Certified nurse-midwives (CNMs) take on a vital role in the healthcare field: they bring new life into the world.
Along with working in a rewarding career, CNMs earn substantial salaries. In 2018, nurse midwives made a median income of about $103,770 at the national level, according to data from the Bureau of Labor Statistics (BLS). This figure is over $30,000 more than the median pay for registered nurses (RNs).
This guide covers basic information about the CNM career and outlines how to become a certified nurse midwife.
What Is a Certified Nurse Midwife?
CNMs deliver babies and offer patients gynecological, prenatal, and post-pregnancy care. These professionals work as advanced practice registered nurses (APRNs), which allows them to prescribe medications and take on more medical responsibilities than an RN. The career also requires more challenging education and experience requirements. CNMs must earn advanced practice licensure at the state level, along with nurse midwife certification. These credentials require graduate-level schooling, so these nurses must earn either a master’s or doctoral degree.
What Do Certified Nurse Midwives Do?
CNMs provide women’s health services, including primary care, gynecological care, and care during pregnancy, birth, and postpartum. CNMs can care for newborns during the first 28 days of life. They can also treat male partners for sexually transmitted infections (STIs).
CNMs can serve as the main and only care provider during childbirth. They are trained to handle all of the most common complications that can arise during labor or immediately after birth. All midwives are also certified in neonatal resuscitation. In hospital settings, CNMs typically have collaborative relationships with physicians, who are available if more serious complications arise. Some CNMs have specialized training to assist physicians in emergencies that call for cesarean sections.
These responsibilities demand critical-thinking skills and the ability to stay calm under pressure. After all, CNMs make decisions that can affect both the infant’s and mother’s health. These professionals should possess strong communication and interpersonal skills. They often work on teams, and they also educate parents-to-be on the birthing experience and caring for newborns.
Where Do Certified Nurse Midwives Work?
CNMs can find work with many different types of employers. They often work in hospitals, clinics, and private practices.. They might also find jobs at health maintenance organizations. CNMs frequently work in teams. While the majority of CNMs deliver babies in hospitals, they can also provide birth services in free-standing birth centers and at people’s private homes.
When working in out-of-hospital birth settings, CNMs sometimes work in conjunction with certified professional midwives (CPMs). While CNMs find their work rewarding, they may also describe it as stressful. As most people know, babies can get born at all hours of night and day! Depending on where they work, sometimes CNMs have to be on call or working at unusual hours. CNMs must remain on-call at all times and work unusual hours.
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Steps to Becoming a Certified Nurse Midwife
The road to becoming a CNM can certainly seem overwhelming. The list below explores the process, taking you through how to become a certified nurse midwife step by step.
EARN A BACHELOR OF SCIENCE IN NURSING (BSN) DEGREE For the first step of certified nurse midwife schooling, students should enroll in a bachelor’s program in nursing. Traditionally, full-time students can finish their bachelor’s degrees in four years. However, students enrolled in accelerated programs may graduate more quickly, while those enrolled part time may take an extra semester or year. This program should hold accreditation from an agency like the Commission on Collegiate Nursing Education or the Accreditation Commission for Education in Nursing. Graduate schools often look for candidates with degrees from regionally accredited institutions.
OBTAIN LICENSURE AS A REGISTERED NURSE To earn licensure, RNs need to pass the NCLEX-RN examination and earn an undergraduate degree. They also need to apply for RN licensure from their state. Every state sets different requirements, with some including an additional exam covering state nursing laws. Check with the licensing board in your state to learn more.
PURSUE SPECIALIZATIONS WHILE WORKING AS AN RN Nurses often work as RNs before pursuing certified nurse midwife degrees and further licensure. This experience allows them to hone their skills and knowledge, affording them a level of authority and expertise they need for advanced practice roles. During this time, nurses can pursue additional certifications to prepare them for their future roles as CNMs. For instance, RNs can earn their neonatal intensive care nursing certification through the National Certification Corporation. This credential, which bolsters nurses’ backgrounds in working with newborn infants, requires one year of professional experience and a passing grade on an exam.
