A midwife who has entered the practice of midwifery directly, without first passing through nursing training. Contrast nurse midwife. In the Western nations, direct-entry midwives handle perhaps one or two percent of all births, except in The Netherlands, where the figure is closer to 25%. Modern direct entry midwives have their origins in the lay midwifery movement of the 1970s, but as they gradually professionalized and gained a body of experience, many came to prefer the term direct-entry, which doesn't have the pejorative connations of lay.
Direct-entry midwives mostly deliver children in their client's homes or in birth centers which they run their practices out of. Most are still not allowed hospital privileges at all, and their practice remains totally illegal in 9 states in America, where they are liable to be arrested for practicing medicine without a license.
Most direct-entry midwives seek to bring a more holistic approach to birth than obstetricians, while still retaining the positive advances in medicine and science which have made modern birth a relatively safe experience. While the stereotype of a dangerous, uneducated quack remains, there is an impressive and increasing body of statistical evidence which demonstrates that home birth with a direct-entry midwife is at least as safe as an obstetrician-attended birth at a hospital, and with far less risk of infection and avoidable Caesarean sections. Most modern direct-entry midwives have been through length apprenticeship programs and are fully trained for dealing with most complications of pregnancy, and know when to contact a hospital for transportation when something they don't have the equipment or experience to handle comes up.
Direct-entry midwifery began as an organic response to many social movements in the late 1960s and 1970s, most notably the counter-culture distrust of traditional procedure and unneccessary technology, and the feminist call for a more woman-centered worldview, and sprang up independently in several differnt regions of the country, most notably in Santa Cruz, California; Vermont; and the commune The Farm in Tennessee, home of founding mother Ina May Gaskin. At that time it was mostly an internal way of dealing with birth for drop-outs who had left most of the institutions of traditional society behind them, but as those drop-outs began reintegrating themselves with mainstream culture in the 1980s, they took the practice of midwifery with them, and began a long process of profesionalization.
The mainstream obstetrical community still views direct-entry midwives with a great deal of distrust, particularly nurse midwives, who feel that direct-entry midwives are a threat to their credibility and medical integrity, though this is slowly changing with the accumulation of more statistics which support the safety of their practices.
Thanks to momomom for looking this over and providing corrections. All errors remain my own.