Nurse Midwifery Guide: Salary, Benefits & Programs

Registered nurses with an interest in advancing their career while dedicating themselves to women’s healthcare may be well suited to becoming a Certified Nurse-Midwife. Certified Nurse-Midwives are Advanced Practice Registered Nurses (APRNs) who provide high-quality care comparable to that provided by gynecologists and obstetricians. 

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Though Certified Nurse-Midwives are most frequently associated with childbirth and breastfeeding, these highly respected professionals provide a full range of holistically focused healthcare services to women from adolescence through old age. 

Surveys showing high levels of patient satisfaction and lowered infant and maternal mortality rates have made Nurse-Midwife services increasingly popular and in demand. 

This educational guide will provide you with the information you need to help you determine whether a career as a Certified Nurse-Midwife is right for you, including important information about Certified Nurse-Midwife programs, salary, and more.

Advantages of a Certified Nurse-Midwife Degree

The Certified Nurse-Midwife degree is one of four advanced practice nurse degrees that a nurse can pursue. Its focus is on providing care to women through all stages of their lives, and the care that they provide is increasingly in demand. Advantages to earning a Certified Nurse-Midwife Degree include:

  • High employment rates. According to the Bureau of Labor Statistics, the demand for Certified Nurse-Midwives as well as all other APRN-degreed nurses is expected to grow 31 percent from 2016 through 2026, a rate that is much faster than other professions. Much of the growth in the Certified Nurse-Midwife field is expected to come from an increased interest in the more patient, less intrusive approach to birth that Certified Nurse-Midwives offer as compared to obstetricians.
  • Generous Compensation. The Bureau of Labor Statistics also shows that APRN salaries are increasing, with a national median annual salary of $103,770
  • Connection with patients. Certified Nurse-Midwives have a high degree of connection with their patients that is reported as one of the most rewarding aspects of their career.
  • High level of job satisfaction. Certified Nurse-Midwives have a high degree of satisfaction with their jobs. They are respected by other healthcare professionals and enjoy high levels of collaboration with both nurses and physicians.
  • Autonomy and responsibility. In half the states in the country, Certified Nurse-Midwives can practice with full autonomy and prescriptive authority, while others require a collaborative or supervisory agreement with a partnering physician. 
  • Wide range of practice environments. Certified Nurse-Midwives practice in a wide range of job settings, including private physician’s offices, hospitals, outpatient care centers and women’s clinics.

About the Certified Nurse-Midwife Degree

Certified Nurse-Midwives begin their educational journey as registered nurses and then pursue a graduate degree in nurse-midwifery. Though the degree is built on the same nursing foundation as the other three APRN degrees (Nurse Practitioners, Certified Registered Nurse Anesthetists, and Clinical Nurse Specialists), the Certified Nurse-Midwife degree emphasizes wellness and individualized care and views menarche, pregnancy, labor and birth and menopause as normal physiological processes that requires minimal interventions.

According to the American College of Nurse-Midwives, Certified Nurse-Midwives “are primary care providers for women throughout the lifespan, with a special emphasis on pregnancy, childbirth, and gynecologic and reproductive health.” They also care for babies up to four weeks old. 

Before applying for a degree in nurse-midwifery, nurses should have:

Next, nurses apply to a Certified Nurse-Midwife program. There are currently 37 Certified Nurse-Midwife programs that are accredited through the Accreditation Commission for Midwifery Education (ACME). Program options include:

  • Master of Science in Nursing (MSN)
  • Doctor of Nursing Practice (DNP)
  • Accelerated DNP for non-BSN holders
  • BNS-MSN
  • BSN-DNP

These programs generally take twenty-four months to complete and require at least one year of experience working as a Registered Nurse, preferably in obstetrics and gynecology. Every Certified Nurse-Midwife program prepares its graduates for the national certification examination to become a Certified Nurse-Midwife.

Salaries and Pay

According to the Bureau of Labor Statistics, annual wages for Certified Nurse-Midwives range between $70,100 and $155,650, depending on location and job setting. Certified Nurse-Midwives are also eligible to receive a wide range of perks and benefits, including

  • Vacation and sick pay
  • Tuition reimbursement and loan forgiveness
  • Pay differential for working nights, weekends, and overtime

Career Outlook

As more and more women in the United States choose to use Certified Nurse-Midwives for their maternal care and general healthcare needs, the demand for degreed professionals will continue to grow. This is especially true in the face of a growing shortage of obstetricians and gynecologists, especially in rural communities. Certified Nurse-Midwives can work in any setting where women’s healthcare is provided, including:

  • Private practices
  • Hospitals
  • Birthing centers
  • Health clinics
  • Home birth centers
  • University hospitals
  • Military hospitals

With roughly ten percent of American women choosing nurse-midwives and only approximately 12,000 CNMs in the United States, CNM career opportunities and salaries are expected to continue to grow. Many Certified Nurse-Midwives have gone from working in hospital settings to opening their own midwife practice or working as consultants. 

