I am not suggesting that there is anything wrong with PA or licensed midwives–my wife saw both during two of her three pregnancies (although I would not have wanted them to exclusively do the deliveries, given her complications in the first two, and especially since the third was a scheduled c-section).

1)Is that midwives*, physician assistants** and nurse practitioners often provide primary care during pregancies. In fact, during my pregnancy (via the Military health care system) my care was primarily overseen by a midwife, and I didn’t even see a doctor until I had complications.

2)All care that is given by these non-doctors as you call them is overseen by a licensed physician. So even though a doctor per se isn’t in the room, a doctor does consult on your case.

3)All of these professionals did recieve additional training. For example to typically become a Nurse Practitioner, one typically gets the equivalent of a Master’s degree with clinical. Physician Assistants and nurse midwives have similar training, undergrad with some of advanced training and clinical.

*Licensed nurse midwives
**To find out what a PA is, Duke has one of the best physician assistant programs in the country.