What Do Nurse Midwives Do?

5 Min Read Published July 7, 2023
What Do Nurse Midwives Do?

certified nurse midwife (CNM) is an advanced practice registered nurse (APRN) who has obtained additional education and certification in midwifery. 

CNMs specialize in providing care to women throughout their reproductive lifespan, including prenatal, childbirth, and postpartum care and gynecological services.

This article will help you learn more about what nurse midwives do, including their day-to-day duties, where they work, and the pros and cons of being a nurse midwife. Keep reading to learn what it's really like to be a nurse midwife and if that might be the right career path for you. 

What Do Certified Nurse Midwives Do?

CNMs play a crucial role in the healthcare system by providing comprehensive care to women throughout their reproductive lifespan. They provide:

  • Prenatal care
  • Labor and delivery assistance
  • Postpartum support
  • Gynecological services

You should also understand that a CNM's scope of practice varies depending on your state. As of April 2022, 27 states and the District of Columbia grant CNMs full practice authority. 

Three states still require physician supervision, and 20 mandate a collaborative practice agreement for certain nurse-midwifery services. Because of these differences, what nurse midwives do daily may change slightly depending on where they practice.

Remember, there are differences in midwife vs nurse midwife scopes of practice. While full practice authority applies to a certified nurse midwife, other types of midwives may not be able to practice independently.

Certified Nurse Midwife Job Duties

Here is an overview of what nurse midwives do, their duties, and their responsibilities:

Provide Prenatal Care

CNMs provide holistic and proactive prenatal care to promote a healthy pregnancy and prepare their patients for childbirth. CNM prenatal care duties include:

  • Conducting physical exams and assessments
  • Providing prenatal education and helping with childbirth preparation
  • Ordering and interpreting prenatal tests and screenings 
  • Using diagnostic tools such as ultrasounds
  • Promoting health and preventing complications through education on prenatal vitamins and healthy lifestyle choices
  • Offering emotional support and counseling 

Assist With Childbirth

CNMs are essential in childbirth as their specialized knowledge in midwifery enables them to facilitate safe and empowering births. 

During childbirth, CNMs monitor labor progress, assess maternal and fetal well-being, offer pain management techniques, and intervene when needed. 

They often work collaboratively with healthcare providers, ensuring the mother's and newborn's physical and emotional well-being.

Specific CNM labor and delivery duties include:

  • Monitoring maternal vital signs, fetal heart rate, and labor progression
  • Assisting with pain management techniques, such as breathing exercises and relaxation techniques
  • Assessing cervical dilation and fetal descent
  • Providing emotional support during the pushing stage
  • Collaborating with obstetricians and other healthcare professionals when medical interventions are necessary
  • Facilitating a safe and supportive environment during birth 
  • Providing immediate postpartum care to the mother and initial assessments of the newborn's health

Provide Postpartum Care

CNMs offer comprehensive care and emotional support during the postpartum period as well. 

They monitor physical recovery, address complications, and help guide breastfeeding and family planning. Specific CNM job duties involving postpartum care include:

  • Assessing and monitoring the physical recovery of the mother
  • Providing guidance and support on breastfeeding
  • Conducting postpartum assessments to monitor vital signs and uterine involution
  • Addressing any postpartum complications or concerns, such as postpartum depression, infections, or breastfeeding difficulties
  • Providing education on postpartum self-care
  • Assisting with family planning by providing contraceptive counseling
  • Promoting the bonding and attachment between the mother and the newborn, encouraging skin-to-skin contact, and facilitating early parent-infant interactions

Provide Gynecological Care

CNMs play a crucial role in providing gynecological care to women across the lifespan. Some specific duties of CNMs in providing gynecological care include:

  • Conducting routine gynecological exams and breast examinations
  • Assessing and diagnosing gynecological conditions, such as menstrual disorders, pelvic pain, and STIs
  • Managing menopausal symptoms
  • Performing screenings for cervical cancer 
  • Referring patients to specialists or collaborating with other healthcare providers for further evaluation if needed

Education and Counseling

CNMs also emphasize patient education and counseling to empower women with reproductive health knowledge. Some of the duties related to education and counseling that CNMs fulfill include the following:

  • Offering information and guidance on reproductive health, family planning, and contraception options
  • Educating patients about STIs
  • Providing preconception counseling 
  • Conducting prenatal education classes to prepare expectant mothers for pregnancy, childbirth, and newborn care

You can learn more about how CNMs apply these duties and responsibilities at work in our certified nurse midwife meaning guide.

