How to Become a Certified Nurse-Midwife (CNM)

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The nurse-midwife (NM), now more commmonly referred to as the certified nurse-midwife (CNM), is a highly trained, advanced practice registered nurse (APRN) who specializes in primary and reproductive care for women and their babies. They typically work in private practices, hospitals, birth centers, public health systems, or other types of clinics. According to the American College of Nurse-Midwives (ACNM), their responsibilities include assisting with births, promoting reproductive and primary care education, offering counseling, and ensuring the health of women and their babies.

 

The ACNM issued a position statement declaring that as of 2010, a Master’s degree be the baseline educational requirement for entry into clinical practice as a Certified Nurse-Midwife (CNM) or Certified Midwife (CM). So whereas in the past nurse-midwives could enter clinical practice with a valid RN license and a BSN degree, now aspiring professionals must first earn an MSN degree from an accredited program and then certify with the American Midwifery Certification Board (AMCB) prior to practicing.

 

There are currently over 6,000 nurse-midwives working in the United States, and according to the Bureau of Labor Statistics (BLS 2014), midwifery is a career on the rise. The BLS projects that openings for nurse midwives will grow 29% between 2012 and 2022, adding 1,700 jobs for these healthcare professionals. This increase is more robust than the average growth anticipated for all occupations during that timeframe (11%).

 

So how does a person become a CNM? Below, NursePractionerSchools.com traces the requirements and steps to join this rewarding, high-growth career.

Certifications and Requirements to Become a Nurse-Midwife

Aspiring nurse midwives (NMs) must fulfill a number of prerequisites prior to practice in most regions and medical settings. First, NMs typically graduate from a bachelor’s program, especially in nursing, and become registered nurses (RNs) in their state or jurisdiction. This process involves sitting for the National Council Licensure Examination (NCLEX-RN). NursePractitionerSchools offers more detailed information on becoming a registered nurse (RN) or a nurse practitioner (NP), including the differences between them. But note that a BSN degree is no longer sufficient to enter clinical practice as Nurse-Midwife. As mentioned, the ACNM now requires that candidates first earn an accredited MSN degree and certify through the AMCB.

 

According to the American College of Nurse-Midwives (ACNM), the vast majority of practicing nurse-midwives now hold graduate degrees. In fact, 82% of certified nurse midwives (CNM) hold master’s degrees and 4.8% have doctoral degrees. This is the largest proportion of high degree holders among all categories of advanced practice registered nurses (APRNs). Therefore, the ACNM advises candidates to enroll in a graduate program accredited by the Accreditation Commission for Midwifery Education (ACME). There are currently 39 ACME-accredited graduate programs in the United States conferring post-graduate certificates, master’s or doctorate degrees upon completion of the program. These typically take a minimum of 24 months to complete, although some accelerated options may be available for candidates with post-baccalaureate degrees. It’s advised that prospective NMs take ACME-accredited programs not only to ensure that their training meets high standards of curricula, faculty, and student outcomes, but also in order to qualify for national certification.

 

Upon graduation, students are eligible to sit for the American Midwifery Certification Board (AMCB) exam in order to become a certified nurse-midwife (CNM). These credentials are valid for five years. The AMCB reports that there are two methods to renew CNM certifications:

 

  • Complete the three AMCB-approved certificate maintenance modules (e.g., Antepartum and Primary Care [PC] of the Pregnant Woman, Intrapartum/Newborn and Postpartum, Gynecology and PC of the Well-Woman), get 20 contact hours of ACNM- or ACCME-approved continuing education units, and complete renewal application (including paying associated fees)
  • Retake the ACMB certification examination ($500) and complete a renewal application

Steps to Becoming a Nurse Midwife

Here is a breakdown of one possible path to become a nurse midwife:

 

  • Graduate from high school. To prepare for an undergraduate program in nursing, it’s advisable to take classes such as biology, chemistry, algebra I/II, physics, statistics, and psychology (if available).
  • Enroll in an associate or (preferably) bachelor’s program in nursing (2 – 4 years). While students can prepare for a graduate program in midwifery by completing an associate program in nursing, it’s generally preferable to pursue a bachelor’s of science in nursing (BSN) degree. If an aspiring nurse midwife has an associate degree and works as an RN, (s)he may have to complete an RN-to-BSN program These programs should be accredited by agencies such as the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN). Some graduate programs may require that the candidate’s BSN institution have regional accreditation as well (e.g., MSCHE, NEASC, NCA-HLC, NWCCU, SACS and WASC.) These accredited BSN programs offer classes such as health promotion across the lifespan, advanced physiology, and pharmacology. They may even offer electives specializing in neonatal or gynecological care which can further prepare a student for his/her future career.
  • Become a registered nurse and gain experience (1 year). After graduating from an accredited nursing program, candidates generally become registered nurses within their state. Although the licensure process may differ across jurisdictions, it typically involves an application to the local State Board of Nursing and passing the National Council Licensing Examination (NCLEX). Prior to being admitted to a midwifery program, candidates typically have at least one year of experience working as an RN, preferably with an emphasis in OB/Gyn.
  • Apply for an ACME-approved graduate program in midwifery (2 – 4 years). In order to ultimately become licensed as a certified nurse midwife (CNM), candidates must first graduate from a master’s (two-year) or a doctorate (four-year) program accredited by the Accreditation Commission for Midwifery Education (ACME). These programs may have course prerequisites such as statistics and community health nursing. There are currently 39 such accredited programs in the United States offering courses such as reproductive pathophysiology, primary care of women, and advanced nursing for vulnerable populations. The vast majority of nurse midwives have advanced degrees. According to ACNM, 82% hold master’s degrees and as of 2010, an MSN is a minimum requirement for practice.
  • Sit for the national certification exam. To become a CNM, candidates must pass the examination offered by the American Midwifery Certification Board (AMCB). This 175-question multiple choice exam is computer-based and offered at several sites around the U.S. five days per week. Each candidate is given four hours to complete the exam.
  • Maintain certification (renew every 5 years). As stated above, CNMs are expected to either retake the certification exam ($500), or complete three training modules and 20 contact hours of continued education.

 

For those interested in promoting family healthcare at the most advanced level, becoming a certified nurse midwife (CNM) can be a rewarding choice.

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