Certified Nurse-Midwife (CNM)

Certified nurse-midwives are caring advanced practice nurses who have received additional training in the care of women and newborns during pregnancy, birth, and postpartum. According to the American College of Nurse-Midwives, certified nurse-midwives reduce the stress of pregnant mothers, the cost of care, and the number of interventions during pregnancy and labor. Certified nurse-midwives also increase access to care as they are relied on heavily in low income and rural areas.

In order to become a certified nurse-midwife, or CNM, nurses must earn either a master’s of science in nursing or a doctor of nursing practice degree with a specialization in nurse-midwifery. During these intensive two- to four-year CNM programs, nurses learn to provide prenatal care, deliver babies, provide postpartum care, and care for newborns. Often these programs also teach nurses to provide well-woman care, prescribe birth control, and administer routine gynecological exams.

Currently, there is a significant physician shortage in the US that could leave the country short 130,000 doctors by 2030 (AAMC 2020). This shortage is driving an increase in demand for advanced practice registered nurses (APRNs), including nurse-midwives.

Between 2019 and 2029, the Bureau of Labor Statistics (BLS 2020) estimates that there will be a 12 percent increase in demand for nurse-midwives, which is three times the expected national average increase for all jobs. Not only is this a growing field, but it can also be lucrative. According to the BLS (May 2019), nurse-midwives earn $108,810 per year on average.

If a career in a growing field caring for mothers and babies sounds interesting, continue reading to learn what is needed to start this career, including a step-by-step guide, top programs, and what certification and licensing may be required.

Certified nurse-midwives are advanced practice registered nurses (APRNs) who have specialized training in midwifery. They will have earned at least a master’s of science in nursing (MSN), although many opt to earn a doctor of nursing practice (DNP) degree. Some MSN and DNP nurse-midwifery degree programs may in fact be dual-specialization CNM / Women’s Health Nurse Practitioner (WHNP) programs, allowing graduates to pursue licensure in both advanced practice areas.

Generally, certified nurse-midwife programs require applicants to be licensed and registered nurses (RNs). Most MSN and DNP programs also require candidates to have already completed a bachelor’s of science in nursing (BSN), although some may accommodate RNs prepared with an associate degree in nursing (ADN) and/or a non-nursing bachelor’s degree. Some DNP programs may require applicants to hold an MSN, although there are BSN-to-DNP programs where, in some cases, students earn their MSN as part of the program.

Other admission requirements can include letters of recommendation, an in-person interview, GRE or Miller Analogies Test (MAT) exam scores, and a personal statement. International students may need to provide proof of English proficiency with an IELTS or TOEFL test score.

The Accreditation Commission for Midwifery Education (ACME) accredits certified nurse-midwife programs. Nurses should ensure the program they attend is accredited by the ACME as this is a requirement to be eligible for board certification. ACME accreditation demonstrates that a CNM program provides high-quality education, is committed to improvement, and has effective administration policies.

Rutgers University – School of Nursing

Rutgers University School of Nursing offers a DNP for licensed nurses, which can be completed in as little as three years of full-time study. Nurses will learn the fundamentals of caring for pregnant women and newborns using evidence-based practices that ensure quality care across ethnicities and socioeconomic backgrounds. In addition to learning the technical skills for day to day work, students will also learn leadership skills and how to incorporate research into everyday practice.

Lecture courses students must complete include management and analysis of health data for the doctor of nursing practice, evidence translation and implementation science, healthcare economics and business practices, and social determinants of health. Clinical rotations are required in gynecology, childbearing, primary care, postpartum, and neonatal care.

• Location: Newark, NJ
• Duration: Three to four years
• Accreditation: Accreditation Commission for Midwifery Education (ACME)
• Tuition: $1,367 per credit-hour

Columbia University-School of Nursing

The Columbia University School of Nursing DNP program is ranked number one in the nation, according to US News & World Report. This full-time on-campus program teaches midwifery and newborn care principles, in addition to well-woman care, gynecology, and family planning. Graduates of this program are eligible to sit for the AMCB certification exam.

This program provides a strong foundation in theoretical health science and then has students apply it in the clinical setting to gain the skill necessary to be excellent midwives. All courses and clinical practices are taught with an emphasis on cultural sensitivity and awareness. Admission requirements include holding an RN license, a BSN or MSN degree, and prerequisite coursework.

• Location: New York, NY
• Duration: Two years
• Accreditation: Accreditation Commission for Midwifery Education (ACME)
• Tuition: $66,156 per year

Georgetown University – School of Nursing and Health Studies

Georgetown University School of Nursing and Health Studies offers a dual MSN program in midwifery and women’s health. Combining these two disciplines allows nurses to provide holistic patient-centered care for women even before or after childbearing years. This part-time program is offered online, with three required on-campus intensive sessions. Graduates are eligible to sit for the AMCB certification exam and the National Credentialing Corporation (NCC) women’s health nurse practitioner (WHNP) certification.

With over 1,000 hours of required clinical practice, nurses in this program have extensive hands-on experience with women and newborns. Admission requirements to this program include already holding a BSN, be a licensed RN, have a 3.0 undergraduate GPA, and have completed a college-level statistics course.

