How to Become a Certified Nurse Midwife


    GUIDE
    July 30, 2020
    Nurse midwife performing tests on pregnant patient

    One of the most fulfilling and lucrative nursing specialties to consider pursuing is that of a Certified Nurse-Midwife. If you're someone with a strong interest in women's gynecological health, prenatal and postnatal care, becoming a CNM is a perfect path. Because you'll be considered an Advanced Practice Registered Nurse (APRN), there is a specific educational path you must take in order to begin your career. 

    Find out more about how to become a CNM, and the special nature of this in-demand nursing career.

    Part One What is a Certified Nurse-Midwife? 

    Certified Nurse-Midwives (CNMs) do more than just deliver babies. CNMs provide health care and wellness care to women, which may include family planning, gynecological checkups, and prenatal care. Although their approach is somewhat different, CNMs in many ways offer similar care to that of an OB/GYN doctor.  

    Perhaps their most important job, however, is helping mothers birth their babies safely and naturally. They help patients manage their labor and monitor both the moms and babies during the delivery to ensure safety. In some cases, they work under the supervision or in collaboration with physicians during C-section births. 

    Nurse-Midwife vs Labor and Delivery Nurse

    They differ from labor and delivery nurses in many ways. L&D nurses are Registered Nurses who trained to monitor patient vital signs and take care of mothers who are in labor. But when the time for delivery comes, they call in the doctor. 

    CNMs are advanced nurse practitioners, meaning they must earn an advanced degree, a special certification, and training to practice.

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    Part Two What is the Salary for Nurse-Midwives?

    According to the Bureau of Labor Statistics, the mean salary for CNMs is $108,810 as of May 2019.

    Because it is an advanced nursing specialty, the earnings are significantly higher than that of a standard RN. It’s also worth pointing out that this represents a mean salary, meaning that there is the potential to earn even more depending on geographic location, experience level, and other factors.

    Highest Paying States for Nurse-Midwives

    The BLS lists the top 5 highest paying states for CNMs as the following:

     

    California

    $154,500
     

    Minnesota

    $121,980
     

    New York

    $120,380
     

    Mississippi

    $119,640

     

    Maryland

    $118,240

    Part Three What is the Career Outlook for a Nurse-Midwife?

    Today, just about 10 percent of US births are attended by midwives. And, according to the American Midwifery Certification Board, as of August 2016, there were 11,475 CNMs in the US. However, over the last few years, there’s been a growing interest among women to consider having their births led by midwives. 

    According to a report in The Atlantic, midwife-led deliveries are generally lower-tech, less invasive, and less inclined toward intervention without a clear medical need. The article cites a 2011 study in the journal, Nursing Economics, which also found that when midwives work in collaboration with physicians, the birth is less likely to end in a C-section. 

    That notion could be one of the reasons why the employment of nurse midwives is projected to grow 26 percent from 2018 to 2028, which is much faster than the average for all occupations. Overall, the nursing profession is in a period of high-growth, but it’s even more true for specialty roles like CNMs.

    Part Four How Do You Become a Certified Nurse-Midwife?

    Becoming a Certified Nurse-Midwife takes multiple steps, and includes earning an advanced degree. As of 2010, a graduate degree is required for entry to midwifery practice as a CNM. In other words, it can take several years to achieve your goal of becoming a CNM. 

    Here’s what your educational path will look like:

    1. Become a Registered Nurse

      Before you can become an advanced nurse practitioner, you must become an RN. That requires graduating from a program of study that is approved by your State Nursing Board, either a bachelor’s degree or associate degree program. Upon completion, you have to pass the NCLEX-RN in order to begin practicing.

    2. Gain Experience

      Many graduate-level nursing programs require one or more years of nursing experience in order to gain admission. 

    3. Earn a Master’s or Doctoral Degree in Nurse-Midwifery

      Most APRN programs prefer candidates who have a bachelor’s degree in nursing, according to the BLS. Therefore, if you became an RN via an associate degree program, you will most likely have to seek out a bridge program that will allow you to go straight into a master’s program. Depending on the program (and whether or not you’re starting out with a bachelor’s degree), it can take two or more years to complete your degree.

    4. Become a Certified Nurse-Midwife (CNM)

      This certification is offered by the American Midwifery Certification Board, and you’ll have to pass its national qualifying exam. Once this is achieved, you will be licensed to practice in all 50 states plus the District of Columbia and US territories.

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    Part Five Top 10 Certified Nurse Midwife Programs

    Methodology

    This list is based on a number of factors including:

    • Reputation
    • Tuition
    • Acceptance rate, when available
    • Only ACEN or CCNE accredited schools are eligible

    Certified nurse midwives can earn either a master's or doctoral degree, so this list takes into account both degree options. 