GAIN ADMISSION TO AN ACCREDITED MASTER OF SCIENCE IN NURSING (MSN) OR DOCTOR OF NURSING PRACTICE (DNP) PROGRAM WITH A SPECIALTY IN NURSE MIDWIFERY Next, RNs should apply for either a master’s degree or DNP with a nurse midwifery concentration. Although you can pursue either degree to earn certification, a doctorate can lead to higher salaries and more job opportunities. Admission requirements vary by school. However, most programs expect each applicant to hold a bachelor’s degree with a satisfactory GPA and an RN license. Some programs specify that applicants must possess some background in midwifery or prenatal care, but many programs do not. You can find an online directory of accredited programs provided at the American College of Nurse Midwives (ACNM) website.
EARN AN MSN OR DNP DEGREE A master’s program may take about two years to complete, while students might need to dedicate 3-4 years to a DNP. While in graduate school, students take advanced nursing courses, such as fetal evaluation and antepartum care. They must also complete practicum hours, which allow them to apply what they’ve learned under supervision. When pursuing a graduate degree, make sure your courses and practicum hours fulfill nurse midwifery certification and licensure requirements.
OBTAIN CERTIFICATION FROM THE AMERICAN MIDWIFERY CERTIFICATION BOARD The American Midwifery Certification Board (AMCB) offers the CNM credential. To earn this credential, candidates need a graduate degree and an RN license. They must also pass the AMCB certification exam. The exam tests a candidate’s grasp of safe practice and knowledge of physiology, pharmacology, and clinical decision making. The test consists of multiple choice questions, and candidates take the exam on computers at testing sites.
OBTAIN CERTIFIED NURSE MIDWIFE STATE LICENSURE Just like with RN licensure, each state determines its own certified nurse midwife requirements concerning advanced practice licensure. Some states, for instance, require nurses who want to prescribe medication to turn in an extra application, while others allow any licensed CNM to possess automatic prescriptive authority. You can find out more information about each state on this page from the Midwives Alliance of North America.
FIND EMPLOYMENT In addition to searching online job boards, CNMs can take advantage of networking at previous workplaces or through professional associations. Attending conferences can also expand their network of professional connections.
Becoming a Certified Nurse Midwife FAQs
How Long Do You Have to Go to School to Be a Certified Nurse Midwife?
This depends on your specific educational path. A bachelor’s degree traditionally takes four years, while students generally take two years to complete a master’s and up to four years for a doctorate. Therefore, some CNMs could spend a decade in school. However, many CNMs pursue only a master’s degree, and others enroll in BSN-to-DNP programs, which allow them to skip a master’s degree altogether. Therefore, some nurses might dedicate 6-7 years to school, or even less if they choose accelerated programs.
Can I Get Licensed if My Degree Is From an Unaccredited Program?
No. All states require nurses to possess accredited degrees before they can earn licensure. This includes all levels within the nursing profession. CNMs need accredited degrees to earn certification from the AMCB.
Are Certified Nurse Midwives in Demand?
Yes. On a national scale, the BLS projects the CNM profession, along with nurse anesthetists and nurse practitioners, to grow by 26% from 2018-28, which is much faster than the average growth rate for all employment.
What Is the Difference Between a Certified Nurse Midwife and a Doula?
A CNM is a licensed, independent healthcare provider. Unlike a CNM, a doula does not need nursing or medical education, so a doula cannot provide any medical care or deliver infants. Instead, doulas focus on helping parents prepare for labor and birth. They can offer support during birth, including things like teaching breathing techniques or giving massages. Sometimes doulas also provide postpartum or lactation support.
While CNMs can provide labor support too, they primarily function as the healthcare provider “in charge” of all of the medical and safety decisions during labor and birth, including delivering (or “catching”) the baby. CNMs can also provide a broad range of medical care before, during, and after pregnancy.
Can a Certified Nurse Midwife Prescribe Medication?
Yes, CNMs can prescribe medication. Several states include prescriptive authority along with APRN licensure. In other states, CNMs may need to apply for an extra credential to earn prescriptive authority. Check with your state licensing board to learn which case applies to you.
Certified Nurse Midwife Credentials
The following section dives deeper into the licensing and certification requirements needed to become a certified nurse midwife. This guide offers as many details as possible without covering specific state requirements, so you should check with your state’s nursing licensing board for more information about state-specific obligations. With a little bit of research, you can find optional certificates that may boost your job prospects and earning potential.
Keep reading to learn how to earn your RN and APRN licensure, in addition to obtaining a CNM credential.
