In many states, certified nurse-midwives, with nurse practitioner status, are available as licensed primary providers of prenatal care during pregnancy. Generally, to obtain status as a nurse practitioner, a midwife must first become an RN through an associate's or bachelor's degree and then get a master's degree or higher in nursing, along with many hours of clinical training in the specialty. Midwives must pass a national exam and maintain an active nursing license.
Knowledgeable nurse-midwives may offer basic testing for causes of recurrent miscarriages in states where they can operate as standalone practitioners, but midwives would most likely refer complicated pregnancies to an OB/GYN. Midwives also usually have an arrangement with a physician for backup support if complications arise unexpectedly. They would usually not be sole providers of prenatal care in high-risk pregnancy situations.
Sources:
American College of Obstetricians and Gynecologists, "ACOG Educatioon Pamphlet AB012." Accessed 10 Jul 2008.