• Location: Washington, DC
• Duration: 27 months
• Accreditation: Accreditation Commission for Midwifery Education (ACME)
• Tuition: $2,214 per credit-hour

Baylor University – Louise Herrington School of Nursing

Baylor University’s Louise Herrington School of Nursing offers a fully online DNP program that can be completed in as little as two years. In 2019, 100 percent of graduates of this program passed their AMCB certification exam, proving that nurses who earn this degree are well prepared to serve mothers and babies in a variety of settings. As this program is entirely online, students can complete their clinical studies at hospitals or clinics near them.

Candidates for this program must already have one year of experience as a nurse in a labor and delivery, mother-baby unit, or outpatient OB/GYN clinic. Nurses who have extensive experience observing childbirth or who have worked as doulas will also be considered.

• Location: Waco, TX
• Duration: Two to three years
• Accreditation: Accreditation Commission for Midwifery Education (ACME)
• Tuition: $1,100 per credit-hour

It takes at least seven years (after graduating from high school) to become a certified nurse-midwife due to education and work experience requirements. If a nurse chooses to pursue a DNP degree, it can take one to two more years of education.

Step 1: Graduate from High School or Complete a GED (Four Years)

Completing high school or obtaining a GED is the first step towards becoming a certified nurse-midwife. Courses such as math, chemistry, and health will help prepare students for future studies necessary to enter this field. Advanced placement classes also help prepare students for the rigors of college coursework.

Step 2: Complete a Bachelor of Science in Nursing (Four Years)

Most advanced nursing degrees require applicants to have already completed a bachelor’s of science in nursing. This degree can either be completed as a stand-alone four-year program or be done as a completer program for nurses who only have an associate. Aspiring nurse-midwives should look for programs that include a rotation in labor and delivery or a mother-baby unit.

Step 3: Become a Registered Nurse (Timelines Vary)

Applicants to MSN and DNP programs typically must already be registered nurses (RNs). While licensing requirements can vary by state, they usually include completing an accredited program, a background check, and passing the National Council Licensure Examination (NCLEX-RN).

Step 4: Gain Work Experience (One Year Minimum)

One of the requirements for many MSN and DNP programs is at least one year of work experience. Aspiring certified nurse-midwives need to earn their work experience in a labor and delivery unit, mother-baby floor, or OB/GYN clinic. Some schools will accept experience observing labor and delivery or as a doula.

Step 5: Complete a Graduate Degree in Nursing (Two to Four Years)

Certified nurse-midwives must complete an MSN or DNP program with a specialization in midwifery. This program must be accredited by the ACME. During their studies, nurses will learn the necessary techniques and skills to care for women and newborns during normal pregnancy, delivery, and postpartum. Some of these programs also include dual degrees in women’s health.

Step 6: Obtain Certification From The American Midwifery Certification Board (Timelines Vary)

Certified nurse-midwives must be board certified through the American Midwifery Certification Board (ACMB). To earn certification, midwives must pass an exam. More details about certification can be found below.

Step 7: Obtain Certified Midwife State Licensure (Timelines Varies)

Certified nurse-midwives must be licensed in their chosen state of practice. While requirements vary by state, most require candidates to hold AMCB certification, have completed an accredited midwifery program, pay a licensing fee, submit a completed application, and pass a background check. The certification and licensing section below has further details.

Certified nurse-midwives work in hospitals, OB/GYN clinics, and birth centers. Some CNMs work independently and provide home birth services. Nurse-midwives work with uncomplicated pregnancies and births. Typical day to day duties include:

• Performing prenatal checks for pregnant clients
• Attending patients’ births
• Repairing lacerations that happen during birth
• Managing emergencies that may arise during a birth
• Caring for newborns immediately after birth
• Providing follow up care post-partum to mother and baby
• Administering gynecological exam
• Prescribing medications including birth control and antibiotics
• Educating patients and their partners on wellness, birth control, and family planning
• Maintaining careful client records

Certified nurse-midwives must be both board-certified and licensed by the state where they practice. Board certification is obtained through the American Midwifery Certification Board (ACMB). To be eligible to sit for the exam, nurses must complete an Accreditation Commission for Midwifery Education (ACME) accredited certified nurse-midwife program and earn either an MSN or DNP.

Licensing requirements for certified nurse-midwives varies by state. Typical requirements include ACMB certification, proof of an ACME accredited degree program, pass a background check, and submit a completed application.

For example, in California, the requirements are:

• Hold a current RN license in California or apply for one by endorsement
• Verification of completion of a nurse-midwife academic program
• Verification of completion of clinical training in a nurse-midwife academic program
• Proof of ACMB certification
• Pay $500 application fee

According to the Bureau of Labor Statics, the 6,930 certified nurse-midwives in the US earned $108,810 per year on average (May 2019). Wages vary based on graduate degree earned, place of employment, and years of experience. The percentiles for wages were:

• 10th percentile: $69,000
• 25th percentile: $86,990
• 50th percentile (median): $105,030
• 75th percentile: $127,110
• 90th percentile: $158,990

Kimmy Gustafson

Writer

At HealthcareDegree.com, Kimmy Gustafson has delivered in-depth and insightful articles since 2019, aiding prospective students to navigate the complexities of choosing the right healthcare degree. Her recent work includes topics such as the ethics of gene editing and physician assistant’s fight for autonomy.

Kimmy has been a freelance writer for more than a decade, writing hundreds of articles on a wide variety of topics such as startups, nonprofits, healthcare, kiteboarding, the outdoors, and higher education. She is passionate about seeing the world and has traveled to over 27 countries. She holds a bachelor’s degree in journalism from the University of Oregon. When not working, she can be found outdoors, parenting, kiteboarding, or cooking.