The following tables present the initial date of issue, general purpose, and revision dates for 3 categories of professional documents created by the American College of Nurse-Midwives (ACNM). These documents describe 1) the professional—certified nurse-midwife and certified midwife, 2) the practice of midwifery, and/or 3) the professional association—the American College of Nurse-Midwives.

Like other professional organizations for health care providers, the American College of Nurse-Midwives issues position statements, guidelines, and documents that define the profession. They reflect the state of practice and knowledge at the time of issue and time of each revision. However, because clinical knowledge and practice can change rapidly, ACNM has always encouraged the certified nurse-midwife (CNM)/certified midwife (CM) to consult the most recent literature when managing care. These lists are not a comprehensive list of all ACNM materials. Rather, they are those documents recognized by the author and members of the national office to be the ones most essential for midwives in practice today (Table 1). These documents can be found on the American College of Nurse-Midwives Web site at

The clinical bulletins (Table 2) are designed to provide an evidence-based, comprehensive analysis of the literature relative to a specific clinical issue. They are peer reviewed and have been published in the Journal of Midwifery & Women's Health.

The strategies for liability risk reduction (Table 3) were designed to guide CNMs/CMs to practice in ways designed to reduce risk of unintended outcomes. Ultimately, the goal of these documents is to decrease malpractice lawsuits and liability judgments against CNMs and CMs.