Key Differences Between Certified Nurse-Midwives and Nurse Practitioners

Like Nurse Practitioners, Certified Nurse-Midwives have an advanced level of education and training and are licensed healthcare providers with prescriptive authority in all fifty states plus the District of Columbia. 

In many ways, the CNM’s skills and responsibilities are most similar to that of certified Women’s Health Nurse Practitioners, but there is a key difference in philosophy and approach. Where both WHNPs and Certified Nurse-Midwives both conduct regular checkups and provide a full range of wellness, gynecologic and family health education, Certified Nurse-Midwives: 

  • Are more extensively trained in the birthing process
  • Offer a holistic approach that allows for greater engagement with the patient
  • Act as the patient’s advocate through the birth and in other areas of health concern. 

Certified Nurse-Midwives can also provide care for the infants they deliver for the first four weeks of their lives.

Types of CNM Programs 

There are currently only 37 midwifery education programs accredited by the Accreditation Commission for Midwifery Education (ACME) offering Doctor of Nursing Practice (DNP) degrees, post-graduate nurse-midwife certifications,  and the Master of Science in Nursing degree. There are also programs that offer dual certifications as Certified Nurse-Midwives and Women’s Health Nurse Practitioners.

The different types of programs include:

Accelerated BSN-MSN Program - Nurses who initially earned a bachelor’s degree with an area of study outside of nursing can take an accelerated program that provides the prerequisites for the BSN, then move smoothly into the MSN program. These programs provide the classroom learning and in-person clinical hours needed to become a Certified Nurse-Midwife.

MSN Program - These programs build on the foundational education that BSN-degreed Registered Nurses have already attained, and add specialized training and a greater degree of knowledge, skills and experience needed to become a Certified Nurse-Midwife. Programs generally take 24 months to complete.

DNP Program - The Doctorate of Nursing Practice is a terminal degree that the American Association of Colleges of Nursing has voted to endorse as the future standard for advanced practice nurses. Doctor of Nursing Practice programs with a Nurse-Midwifery track are available as BSN-to-DNP programs as well as post-Masters programs. Both are designed to prepare graduates to be primary care providers for women, as well as leaders in advancing clinical practice, community health, education, and policy.

Post-Masters Certificate in CNM – Nurses who have already earned their MSN can choose to continue their studies in order to take the Certified Nurse-Midwife certification exam. 

Online CNM Programs 

Though many of the Certified Nurse-Midwife programs that are currently available are traditional, face-to-face programs, online programs that allow students to pursue their education while continuing to work and attend to their personal and family needs are available. 

Most online CNM programs are hybrids which combine both internet-based classroom learning and some in-person attendance. Clinical experience is required of all Certified Nurse-Midwife programs and can usually be arranged with your current employer. 

The benefits of an online CNM program include:

  • Flexibility so nurses can continue working while earning their degree
  • No commute for online classes
  • Accessibility from a distance
  • Lower costs than traditional, on-campus programs
  • Full and part-time options
  • Efficient programs that let you earn your degree faster
  • Federal financial aid eligibility

Nurses who choose to pursue their Certified Nurse-Midwife degree online need to be self-motivated and responsible. If you are considering an online CNM program, it is a good idea to do some initial investigation into exactly how often you will need to personally attend in-class sessions, as well as what arrangements need to be made for ensuring that you meet your clinical experience requirements.

It is also important to only choose a program that’s accredited. Accreditation ensures that the program meets a minimum standard of quality, and most employers prefer graduates from accredited schools.

There are two accrediting bodies for nursing programs:

The Accreditation Commission for Education in Nursing (ACEN), which accredits all levels of nursing degrees,

The Commission on Collegiate Nursing Education (CCNE), which provides accreditation for programs offering Bachelors’ degrees and higher.

Classes and Clinicals

Certified Nurse-Midwife programs are each unique, but all have the same goals: 

  • To prepare their graduates to pass the national certification examination to become a CNM
  • Have nurses demonstrate the knowledge and skill to provide annual gynecological exams and family planning education, prenatal and labor and delivery care, guidance through menopause and more.

In order to achieve this, students can expect to take classes including:

  • Maternal/Fetal/Newborn Physiology
  • Pelvic Assessment of Adult Women
  • Prevention, Assessment and Intervention of Domestic Violence and Abuse
  • Health and Social Policy
  • Advanced Pharmacology
  • Disparities in Women’s Healthcare
  • Well Patient Gynecology
  • Labor Support
  • Breastfeeding, Post-Partum and Newborn Care
  • Normal Antepartum
  • Primary Care of Women
  • Intrapartum
  • Comprehensive Care Across the Lifespan

In addition to classroom hours, most Certified Nurse-Midwife programs will require a minimum of 500 practice hours.