    Nurse Panel

    Our selection panel is made up of 3 Registered Nurses with years of experience and multiple degrees:

    • Tracy Everhart, MSN, RN, CNS
    • Tyler Faust, MSN, RN
    • Kathleen Gaines, MSN, BSN, RN, BA, CBC

    There are numerous programs that prepare students to become certified nurse midwives and our panel of nurses ranked them based on factors mentioned in the methodology. Because individual nursing pathways and careers take various forms, the top 10 programs are ranked in no particular order. 

    1. Yale University

    Annual Tuition: $48,795

    Online: No

    Program Length: 2 years

    Yale University, an Ivy League school with a reputation as one of the best places for graduate nursing programs, offers a master's in nursing with a specialty in nurse-midwifery. The program only hosts courses on campus in Orange, Connecticut, but boasts a low student-to-faculty ratio of 10:1. Students complete the clinical experience portion at various sites in the area until the final semester of the program where Yale places nurses in a 3-4 month clinical setting somewhere in the nation. So, students also need to get a license wherever they're placed. The result is a perfect pass rate for graduates on the MMCB nurse midwife certification exam.

    2. Oregon Health and Science University

    Annual In-State Tuition: $36,683 Annual Out-of-State Tuition: $41,533

    Online: No

    Program Length: 3 years

    Known for its excellent healthcare facilities and great educational programs, Oregon Health and Science University offers a DNP in nurse midwifery that's perfect for anyone interested in working in Portland or the surrounding area. After finishing four quarters of intrapartum clinical experience, students finish their practicum at another site in Oregon or elsewhere. In total, students complete over 1,000 hours of experience over the three-years they earn the degree, and every graduate of the program over the past six years passed a certification exam.

    3. University of California, San Francisco

    Annual In-State Tuition: $31,755 Annual Out-of-State Tuition: $44,000

    Online: No

    Program Length: 2 years

    The University of California, San Francisco boasts some of the best healthcare education programs in the nation. UCSF's master’s degree with a nurse midwife/women's health nurse practitioner concentration teaches nurses to provide healthcare to mothers and newborns throughout the birthing process. Also, UCSF doesn't require any RN experience, though applicants should first earn their BSN and RN license. Anyone looking to become a licensed nurse midwife in the high-paying state of California should consider applying for this program. 

    4. University of Minnesota

    Annual Tuition: $23,000

    Online: No

    Program Length: 3 years

    As the main public university in the Twin Cities, the University of Minnesota hosts various great programs at a low tuition cost. Those interested in becoming a nurse midwife enroll in the DNP program, a three-year degree. The program blends nursing with coursework in informatics and economics, helping nurses become well-rounded leaders, experts, and nurse midwives. Students earn roughly 1,000 clinical hours during the full-time program, and graduates go on to excel on the AMCB certification exam. 

    5. University of Michigan

    Annual In-State Tuition: $25,100 Annual Out-of-State Tuition: $50,686

    Online: No

    Program Length: 2-4 years

    Another excellent school located in the North, the University of Michigan boasts great graduate programs, especially for nurses. Those interested in nurse midwifery have several options: an MSN or DNP, which comes in 2-3 or 3-4 year plans, respectively. The shorter plan options require full-time study while the longer options use a year-round, part-time format. U-Michigan graduates regularly succeed in certification exams, too. Current Michigan residents also get to take advantage of incredibly low tuition rates, making this an ideal option for those students. 

    6. University of Washington

    Annual Tuition: $28,117

    Online: No

    Program Length: 3 years

    Located in Seattle and with access to some of the best healthcare facilities in the region, the University of Washington blends great clinical practice with quality education for its DNP in nurse midwifery. The program only accepts full-time, on-site nurses, but teaches skills beyond nurse midwifery including leadership, healthcare systems management, and equity. The aggregate AMCB certification exam pass rate from 2014-2018 is 93%, and those that didn't pass the exam on their first try enjoyed a 100% retake pass rate. 

    7. Vanderbilt University

    Annual Tuition: $43,758

    Online: No

    Program Length: 2 years

    Based in the vibrant city of Nashville, Vanderbilt University is one of the world's top research universities. The MSN in nurse midwifery provides nurses with a chance to learn innovative theories through research-based courses, followed by clinical experience at sites across Tennessee, Kentucky, Alabama. Of course, students also gain experience at Vanderbilt's world-class healthcare facilities. Students can also choose a dual-focus in nurse midwifery/family nurse practitioner, increasing the scope of practice. 

    8. New York University

    Annual Tuition: $50,910

    Online: No

    Program Length: 2 years

    New York University provides students with a high-caliber education in one of the global business capitals. Nurses in the MSN in nurse midwifery program learn theories and gain hands-on practice at the same time, applying the skills they learn early on through clinical experience. Graduates of the program regularly pass the AMCB certification exam, and the only students who did not pass in 2019 have had their retest postponed due to COVID-19. NYU also only accepts 10-15 students per year, but only receives 15-20 applications each year. The cost of education is steep compared to some public options, but the cost is well worth it. 

