Nurse with a pregnant patient

How to Become a Certified Nurse Midwife

Duties, Responsibilities, Schooling, Requirements, Certifications, Job Outlook, and Salary

Nurse with a pregnant patient

This career guide offers a deeper look into one of the highest paid nursing jobs in the United States, the Certified Nurse Midwife (CNM).

(Click here to see our full list of best paying nursing jobs).

While the number of nursing specializations are many, Certified Nurse Midwives (CNMs) provide women with specialized care throughout the course of their lives. This may include pregnancy, family planning, or general care.

In addition to higher wages, Nurse Midwives reap other benefits as well.

If you feel passionately about obstetrics or child delivery, becoming a Nurse Midwife could be the ideal career path for you.

Continue reading our comprehensive career guide to learn more about the requirements, responsibilities, training, and average salaries of Nurse Midwives.

Certified Nurse Midwife Definition

What Is a Nurse Midwife?

The role of a Nurse Midwife can be defined as an Advanced Practice Registered Nurse (APRN) who specializes in childbirth and women’s reproductive health. Not only do they attend to women during pregnancy, childbirth, and postpartum, but they are also responsible for women’s general health and quality of life.

Certified Nurse Midwife Requirements

How to Become a Certified Nurse Midwife

As with several other nursing specialties, your educational path to becoming a Nurse Midwife can vary.

Regardless of how you get there, you will likely be required to earn a Master of Science in Nursing (MSN) degree with a specialization in Midwifery.

Although it’s not required, some Nurse Midwives also hold a Doctorate of Nursing Practice (DNP) degree.

Certified Nurse Midwife Job Requirements

All Advanced Practice Registered Nurses (APRNs), including Certified Nurse Midwives, must meet the following requirements minimum requirements:

  1. A master’s degree from an accredited MSN program
  2. Be a licensed Registered Nurse in your state of employment
  3. Pass a national certification exam
  4. Hold a state APRN license

Traits for Success

Becoming a Certified Nurse Midwife may be a great fit for you if…

  • You enjoy working with women from varied backgrounds
  • You enjoy educating patients and promoting holistic health
  • You are adept at building relationships based on trust
  • You can remain unbiased in most situations
  • You work well under pressure
  • You can provide support during stressful or emotional events

Certified Nurse Midwife Duties & Responsibilities

What Does a Certified Nurse Midwife Do?

The duties of a Nurse Midwife can vary from state to state. However, they typically include the following responsibilities:

Women’s health maintenance

  • Encouraging preventive health screenings and tests
  • Educating others on women’s health issues
  • Recognizing and treating gynecological disorders such as infertility, sexually transmitted diseases and urogynecological disorders

Family planning

  • Providing support and educational guidance around contraception
  • Educating, treating, or referring patients suffering from infertility
  • Offer counsel and support for patients with unexpected pregnancies
  • Addressing various concerns surrounding menopause

Antepartum period

  • Confirming and dating pregnancies
  • Screening for domestic violence, substance abuse, and high-risk behaviors during pregnancy
  • Monitoring patients for potential congenital disabilities
  • Monitoring fetal development and patient health

Intrapartum period

  • Assessing labor progress
  • Monitoring the mother and fetus during labor
  • Managing complications during labor
  • Administering medications or other treatments to help manage pain
  • Facilitating labor when necessary
  • Delivering the newborn
  • Performing episiotomies if necessary

Postpartum care

  • Assisting mother with uterine massage after birth
  • Educating mothers on the physiologic and psychological changes that can occur post-birth

Newborn care

  • Establishing and maintaining newborn respirations
  • Assisting new moms with feeding/latching
  • Promoting bonding and attachment
  • Health evaluation and treatment of newborns
  • Monitoring feeding and weight gain for newborn babies
  • Educating caregivers on infant care
  • Ordering preventive care and screenings for newborns

Where Do Certified Nurse Midwives Work?

According to the U.S. Bureau of Labor Statistics (BLS), hospitals and physician offices are the largest employers of Nurse Midwives.

Nurse Midwives can work in a variety of facilities, including the following healthcare settings:

  • Hospitals
  • Clinics
  • OB/GYN offices
  • Private Practices
  • Outpatient care centers (i.e. birthing centers)
  • Patient Homes
  • Schools

Nurse Midwife Work Hours

Like most nursing specialties, the hours of a Certified Nurse Midwife will depend on their employer, location, and work setting.

