to six weeks. Ask what the current rate is, since it can differ from private fees.

04 · Income and caseloadHow many births make a living

Births per yearGross at about $5,500 eachWhat it looks like
8about $44,000A part-time practice. On call for roughly one birth every six weeks.
12about $66,000A strong second income. One birth a month, with prenatal and postpartum visits in between.
20about $110,000Reaches the three-child bar before costs. Rarely more than a few weeks without a birth.
30+$165,000+Usually a shared practice with a partner midwife and a birth assistant.

These gross figures are before business costs. The costs include birth supplies ($200–$500 a birth, often billed to the family), equipment, malpractice insurance if carried, license and certification fees, continuing education, fuel and an assistant at births.

For a parent at home

Midwifery can fit a homeschooling family better than almost any other healthcare field, with one hard catch. Most visits are scheduled, often in the client’s home, so the midwife sets her own days. Births are not scheduled. From about 37 weeks, she must be able to leave at any hour for a labor that may last all night and into the next day. That takes a spouse, grandparent or older child who can take over the house on short notice. The apprenticeship years work the same way, with less control over the calendar.

05 · The home-school yearsWhat to study before the apprenticeship

Grades 6–8

  • Life science, with a focus on human reproduction and growth, taught as the family sees fit
  • Fractions, ratios and unit conversions (dosages, due dates, weights in pounds and ounces)
  • Helping with babies and young children, and caring for animals at birth on a farm

Grades 9–10

  • Biology and chemistry with labs
  • Nutrition, since midwives counsel on diet through pregnancy
  • CPR and first-aid certification
  • A doula course and a childbirth-education class

Grades 11–12

  • Anatomy & physiology I and II and microbiology through dual credit at North Idaho College. These also keep the nursing and CNM route open.
  • Statistics, for reading studies and explaining risk to families
  • NRP, and observing prenatal visits and births with a willing midwife
  • Contacting local midwives about a preceptorship to start after graduation

Every year

  • Calm under pressure, and honest records of what happened and when
  • Stamina: long nights, driving country roads in winter, kneeling for hours
  • Talking plainly with families about risk, including when to go to the hospital

Tie to the Verification Track

A midwife works far from a second opinion, so she has to check her own work. She confirms fetal heart tones against her own count, charts blood pressure and blood loss as she goes, and runs each patient against the legal list of conditions that rule out a home birth. When a transfer comes, she hands the hospital a record it can trust. The Verification Track trains the same habit: check the reading, check the record, and know when to stop and call for help.

06 · SourcesWhere these facts come from

Checked 2026-09-26