    9. University of Pennsylvania

    Annual Tuition: $51,094

    Online: No

    Program Length: 2 years

    Another Ivy League school with many great programs, the University of Pennsylvania offers a dual major nurse midwifery/women's health nurse practitioner degree. Students can choose to study either full-time or part-time with part-time students taking three years to graduate. UPenn organizes all the clinicals and preceptors, too, making the process easier for students. Applicants should earn a BSN and hold an RN license, and professional experience helps strengthen applications. The private, Ivy League school is pricey, but the education is among the best available. 

    10. Emory University

    Annual Tuition: $45,732

    Online: No

    Program Length: 2 years

    A university that focuses heavily on healthcare programs, Emory University of Atlanta, Georgia, has one of the oldest nurse midwife programs in the nation. Created in 1977, the master's in nurse midwifery is a four-semester program that comes in both a full-time and part-time format. Students gain clinical experience in sites across Atlanta, learning to become leaders in the field and making positive changes to regional communities. From 1977-2015, a total of 370 nurses graduated from the nurse midwifery program, and every student from 2015-2017 passed their certification exam.

    Part Six What is it Like to be a Nurse-Midwife?  

    As mentioned above, nurse midwives have numerous responsibilities, but generally, they are focused on women’s health care. Among their most common duties include delivering babies, providing prenatal and postpartum care, assisting obstetricians, and performing routine check-ups to pregnant patients.

    According to Midwife.org, 53% of CNMs identify reproductive care and 33% identify primary care as main responsibilities in their full-time positions. This includes things like annual exams, writing prescriptions, basic nutrition counseling, patient education, and reproductive health visits. Also worth noting is that as of 2014, almost 95% births attended by midwives took place in hospitals, with the rest happening in birth centers or homes.  

    Like most healthcare professionals, being a CNM means working nontraditional hours, and being “on call” to respond to patients who go into labor. CNMs typically work in private practices alongside obstetricians, in hospitals, or in birthing centers.

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    Part Seven What Are the Continuing Education Requirements for Nurse-Midwives? 

    Recertification by the American Midwifery Certification Board is required every five years.  CNMs have two main certificate maintenance options:

    Option 1 requires CNMs to complete three modules over a 5 year period and submit proof of 20 hours of relevant continuing education. The required education hours can be completed through a variety of options that include attending a conference, publishing an article, etc. All of the options require proof of attendance or validation/verification.

    Option 2 allows a CNM to retake the certification exam as another means to demonstrate continued competence in midwifery practice.

    Part Eight Where Can I Learn More About Nurse-Midwives? 

    Embarking on a CNM career is exciting, but challenging. To learn more about the profession, it’s a great idea to explore the career resources and information that professional organizations have to offer. Here are two to look into if you’re an aspiring CNM:

    The American College of Nurse-Midwives is the professional association that represents CNMs.

    The Midwives Alliance of North America (MANA) is a professional midwifery association uniquely positioned to unite and strengthen all midwives through dedication to innovative education, professional development, and recognized autonomous practice. 

    You can also see if your state has an association, such as the New York State Association of Licensed Midwives. 

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    Part Nine Where Can I Find the Best Nurse-Midwife Jobs?

    Because of the nature of a CNMs expertise, finding work shouldn’t be a challenge no matter where you live. Add to that the fact that the demand for nurses overall is strong as much of the workforce is reaching retirement age.  

    CNMs are also not limited to hospitals, as many run their own private practices, or work in groups with OB/GYNs.

    Take a look at some current openings for Certified Nurse-Midwives in your area to get an idea of the positions available. 

    Part Ten Nurse Midwife FAQs

    • What degree does a Nurse-Midwife need?

      • Nurse-Midwives need either an MSN or DNP degree and they also need to pass the certification exam offered by the American Midwifery Certification Board.
    • Where can Nurse-Midwives work?

      • Certified Nurse-Midwives can work in a variety of locations including, hospitals, private practices, international medical relief organizations, concierge services, birthing centers, health clinics, or home birth services.
    • How much do Nurse-Midwives make?

      • According to Payscale.com, Certified Nurse-Midwives make an average salary of $96,853. 
    • What is the difference between a Midwife and a Certified Nurse-Midwife?

      • The term midwife is used for direct entry into the profession including doulas. A midwife does not have any training in nursing and does not hold an advanced practice degree in nursing. While some of the training is similar, a Certified Nurse-Midwife has more education and experience than a traditional midwife. 

    As more and more families seek a natural, positive birth experience, the demand for Certified Nurse-Midwives will continue to grow. But beyond just deliveries, women are turning to CNMs for their overall health care needs.

    If you’d like to devote yourself to a profession that promotes wellness in women and helps ensure safe deliveries and healthy babies, a Certified Nurse-Midwife career may be your ideal path. 

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