>> Show Me Online Nurse Midwifery Programs

Where Nurse Midwives Work 

You can find CNMs providing comprehensive care in various healthcare settings. Common places where nurse midwives work are:

  • Hospital settings (public or private)
  • Birth Centers
  • Women's Health Clinics
  • Private Practices
  • Military Hospitals
  • Academic Institution
  • Public Health Settings
  • Government Agencies

Remember, the specific work settings for CNMs may vary based on state regulations and local healthcare systems.

A Day in the Life of a Nurse Midwife 

CNMs have dynamic careers that vary widely from one day to the next. 

Often, CNMs begin their shifts with prenatal appointments, deliveries, postpartum care, or attending to the gynecological needs of their patients. They may also start their day by reviewing patient charts and staying updated on new developments or concerns.

CNMs also collaborate with obstetricians and healthcare teams when medical interventions are necessary, ensuring the mother's and newborn's safety and well-being. 

To give you an idea of what nurse midwives do on a day-to-day basis, here are some key tasks that a CNM may perform during their shift:

  • Review patient charts and stay updated on developments
  • Conduct prenatal appointments
  • Perform physical exams 
  • Monitor laboring women, offering guidance, and pain management techniques
  • Provide postpartum care, including check-ups and breastfeeding support
  • Engage in administrative tasks such as documentation
  • Review test results and consult with other healthcare professionals
  • Participate in interdisciplinary meetings
  • Stay informed about changes in regulations and evidence-based practices

>> Show Me Online Nurse Midwifery Programs

Becoming a Nurse Midwife Pros and Cons

Knowing what nurse midwives do is the first step to choosing whether you want to pursue a career as a CNM. But you should also weigh the pros and cons of nurse-midwifery before deciding. Understanding the benefits and challenges of becoming a CNM can help you make an informed and well-rounded choice that aligns with your personal and professional goals.

Nurse Midwife Pros:

  • CNMs typically take a holistic approach to care

  • CNMs are trained to provide care and support natural births during normal, low-risk pregnancies and childbirth

  • CNMs often have a broad scope of practice that includes primary care, prenatal care, family planning, and gynecological care

  • CNMs often work in collaboration with obstetricians, gynecologists, and other healthcare professionals

  • Many CNMs take great pride in their work and the opportunity to make a positive impact on women’s health

Nurse Midwife Cons:

  • CNMs often have irregular working hours, as births are not on a set schedule

  • The career can be emotionally demanding and intense

  • As with any healthcare profession, CNMs have a risk of malpractice claims (and require malpractice insurance coverage)

  • The scope of practice can vary from state to state, with some states requiring practice agreements or physician supervision

  • A CNM career can be very physically demanding



Next Steps

As a nurse midwife, no two days look the same, and many experienced CNMs will say the work is gratifying. However, if you want to become a nurse midwife, you should weigh the pros and cons of entering this demanding career field. Understanding these aspects will help you make informed decisions about pursuing a career as a CNM. Read our full guide about becoming a certified nurse midwife to learn more, or explore top certified nurse midwife programs

Sarah Jividen
Sarah Jividen
Nurse.org Contributor

Sarah Jividen, RN, BSN, is a trained neuro/trauma and emergency room nurse turned freelance healthcare writer/editor. As a journalism major, she combined her love for writing with her passion for high-level patient care. Sarah is the creator of Health Writing Solutions, LLC, specializing in writing about healthcare topics, including health journalism, education, and evidence-based health and wellness trends. She lives in Northern California with her husband and two children. 

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