A midwife, doula and childbirth educator are *not* the same thing. A doula assists a woman through her pregnancy, labor, birth and postpartum period. She is not trained to perform any medical tasks, unlike a midwife.
Also, there are thousands of direct-entry midwives practicing in the US and throughout the world. These midwives learn through apprenticeships and may choose to attend a formal midwifery program at a college or midwifery school.
Direct-entry midwives and certified nurse-midwives are very different. Most CNMs attend birth in a hospital setting and have been trained to treat birth in a medical way. Direct-entry midwives attend births in a home or freestanding birth center and treat birth as a natural, physiological process rather than an illness in need of medical intervention.