Lay-midwives in West Virginia, sometimes known as granny women, delivered many babies up until the middle of the 20th century. In the 1930s and 1940s, hospital births became more common and home births began to decline. By 1983, there were no known granny-midwives practicing in the state. However, a new movement of young lay-midwives began in the 1970s, providing for the few women who were choosing home birth at that time. They have an organization, founded in 1976, called the Midwives Alliance of West Virginia.

Traditionally, lay-midwives learned their skills from experience, and from older midwives and doctors. They could go to the local health department for classes and a license. A few were registered nurses. Most lay-midwives were associated with a doctor who supported them in their work. Granny women relied on many home remedies such as herbal teas and salves. Their childbirth kit might include castor oil, camphor, Lysol, homemade pads of folded newspaper and cloth to protect the bed, and scissors and string for cutting and tying the umbilical cord. Those who were licensed carried silver nitrate to put in the baby's eyes to prevent infection. All used boiling water for sterilizing equipment in the home.

Minnie Hammonds of Huttonsville began midwifery at age 16, apprenticed to her mother. She delivered her first baby alone at age 17, and at 18 she delivered her own child alone. Annie Brake of Valley Head began midwifery in 1921; her physician told her how to do it, and she did. Hazel Libert in the Buckhannon-Elkins area had no instruction, but she lived on a farm and had aided the farm animals on many occasions. These three delivered more than 500 babies with no maternal deaths and only one infant death.

Certified nurse-midwives have existed in the United States since 1925 but have gained significantly in numbers and popularity since the 1970s. They are registered nurses who have graduated from one of the advanced programs approved by the American College of Nurse-Midwives and passed the certification test. A nurse-midwife cares for a woman throughout her pregnancy, delivery, and post-partum period. Often she becomes the woman's primary caregiver during her childbearing years. Nurse-midwives deliver babies in West Virginia hospitals and birthing centers, with an obstetrician who will help if the delivery becomes complicated. They can write prescriptions and do minor surgical procedures in the office. Care for the whole woman—emotional, spiritual, and physical—is a primary concern of nurse-midwives.