I'm in Virginia, USA. My state started licensing "certified professional midwives" in December 2005. (This is a credential administered by the "North American Registry of Midwives." One can become a "CPM" through a MEAC-approved school (I don't know much about that avenue since I didn't chooses it - couldn't afford to take on debt when I have 3 children who'll be needing to go to university before too long). The other way to become a "CPM" is to do an apprenticeship with someone who is already a CPM or otherwise a documented experienced midwife. I chose the apprenticeship route, again, partly as a financial choice, but also because to me it seemed a very valid model, given how hands-on midwifery is in real life (as opposed to theoretical). I apprenticed with two different senior midwives (it is not required to work with more than one, although it is recommended because it's so good to see the variety of styles of homebirth midwifery. The apprenticeship training must be a minimum of one year in length, but unless the candidate has a great deal of preparation in advance, most often it is closer to three years in length. Among the requirements are a list of specified midwifery skills (e.g., counseling, prenatal care, care in labor, postpartum care, newborn care, lactation), each skill which must be demonstrated to the senior midwife's satisfaction. This list is 45 pages long and contains 750 separate skills. Additionally, the Apprentice must document to NARM, that she has attended at least 20 births as an "active participant," 75 prenatal exams (20 of which must be the initial exam), 20 newborn exams, 40 postpartum exams, and 20 births as the "primary midwife under supervision." When all of this is done, and completely documented, the application is submitted to NARM. After NARM reviews and audits the application (NARM randomly requests copies of client charts to confirm the accuracy of submissions), then the candidate is permitted to take a "Skills Assessment," with a "Qualified Evaluator," a midwife who has been trained to administer this test for NARM. In the Skills Assessment, the candidate might be asked to perform a routine prenatal examination (with a "live" expectant mum), a full physical exam, and or a newborn examination. Once this test is passed, the final hurdle is a comprehensive written examination which NARM offers 3 times per year. The cost is currently about $1500 in direct payment to NARM, and of course, the candidate incurs her own costs in securing an apprenticeship and getting the experience necessary to complete the requirements. For me, working with two different senior midwives, it was fairly expensive as one lived an hour and a half from me, and the other one half hour drive from me, and then in turn, each of these midwives served clients within a one and one half hour drive from their homes...so, suffice to say, I put A LOT of miles on my car during my apprenticeship... and spent tons on gas, which had just soared to all time historic high prices just in time to start my apprenticeship! I believe it's a great way to train a homebirth midwife, as I feel confident that I have the skills to serve women safely on my own now. (I've passed the Skills Assessment and am just waiting to sit the final written exam).
The other option that exists in Virginia, as in Kansas, is to be a CNM, or Certified Nurse Midwife. The schooling for that option has already been outlined, but I will add that in my state, the CNM's can only work if they have physician backup, and the physicians effectively get to mandate the CNM's protocols - i.e., who they can serve, and under what conditions. At this moment in time, this is more restrictive than how the CPMs may practice. Legislation is currently being proposed in our state to restrict the scope of practice of CPMs, so the future is uncertain here right now.
Last but not least, there are still (of course?!) traditional midwives - those who may or may not hold the CPM certification, who have chosen to remain in an "illegal" status, so that they can practice as truly independent midwives. They do so, unfortunately, at risk of being jailed if they are turned in for the "unlicensed practice of medicine." It is a grave error, IMHO, that midwifery has been categorized being r under the jursidiction of the board of medicine in our state. I believe midwifery is a separate and distinct discipline, and if it is to be regulated, it should be under a "board of midwifery," as the Midwifery Model of Care is so dramatically different then obstetric medicine as it is practiced in Virginia in 2008 (cesarean rates well over 30 percent, VBAC rates under 3 percent, induction rates hovering around 90 percents, etc.).
More than you were looking for, I'm sure, but I happen to be stuck in bed with a bad head cold (which was seriously exacerbated by staying awake for 49 straight hours at a birth on day 2 of this cold!).
Cheers to all my fellow international student midwives! Keep the faith.