How to Become a Certified Nurse Midwife

    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:






    New York







    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 What are the Best Nurse-Midwifery Schools?

    There are approximately 40 midwifery education programs that are accredited by the Accreditation Commission for Midwifery Education (ACME). 

    U.S. News and world Report ranks these as the top 10 nursing midwifery programs of study:

    1. University of California-San Francisco
    2. University of Michigan-Ann Arbor 
    3. Vanderbilt University (Nashville, TN) 
    4. Oregon Health and Science University 
    5. University of Minnesota-Twin Cities
    6. Yale University
    7. University of New Mexico 
    8. University of Pennsylvania
    9. University of Utah 
    10. Baylor University (Dallas, TX)

    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, 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, 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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