We have a lot of midwives here in WV. They practice out in the country and in the cities. The doctor I go to has about 7 or 8 CNMs in his practice. Midwives fit in here culturally, as they were used for years by the apalachians in the mountains. They were the "witches" known as "granny women". They provided women with birth control methods, midwivery, herbal remedies, etc. Good luck, and if you know you are meant to be a midwife, don't let anything stop you.