Due to the nature of their profession, births can be unpredictable and may result in unpredictable work hours.

Some Nurse Midwives may have to work weekends and night shifts, while others may need to be on call.

The Nurse Midwife Uniform

The work uniform of a Nurse Midwife largely depends on their workplace setting.

In a hospital, Nurse Midwives will typically wear professional attire, lab coats, and comfortable shoes. In contrast, Nurse Midwives who work in patient homes might wear more casual attire.

All Nurse Midwives typically wear hospital scrubs during the child delivery process.

What Are the Benefits of Midwife-Assisted Births?

According to the American College of Nurse-Midwives, the benefits of a Midwife-assisted birth include but are not limited to:

  • Lower rates of cesarean births
  • Lower rates of labor induction/augmentation
  • Significant reduction of third and fourth-degree perineal tears
  • Less use of regional anesthesia
  • Higher rates of breastfeeding

Women under the care of CNMs are also more likely to receive:

  • Prenatal education
  • A more hands-on approach and closer relationship with their provider
  • Fewer technological and invasive interventions

Certified Nurse Midwife Education

What Training Is Required to Become a Certified Nurse Midwife?

To become a Nurse Midwife, you must earn a Master of Science in Nursing (MSN) degree and receive a state APRN license.

Although certification requirements may differ by state, an MSN degree is considered the minimum requirement for all Nurse Midwives.

For aspiring Nurse Midwives who have a non-nursing bachelor’s degree but would like to earn the MSN, some schools offer a Master’s Entry Program in Nursing (MEPN), allowing them direct entry into a Master’s program.

Steps to Becoming a Certified Nurse Midwife

Step 1: Earn an associate or BSN degree in nursing

Step 2: Pass the NCLEX-RN certification exam to become a licensed Registered Nurse

Step 3: Earn your graduate degree in nursing

Step 4: Pass a national certification exam

Step 5: Obtain your state’s advanced practice nursing license

Baby holding hands

Nurse Midwife Programs

To understand the core curriculum of a Nurse Midwife program, you should look at nursing courses that fall under the Master of Science in Nursing (MSN) degree, as this is the requisite education you must receive to become a Nurse Midwife.

An MSN degree builds on theories and skills learned during your undergraduate studies, so applicants are typically required to fulfill some prerequisite requirements.

To be accepted into a nursing master’s program, candidates are typically required to submit several standard application materials, such as academic transcripts, GRE scores, personal essays, and letters of recommendation.

The curriculum for a Master’s degree in Nursing with a specialization in nurse midwifery can vary depending on your chosen college or university, but it will generally include the following core subjects or topics:

  • Health promotion and maintenance
  • Advanced pathophysiology
  • Advanced health assessment
  • Pharmacology for advanced practice nurses
  • Primary care of women
  • Role of the nurse midwife
  • Care during pregnancy, labor, birth, and postpartum, to include newborn care
  • Women’s health

Nurse Midwife School Cost

As previously mentioned, you must typically earn a master’s degree to become a Nurse Midwife.

Tuition costs for MSN-degree programs are usually listed on a per credit hour basis, ranging anywhere from $500 to $1,000 (or more) per credit.

The following considerations should be taken into account before you enroll in an MSN program:

  • Tuition costs do not always include expenses like books, program fees, or other mandatory fees
  • Most schools offer some form of financial aid
  • While you will likely accumulate student debt, the average Certified Nurse Midwife earns an average salary of $106,910 per year (BLS)

According to the BLS, state requirements for APRNs can vary. However, APRNs must usually have an RN license, complete an accredited graduate-level program, pass a national certification exam, and have an APRN license. For more details, be sure to visit your state’s board of nursing.

Nurse Midwife Certification

To become licensed and use an APRN title, most states require national certification.

Here are some of the requirements to becoming a licensed Certified Nurse Midwife:

  1. The American Midwifery Certification Board (AMCB) offers the Certified Nurse-Midwife (CNM). Individuals with this designation must recertify via the Certificate Maintenance Program.
  2. In addition, APRN positions may require cardiopulmonary resuscitation (CPR), basic life support (BLS), or advanced cardiac life support (ACLS) certification.

The AMCB has outlined the following requirements for testing and Nurse Midwife certification:

  • Submitting proof of licensure as an RN or NP
  • Completion of a graduate program accredited by the Accreditation Commission for Midwifery Education
  • Verification by the director of the Nurse Midwife program, confirming all program requirements were met, along with the date of completion
  • Attestation by the director of the Nurse Midwife program that the applicant performs at a safe and competent beginner level

Applicants can attempt the certification exam four times within 24 months of program completion.

