I  may be wrong, but in my part of the country a "lay midwife" means a 
midwife with no "formal" education.  A CNM in california is a certified nurse 
midwife.  A registered nurse who has labor and delivery experience and 
furthers her degree with a masters program in midwifery.  Again, I don't know 
about other countries.  Lay midwives get their training watching and going to 
home births under the guidance of another lay midwife.  Hope that helps.
robin

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