The way members of an occupation or profession define themselves influences both their interaction with other occupations in the workplace and the future direction of their profession. In order to determine how certified nurse-midwives define their occupational identity, a two-phase study was done. In the first phase, 20 nurse-midwives were interviewed at length. It was found that they used traditional midwifery ideologies of advocacy, normalcy, and competency to differentiate themselves from physicians and nurses. A nationwide survey was then sent to 300 nurse-midwives in which they were asked whether they identified more with midwifery, nursing, or medicine. Their choice of identity was then examined in light of midwifery, ideologies, situational and background factors, and ability to tolerate ambiguity. The analysis of the survey indicated that nurse-midwives identify occupationally with midwifery, rather than nursing or medicine, even though there is some alliance with both of the other occupations. The variables that were most predictive of a positive midwifery occupational identity were philosophical agreement with nurse-midwifery ideologies and increased years of nurse-midwifery practice. A short discussion of the implications of a midwifery versus a nursing identity concludes the article.