Table 1.  Essential Documents From the American College of Nurse-Midwives
Date First IssuedName of DocumentDescription of Document and PurposeDate of Revisions, Ammendments
1955Articles of Incorporation and BylawsDefines the purpose, membership, method of conducting business and leadership structure of the organization.1963, 1969, 1974, 1975, 1981, 1984, 1987, 1988, 1989, 1997, 1998, 2002
1955The Emblem of the American College of Nurse-MidwivesThe emblem, designed by Rita A. Kroska, was printed on the first page of the Bulletin of the American College of Nurse-Midwifery in vol. 1 (1). The article titled “The Emblem of the American College of Nurse-Midwives” describes the creation and symbolism of this emblem. Written by the designer, Rita A. Kroska. Originally published in the Bulletin vol 18(3):23–4.Reprinted in Journal of Nurse-Midwifery 18 (3) 1973
1966Functions, Standards, and QualificationsThe first document to define the scope of practice, standards for practice, and educational requirements for the practice of a nurse-midwife. Became the Standards and Core Competencies.1975, 1983
1962Definition of a Certified Nurse-Midwife (CNM). Became Definition of CNM and Certified Midwife (CM). In 2004, included the Definition of Midwifery Practice.Defines the education and role of the CNM/CM. Has expanded to include CMs and a broader definition of scope of practice including primary health care issues.1978, 1992, 1997, 2004
1963Philosophy of the ACNMStates the foundational principles of ACNM.1972, 1983, 1989, 2004
1971Joint Statement on Maternity Care became the Joint Statement on Practice Relations Between Obstetrician-Gynecologists and Certified Nurse-Midwives and Certified Midwives in 2002.Initially approved by ACNM, ACOG, and NAACOG, addressed the role of nurse-midwives in providing maternity care. Later revisions were signed only by ACNM and ACOG. The 2002 version clarifies a degree of autonomy and responsibility not clearly stated in earlier versions.1975, 1982, 2001, 2002
1972Standards (and later Guidelines) for Evaluation of Nurse-Midwifery Procedural Functions became Guidelines for Incorporating New Procedures Into Nurse-Midwifery Practice in 1987. In 1992 it was replaced by Expansion of Midwifery Practice and Skills Beyond the Core Competencies (see 1992).Outlines the mechanism by which a CNM/CM can expand practice to include skills not taught in the education program or tested in the certification examination. As of March 2003, the document Guidelines for the Incorporation of New Procedures Into Nurse-Midwifery Practice has been retired. These Guidelines have been incorporated into the Standards for the Practice of Midwifery.1977, 1979, 1987, 1990, 1992, 1997, 2003
1978Core Competencies in Nurse-Midwifery and Expected Outcomes of Nurse-Midwifery Education. Became the Core Competencies for Basic Midwifery Practice in 1997.Defines the fundamental knowledge, skills, and behaviors expected of a new practitioner (CNM/CM).1985, 1992, 1997, 2002
1980ACNM Statement on Practice SettingsRevision reestablished the home as a site for CNMs/CMs to practice and reaffirms that the Birth Center and hospital are also sites of practice.1997
1983Standards for the Practice of Nurse-Midwifery became the Standards for the Practice of Midwifery in 2003Replaced the FS&Qs and set the professional standards for practice.1987, 1993, 2003
1990Code of Ethics for Certified Nurse-MidwivesEstablishes ethical guidelines and moral precepts for the practice of midwifery.Revised, 2004
1991Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS)Outlines ACNM's position on counselling and appropriate care for women with HIV/AIDS.1996, 1997, 1998, 2003
1991The Appropriate Use of Technology in ChildbirthDiscusses the use of technology from a midwifery perspective.1996, 1997, 2001, 2003
1991Reproductive ChoicesOutlines the ACNM belief in a woman's right to self-determination and active participation in all aspects of her reproductive health care.1997
1992ACNM Mission StatementStates the purpose of the organization and reflects changes over time. Most recent version changed reference from infant to newborn.1998, 1999, 2003
1992CNMs & CMs as Primary Care Providers/Case ManagersThis document outlines the scope of midwifery practice as expanded to include primary care1994, 1997
1992Mandatory Degree Requirements for MidwivesThis document reviews the rationale for supporting certificate as well as degree programs in midwifery and opposes mandatory master's degree requirements for licensure.1997, 1998
1995Independent Midwifery PracticeDefines independent midwifery practice, which occurs in accordance with the ACNM Standards for the Practice of Midwifery. The independent practice of midwifery is not defined by employment agreements or requirements for physician relationship.1997, 2004
1996Midwifery EducationThis document replaced 3 others (Nursing as a Basis for Midwifery Education [1990]; Midwifery and the Title Midwife [1991]; and Nurse-Midwifery Education [1986, 1992, 1994]). It outlines educational requirements for basic midwifery practice. Education programs require a baccalaureate degree on entry or award one on exit.1997
1992Collaborative Management in Midwifery Practice for Medical, Gynecological, and Obstetric ConditionsThis document defines and outlines the role of consultation, collaboration, and referral in midwifery practice.1997
1992Vaginal Birth After Cesarean DeliveryDiscusses this procedure as included in the practice of CNMs/CMs and reviews current research and safety in all settings.1997, 2000
1994The President's MedallionDescribes the creation and symbolism of this medallion.
1995Guidelines for Midwifery Practice Relating to Violence Against WomenPractice guidelines for midwives when caring for a woman who is the victim of violence.2003
1997Issue Brief: Recent Developments in Midwifery Certification in the U.S.Discusses the nursing and non-nursing routes to certification in midwifery.1998, 1999
Table 2.  Clinical Bulletins Issued by the American College of Nurse-Midwives
Date Initial IssueName of the Clinical BulletinNumberDescription of Document and PurposeDate of Revisions, Ammendments
1996Limited Obstetrical Ultrasound in the Third TrimesterNo. 1States midwives are appropriate practitioners to perform limited ultrasound in the third trimester. It discusses procedures for incorporating ultrasound into practice. 
1997Early-Onset Group B Strep Infection in Newborns: Prevention and ProphylaxisNo. 2Discusses the epidemiology of GBS and the 2002 CDC Universal Screening and Prophylaxis Protocols.2003
1999Intrapartum NutritionNo. 3Reviews the physical changes in pregnancy and labor that led to the rationale restricting food and fluids to women in labor and presents current research that questions the efficacy of this practice.2000
1998Bacterial Vaginosis in PregnancyNo. 4Reviews the epidemiology of bacterial vaginosis transmission, testing, diagnosis, and treatment.(Retired)
2001Endometrial BiopsyNo. 5Reviewed the indications and techniques for performing endometrial biopsy. 
2002Abnormal and Dysfunctional Uterine BleedingNo. 6Reviews the diagnosis and clinical management for abnormal and dysfunctional uterine bleeding. 
2002Criteria for Provision of Home Birth ServicesNo. 7Reviews the current research on safety, and discusses the responsibilities of both midwife and client when a home birth is planned. 
2003Vaginal Birth After Previous Cesarean Section (VBAC)No. 8Presents current evidence regarding the safety of VBAC, and identifies the required infrastructure supports for promotion of optimum outcomes. It offers suggested areas for future research. 
Table 3.  Strategies for Liability Risk Reduction Documents From the American College of Nurse-Midwives
Date Initial IssueName of Risk Reduction DocumentDescription of Document and PurposeDate of Revisions, Ammendments
1993Midwifery Strategies for Liability Risk Reduction, Preterm DeliveryPresents antepartum and intrapartum liability risk reduction strategies.2003
1993Midwifery Strategies for Liability Risk Reduction, Postdates Pregnancy/Post MaturityPresents antepartum and intrapartum liability risk reduction strategies.2003
1996Midwifery Strategies for Liability Risk ReductionDiscusses general risk reduction strategies for clinical practice.2003
2003Midwifery Strategies for Liability Risk Reduction, Shoulder DystociaPresents antepartum and intrapartum liability risk reduction strategies. 
2004Midwifery Strategies for Liability Risk Reduction in Informed ConsentDiscusses the recognition of conditions and situations where special attention should be given to client education and informed consent.