Michigan's Public Health Code defines midwifery as a subset of nursing, and refers to CNMs as Advanced Practice Nurses. Rules that guide practice for nurses also apply to Nurse Midwives. The tricky part is that most standards for practice are governed by an employer. If a CNM works in the hospital setting, or a hospital affiliated birth center, safety standards and guidelines are in place.
CNMs are also permitted to work outside hospitals, as is the case with homebirth and freestanding birth centers. When a CNM practices outside the hosptial, she sets her own practice guidelines, and essentially follows her own set of rules. A good example is considering the fact that CNMs working in the hospital setting carry malpractice insurnace, while those who function outside the hospital most often do not. There are no laws that say a midwife must carry malpractice insurance. The same is true for risking out criteria, scope of practice, professional development, etc. In the hosptial these things are defined by the employer, not state law.
It is also important to know that midwifery in our state is considered "alegal" meaning laws don't necessarily say it is illegal to practice as other types of "midwives". There are absolutely NO LAWS whatsoever in Michigan that govern the practice of other midwives (CPMs, CMs, DEMs, or Lay Midwives. That means there are no consistent standards for education, for scope of practice, for standards of practice, for minimum educational standards, etc. It also means that if something does go wrong, there is nothing the state can do about it because there is no oversight.
The important message here is that if you are considering a birth that takes place outside hospital walls in the state of Michigan, it is imperative that you understand there are NO LAWs pertaining to how midwives practice, and there is no oversight. Little, if any accountability can take place under these circumstances. It's difficult to know who you're hiring, and your safety is subject to chance.
For more about current Michigan laws as they pertain to midwifery, please visit Current MI Laws and Licensing.