Certification is valid for five years, but the AMCB also offers recertification options. In addition, Nurse Midwives must register with their state’s Board of Nursing.

If you are interested in Nurse Midwifery, you can learn more about the Certified Nurse-Midwife (CNM) and other designations through the American Midwifery Certification Board.

Other helpful organizations, societies, and agencies include:

How Long Does It Take to Become a Nurse Midwife?

The estimated time commitment to become a Certified Nurse Midwife can take anywhere from four to seven years, depending on your level of nursing education and prior experience.

For example, your BSN degree could take about three to four years to complete, however, current RNs who don’t hold a bachelor’s degree can enroll in an RN to BSN program, which can take as little as 12 months to complete.

The time it takes to earn your master’s degree from an accredited program also depends on your starting point. If you already have your bachelor’s degree (be it a nursing or a non-nursing concentration), you can earn your Master of Science in Nursing degree in about two years.

You must also pass a national certification exam and earn your advanced practice nursing license.

Certified Nurse Midwife’s Salary

How Much Does a Nurse Midwife Make?

The average salary of a Nurse Midwife is $106,910 per year (or $51.40 per hour).

Nurse Midwives in the lowest 10th percentile can make up to $70,000, while the average pay for Nurse Midwives in the 90th percentile can reach up to $151,000 or more.

It’s important to keep in mind, however, that a Nurse Midwife’s pay is also dependent on factors, such as location, employer, experience, bonuses, etc.

Highest Paying Industries for Nurse Midwives

The following is a list of the highest paying Nurse Midwife salaries based on occupational settings, ranked in order of average salary:

Industry Average Hourly Wage Average Salary
Local Government $74.83 $155,650
Outpatient Care Centers $55.02 $114,450
General Hospitals $54.52 $113,400
Colleges and Universities $49.77 $103,520
Physicians’ Offices $49.65 $103,260

Highest Paying States for Nurse Midwives

Your city or state of residence can also affect your salary as a Nurse Midwife.

Below are some of the highest paying states for Nurse Midwives:

State Average Hourly Wage Average Salary
California $67.30 $139,990
Massachusetts $57.40 $119,380
Maryland $55.50 $115,440
Arizona $55.24 $114,900
New Jersey $54.80 $113,980

Highest Paying Cities for Nurse Midwives

Here are the highest paying cities for Nurse Midwives:

City Average Hourly Wage Average Salary
San Bernardino, CA $82.01 $170,590
San Francisco, CA $71.07 $147,820
Los Angeles, CA $62.08 $129,130
Cleveland, OH $60.07 $124,950
Charlotte, NC $58.85 $122,400
Boston, MA $57.54 $119,690
Baltimore, MD $56.66 $117,840
Salt Lake City, UT $55.60 $115,650
Buffalo, NY $54.96 $114,320
St. Paul, MN $54.78 $113,940

Certified Nurse Midwife Job Outlook

Nurse Midwife Jobs in the Years Ahead

According to the U.S. Bureau of Labor Statistics (BLS), overall employment of Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners is expected to increase 26 percent by 2028.

The BLS has identified various factors for this projected increase, including an expanded emphasis on preventive care. In addition, some states are changing their laws regarding APRN practice authority. This will allow certain APRNs to perform more services and act as a source for primary healthcare.

Why Pursue a Career as a Nurse Midwife

Nurse with a patient and baby

As with the other specializations in our list of top nursing careers, Nurse Midwives fill a vital role in the healthcare field. They receive a generous salary and enjoy a greater deal of autonomy than other Registered Nurses. In some places in fact, many Nurse Midwives can perform some of the same duties and responsibilities as a physician.

Nurse Midwives also approach patient care with a holistic view. They focus on the physical, mental, and psychosocial needs of their patients. In the fields of obstetrics and gynecology, for example, Nurse Midwives have proven to reduce many of the stresses and healthcare costs for their patients.

RegisteredNursing.org said it best: “With the option to work in a variety of women’s health settings, or to take on patients on their own in certain states, CNMs have the opportunity to shape their careers as they see fit.”

If you’re an aspiring nurse but don’t know where to begin, you can earn your BSN degree or enroll in one of several nursing programs at Unitek College.