Certified Nurse-Midwife Program Requirements

Though every Certified Nurse-Midwife degree program is different, most have similar entry requirements, which generally include:

  • Unencumbered, active RN license
  • BSN degree (unless pursuing an RN-to-BSN-to-MSN program)
  • Minimum of one year of women’s health/labor and delivery experience
  • Official transcripts sent to the school
  • Minimum 3.0-grade point average 
  • Minimum GRE score of 300 or better
  • Prerequisite courses 
  • Personal letters of recommendation
  • TOEFL test if applicable

Upon completion of your degree, you will need to pass a 175-question multiple choice test administered by the American Midwifery Certification Board. The exam must be passed within 24 months of graduation from the program, and there is a maximum of four attempts within that time period. 

How Much Does a CNM Degree Cost

The cost to attend a Certified Nurse-Midwife program varies based upon variables such as:

  • Geographic location
  • whether the program is offered in-person or online
  • The school’s reputation
  • Whether the program offers the CNM degree alone or provides both the CNM degree and the WHNP degree

Annual full-time costs range from $20,000 to as high as $65,000 per year.

Paying for the CNM Degree - Financial Aid, Scholarships, Loans 

Though the Certified Nurse-Midwife program offers the opportunity to significantly increase your earning capacity, that does not change the fact that the cost to attend one of these programs can be prohibitive. Pursuing a degree part-time while still earning a salary is a good way to offset the costs. Also, pursuing your studies through one of the online programs is generally less expensive than a traditional in-person program and eliminates the additional costs of relocation. 

There are also many types of financial support and that can help you pay for your education. 

  • Tuition reimbursement through your employer – With the increase in demand for Certified Nurse-Midwives, many healthcare employers are providing tuition reimbursement that can help pay for all or part of your educational expenses. Others are offering assistance in paying off student debt.
  • Your program’s financial aid office – One of the most invaluable sources of information for helping you pay for your CNM degree is your program’s financial aid office. The professionals who work in these offices are constantly searching for scholarships, grants and other forms of financial support to help their students focus on their studies rather than on their economic needs. 
  • Loan repayment programs – The Health Resources and Services Administration (HRSA), the National Health Services Corporation (NHSC), and the Indian Health Service (IHS) offer loan repayment programs that support health professionals in exchange for working in underserved areas.
  • Scholarships – There are numerous scholarships available to support nurses who are advancing their careers and becoming Certified Nurse-Midwives. Some of these include:
    • ACNM Foundation – The ACNM Foundation provides scholarships for midwifery students who are pursuing both MSN-level and DNP-level degrees. Applicants are judged on academic excellence, financial need and leadership potential. 
    • AAUW Career Development Grants -  The American Association of University Women provides funding for women who earned a bachelor’s degree at least five years earlier and who are preparing to advance or change careers. Grants range from $2,000 to $12,000.
    • AfterCollege/AACN $10,000 Scholarship Fund - For students pursuing a bachelor’s master’s or doctoral degree in nursing. One scholarship in the amount of $2,500 is awarded each quarter.
    • March of Dimes Graduate Nursing Scholarships – The March of Dimes offers several $4,000 scholarships to nurses registered in graduate programs of maternal-child nursing.

Next Steps to Enroll In a Certified Nurse-Midwife Program

Making the decision to become a Certified Nurse-Midwife is just the first step. Now you need to make your dream a reality. Here are the steps you need to take:

  • Start investigating the available programs. With less than forty accredited programs available, the task can be accomplished relatively quickly, especially if you are interested in a specific type of program such as a DNP program, an accelerated program, or an online program. If you start off knowing what your goals and priorities are and then compare what you’re looking for to the list of accredited programs provided here, you will quickly identify the programs that will work best for you.
  • Make a list of each program’s application requirements and start collecting your documentation. The key to a successful application process is organization. By making a comprehensive list of what each program expects you will be able to check off each requirement and keep track of your progress, deadlines, and more.
  • Send in your applications.
  • Apply for financial aid, scholarships, grants.

Is the CNM Degree Right for Me? 

A Certified Nurse-Midwife degree lets you provide comprehensive healthcare services to women in a caring, compassionate way that focuses on individualized, holistic attention. CNMs provide 

  • Primary care
  • Gynecologic services
  • Family planning education
  • Preconception and prenatal care
  • Childbirth and post-partum care. 

They also can provide newborn care during the first four weeks of an infant’s life. 

CNMs have extremely high levels of job satisfaction; they build special relationships with their patients, working hard to address their healthcare goals throughout their lifespan, but particularly surrounding childbirth.

Registered Nurses who decide to become Certified Nurse-Midwives work collaboratively with other professionals, enjoy high salaries and a secure employment outlook, and have the special joy of bringing new life into the world and partnering with women throughout their healthcare journey.

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References

American College of Nurse-Midwives

Connecticut Health I-Team

Bureau of Labor Statistics

The Atlantic

New Mexico State University

Georgetown University School of Nursing and Health Studies

National Institutes of Health

National Council of State Boards of Nursing

Accreditation Commission for Midwifery Education

Time Magazine

Association of American Medical Colleges

University of Pennsylvania

Premier Health

American Midwifery Certification Board

Union Leader

ACNM Foundation

Health Resources & Services Administration

National Health Services Corporation

Indian Health Service

AfterCollege

March of Dimes

Nurse.org

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