CERTIFIED NURSE MIDWIFE LICENSING
CNMs need two licenses at the state level: RN licensure and APRN licensure. Each state sets distinct requirements for these licenses, so the information below provides a general overview.
An RN license requires each candidate to hold an associate or bachelor’s degree. Nurses hoping to gain advanced licensure should choose a bachelor’s degree, which they will need to enter graduate school. States sometimes publish a list of accredited programs that include a comprehensive curriculum and the clinical hours that RN candidates need for licensure. Candidates also need to pass the NCLEX-RN examination. State licensure boards also usually require a background check and charge an application fee.
An aspiring CNM can apply for an APRN license after earning a graduate degree. They can either earn a master’s or a doctorate in nursing, and they should also hold RN licensure. These nurses usually need a certification in a specialized area before qualifying for APRN licensure. In this case, they need the CNM credential. Finally, check with your state licensing board to learn how many hours or years of experience you need for your APRN license.
CERTIFIED NURSE MIDWIFE CERTIFICATION
Offered by the AMCB, the CNM credential qualifies APRNs to work as midwives. Candidates need RN licensure and at least a master’s in nursing, although some opt for a doctoral degree instead. The graduate program should hold accreditation from the ACNM Accreditation Commission for Midwifery Education.
Aspiring CNMs must also possess clinical expertise with skills related to women’s health, providing reproductive care, assisting with delivery, caring for newborns, and managing sexually transmitted diseases. Last, each candidate must pass a national certifying exam. This multiple choice, computer-based exam tests nurses’ knowledge of medical and nursing theory and clinical skills.
Certified Nurse Midwife Resources
American College of Nurse-Midwives As one of the most prominent professional associations for CNMs in the U.S., ACNM supports experienced professionals and students alike. Members can attend events, participate in professional development opportunities, and meet their peers through volunteering.
Midwives Alliance North America This professional organization connects midwives all over North America, not just the United States. It offers several resources, like home birth summit transfer guidelines and a waterbirth guidance template.
ACNM Career Center ACNM runs an online career search engine with opportunities offered all around the country. Users can narrow their criteria by sector, discipline, location, and more.
American Midwifery Certification Board This organization offers certifications for midwives, CNMs, and professional midwives. Individuals can visit this website to answer their questions about the certification and renewal process.
HiveCE This organization offers plenty of ACNM-approved continuing education courses in an online format. Professionals can access courses covering topics like newborn weight loss and functional nutrition to prevent gestational diabetes.
Learn More About Certified Nurse Midwives and Related Careers
Advanced practice nursing covers many different areas beyond midwifery. The resources below outline how to earn other nursing specializations, such as pediatrics and women’s health. You can also find pages that offer more information about the midwifery career, including what salaries a CNM can expect.
This page outlines what prospective CNMs can expect from academic programs, including curriculum and courses, prerequisites, and possible specializations. The page also offers more helpful advice on how to become a certified nurse midwife.
Individuals interested in becoming clinical nurse specialists can learn how to get started with their careers by following this step-by-step guide. Visitors learn which degrees and what kind of work experience they need.
Anyone interested in a leadership position might consider becoming a nurse executive. This page covers the different levels of management positions within the nursing industry and outlines the steps needed to achieve this professional level.
ediatric nurse practitioners work in advanced nursing positions, but they care specifically for children. This resource outlines the educational and certification requirements needed to become a pediatric nurse practitioner.
As the title suggests, these APRNs focus on women’s health, like gynecology. Individuals can visit this webpage to learn about undergraduate, graduate, and experience expectations for women’s health practitioners.
Medically Reviewed by Meredith Wallis CNM, NP
Meredith Wallis is a certified nurse-midwife, nurse practitioner, and International Board Certified Lactation Consultant (IBCLC). She received her master’s degree in midwifery from Oregon Health & Science University in 2011. Meredith specializes in out-of-hospital birth, lactation support, and childbirth education. Her professional passions include holistic medicine, VBAC, and evidence-based care.
Certified nurse-midwives—advanced practice healthcare professionals with graduate-level degrees and credentialing—still struggle to practice autonomously in some U.S. states. The issue of practice authority varies widely by region, affecting the ability of CNMs to work in accordance with their high level of training and certification.