GUIDE
February 21, 2022
Nurse midwife performing tests on pregnant patient

Part One What is a Certified Nurse-Midwife (CNM)? 

A Certified Nurse-Midwife (CNM) is a type of advanced practice registered nurse (APRN) that provides healthcare to woman throughout the entire course of their lives. This 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. 

Certified Nurse-Midwife Fast Facts

  • Education Requirements: MSN or DNP
  • How long does it take to become a certified nurse-midwife? 6-8 years 
  • Salary: The average nurse-midwife salary is $111,130 per year

Part Two What Does a Nurse-Midwife Do?

Nurse midwives 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.

One of their most important roles 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 of, or in collaboration with, physicians during C-section births. 

According to the American College of Nurse-Midwives, 76% of CNMs identify reproductive care and 49% identify primary care as the main responsibilities in their full-time positions. This includes things like:

  • Annual exams
  • Writing prescriptions
  • Basic nutrition counseling
  • Patient education
  • Reproductive health visits

Also worth noting is that as of 2019, almost 89% of births attended by midwives took place in hospitals, with the rest happening in birth centers or homes.  

Why I Became a Nurse Midwife

"I chose my career because I wanted to empower women to make their own informed choices regarding their health. Midwifery care is about providing health information and then placing power in the hands of the individual, so they are empowered to make the choices that best suit them."

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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Nurse-Midwife vs Labor and Delivery Nurse: What's the Difference?

Nurse-midwives differ from labor and delivery nurses in many ways.

  1. 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. 
  2. CNMs are advanced nurse practitioners, meaning they must earn an advanced degree, a special certification, and training to practice.

>> Top Certified Nurse Midwife Programs

Part Three Average Nurse Midwife Salary

According to the Bureau of Labor Statistics (BLS), the median average certified nurse midwife salary is $123,780 as of May 2021, or $59.51 per hour.

CNM Salary Range

The lowest 10 percent earned less than $79,870, and the highest 10 percent earned more than $200,540. 

Nurse Midwife Salary by Years of Experience

Midwives have the ability to earn increased pay with increased years of experience. According to paycale.com, midwives can earn the following: 

  1. Less than 1 year of experience - $92,661
  2. 1 to 4 years of experience - $94,720
  3. 5 to 9 years of experience - $98,410
  4. 10 to 19 years of experience - $106,163
  5. 20 years or more of experience - $100,953

Highest Paying States for Nurse-Midwives

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

State

Annual Mean Wage
West Virginia $163,190
Utah $143,890
California $137,070
Massachusetts $129,360
New York $126,170

Highest Paying Cities for Nurse-Midwives

Top paying metropolitan areas for Nurse-Midwives are:

Charleston, WV $169,460
San Francisco-Oakland-Hayward, CA $162,800
San Jose-Sunnyvale-Santa Clara, CA $157,570
Sacramento--Roseville--Arden-Arcade, CA $150,990
Salt Lake City, UT $133,950

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Part Four How to 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.

What I Love About Being a Nurse Midwife

"I love that I get to play a role in patients discovering their own strength. I love that I get to support families through some of the most challenging and most fulfilling moments in their lives. Midwifery is truly a calling and my education has enabled me to answer the call."

Part Five Top Certified Nurse Midwife Programs

These are the top 5 best CNM programs, check out our full list of the best programs here: Best midwifery schools.

1. Vanderbilt University, Nashville, TN

Vanderbilt’s midwifery program is located next door to their University Medical Center, which is also one of the top medical centers in the nation. They boast a rigorous midwifery program and one of the largest nurse-midwifery programs in the US.

2. Oregon Health and Science University, Portland, OR

Oregon Health and Science University (OHSU) in Portland, Oregon, is located between the Pacific Ocean and the Cascade mountain range. Many Nurse-Midwifery students appreciate the geographical beauty of the area and the fact that the state has a solid reproductive and maternity care reputation. Nurse-midwives are present in nearly 20% of all births in the Portland area!

The OHSU Nurse-Midwifery program has taught students for over 30 years between the university hospital and surrounding clinics. Students learn by attending many of the births at the OHSU hospital. 

3. University of Michigan, Ann Arbor, MI

The University of Michigan (UM)  at Ann Arbor, Michigan, offers two options for nurses who want to be nurse-midwives:

  • A Nurse-Midwifery-MSN
  • A Nurse-Midwifery-DNP

4. University of Pennsylvania, Philadelphia, PA

The UPenn midwifery program offers unique clinical education opportunities offered through the school and the most current research in the field. Some of the skills they say they teach that may not be available through other programs include procedures such as OB ultrasonography, IUD insertion, and endometrial biopsies, to name a few. 

5. East Carolina University, North Carolina

East Carolina University in North Carolina has a nurse-midwifery program to prepare registered nurses to become competent practitioners of nurse-midwifery and become Certified Nurse-Midwives (CNMs).

Part Six Career Outlook for Nurse-Midwives

Today, just about 10 percent of US births are attended by midwives. According to the BLS, there were 7,300 midwives practicing in the United States in 2020. According to the American Midwifery Certification Board, as of December 2020, there were 12,805 CNMs. 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 BLS predicts the employment of nurse midwives is projected to grow 45% percent from 2020 to 2030, 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.

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Part Seven Continuing Education Requirements for Certified 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. One module must be completed in EACH of the three areas of practice: Antepartum and Primary Care of the Pregnant Woman; Intrapartum, Postpartum, and Newborn; and Gynecology and Primary Care for the Well-Woman. 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 Certified 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 nurse jobs 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.
  • What is the difference between a midwife and a certified nurse-midwife?

    • The term midwife is used for direct entry into the profession. 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. 

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