Certified Nurse-Midwife

Certified Nurse-Midwives are registered nurses who have successfully completed a graduate degree program in nursing and attained an advanced practice nursing degree. They provide primary care for women throughout the lifespan with a special emphasis on maternal nursing. Certified nurse-midwives are competent to care for women through all semesters of pregnancies and to deliver their babies. They focus on women’s gynecological and reproductive issues and perform tests such as pap smears and breast exams. Certified Nurse-Midwives careers are on the rise since more women are choosing their services over traditional obstetricians for maternity care, according to the American College of Nurse-Midwives.

Mary BreckinridgeNurse Midwives have been providing care for women in the United States since 1925. Mary Breckenridge was the first pioneer of nurse midwives in the U.S. Because of experiencing several personal tragedies, Mary Breckenridge developed compassion for less fortunate women in rural areas who received substandard care. Mortality rates were high in rural Kentucky until she decided to make a difference. Mary Breckenridge came from a wealthy family and was able to start and fund Frontier Nursing School in Kentucky with a combination of family funds and funds from speaking engagements. Today certified nurse-midwives provide safe and cost-effective care mostly to women who live in rural and inner cities areas. They include family in the care of patients during pregnancy and allow them to participate in the birth if it's what the patient wants. Certified nurse-wives exhibit leadership abilities, great communication skills, and strong assessment skills. They also stay up to date with the latest in medical technology, collaborate with the entire health care team for the health and benefit of their patients and are compassionate and caring people.

The certified nurse midwife can also be an expert in educating – not just the patients but also – the patient's family. After all, the gynecologic and obstetric needs of a woman should be understood by everyone in her family. The CNM's role does not end once the baby is delivered; it is also her responsibility to monitor the new mother's physical, mental and emotional well-being.  

What You Need to Be

To become an ideal certified nurse midwife, you need to have the following skills:

  • Strong evaluation skills
  • The ability to communicate effectively with patients and the health team
  • Excellent organizational and leadership skills
  • Technological knowledge
  • A compassionate or caring attitude
  • The ability to deal with people on different levels   

Education Requirements

There are several types of graduate programs leading to a degree in nurse-midwifery. After completing a program, graduates are able to test for licensure and begin their practice as a certified nurse midwife. The most popular certified nurse midwife program is the Master's degree program; Ph.D. programs are available as well as a Post-Master's Certificate Programs. Most full-time Master's degree certified nurse-midwives programs can be completed in two years and part-time programs in three to four years. Nurses are required to have a bachelor's degree in nursing for entry to the program; nurses that don’t have a bachelor's degree can complete a bridge program leading to a bachelor's degree first before starting the midwifery part of the program.

The ACNM or American College of Nurse-Midwives Certification Council persuades students to prepare for their nursing degree as early as their high school years. If you are aspiring to work as a CNM, you need to complete at least three years of Mathematics including Algebra II and Geometry. The same number of years is required of science courses inclusive of Biology and Chemistry. Four years of English is asked as well as two years of studying a foreign language (preferably Spanish).

Apart from these, enrolling in electives such as Child and Human Development or Food Science and Nutrition would greatly help.

Most Nurse-midwife programs are accredited by ACNM and Accreditation Commission for Midwifery Education. Admission to these programs is very competitive. Many nursing schools now take your undergraduate grades into consideration to decide whether you get admitted to the MSN program or not.

Continuing Education and Certification

Students who attended accredited Nurse-Midwives programs are allowed to sit for American Midwifery Certification Board Exam. Once certified, you won't take any exam for another 8 years. However, during this period all CNMs are required to complete some continuing education credits called the Certification Maintenance Program (CMP). Meet this requirement and you'll get your license renewed; if you fail to do so, your license will not be renewed until you pass the national certification exam once more. 
CMP hours requirement actually vary from state to state. In Iowa, for example, a certified nurse midwife needs to have at least 36 hours of continuing education every three years to be able to undergo license renewal. In Kentucky, it is required to have 14 hours on a yearly basis. You can find out more about this from your state's board of nursing website.

Job Description & Duties

Certified nurse midwives address the physical, mental and emotional aspects of expectant mothers throughout their pregnancy. They also assist women through labor and delivery by way of natural birth techniques and provide postpartum care. Certified nurse midwives are primary care providers who educate women how to take care of themselves as well as perform physical examinations, prescribe medications and order labs and other diagnostic tests. They focus on maternal-child nursing and advocate contraceptive methods for childbearing women. Nurse-midwives work independently or with physicians. They refer patients to obstetricians if they feel a case is too complicated for them to handle. Certified nurse midwives advocate natural child birth and deliver babies in birthing rooms in hospitals and in patients’ homes at their request, only if it is safe for both mother and baby.

Difference Between Certified Nurse-Midwife and Midwife

The certified midwife may be trained just like the certified nurse midwife but there are two, major differences between the two – their educational pathway and the facility that they work in.

A certified midwife is direct entry midwives that have not attended nursing school while CNMs were nurses first prior to specializing in midwifery.

More often than not, certified nurse midwives practice in hospitals or birth centers that are affiliated with hospitals. Individualized attention and birthing information are also provided by these healthcare professionals. 

Home births are often done by CMs though this may also be handled, if chosen so, by a CNM.

Unlike the North American Association of Midwives (NARM) exam taken by a certified midwife and licensing for CNMs is provided by the State Board of Nursing. 

Job Outlook and Salary

The median salary for a certified nurse midwife is $94,000. The salary may be more or less depending on the geographical area of the job. The job outlook for certified nurse midwives is great since nursing happens to be the largest health care occupation in the United States. There is also a shortage of advanced practice nurses who specialize in the field of nurse-midwifery. Employment opportunities for certified nurse midwives are expected to grow by 21% to 35% until 2020, according to the Health Careers Center.

Median Salary
Annual Hourly Total Employed Job/1000
U.S. $100,590 $48 6,530 0
Alaska $85,700 $41 70 0
Arizona $102,410 $49 0 0
California $133,080 $64 720 0
Colorado $97,160 $47 0 0
Connecticut $103,660 $50 70 0
Delaware $96,110 $46 40 0
District of Columbia $81,110 $39 40 0
Florida $94,200 $45 330 0
Georgia $99,840 $48 430 0
Illinois $85,950 $41 230 0
Indiana $105,420 $51 80 0
Kansas $99,040 $48 30 0
Kentucky $94,820 $46 120 0
Maine $98,420 $47 30 0
Maryland $94,060 $45 310 0
Massachusetts $119,540 $57 290 0
Michigan $101,600 $49 170 0
Minnesota $104,370 $50 280 0
Missouri $61,780 $30 130 0
Nebraska $51,790 $25 0 0
New Hampshire $100,230 $48 70 0
New Jersey $112,290 $54 210 0
New Mexico $104,170 $50 100 0
New York $104,610 $50 510 0
North Carolina $99,360 $48 170 0
Ohio $96,120 $46 190 0
Oregon $106,740 $51 160 0
Pennsylvania $96,530 $46 300 0
South Carolina $84,910 $41 40 0
Tennessee $84,860 $41 70 0
Texas $94,700 $46 170 0
Utah $105,930 $51 90 0
Vermont $90,470 $43 30 0
Virginia $98,450 $47 0 0
Washington $98,140 $47 90 0
West Virginia $98,010 $47 30 0
Wisconsin $101,480 $49 80 0


Websites and Professional Organizations

Written by

Carrie Cronkite BSN, RN

Carrie has been a registered nurse for 14 years and works at a local hemodialysis outpatient center. She has experience in cardiac nursing, orthopedic rehabilitation and [...]