What Is a Nurse Midwife?
Certified nurse midwives (CNMs) specialize in women's healthcare and are advanced practice registered nurses. Similar to OB/GYN physicians, they deliver babies and offer gynecological checkups and prenatal and postpartum care. CNMs must hold an RN license, earn a master of science in nursing, and pass the American Midwifery Certification Board's national exam.
What Does a Nurse Midwife Do?
- Provide prenatal care to pregnant women
- Perform routine well-woman annual exams and provide other primary and gynecological care
- Provide patient education at exams, in classes, and through written materials
- Deliver babies in hospitals, birth centers, and homes
- Provide postpartum care to women after they give birth
Why Should You Become a Nurse Midwife?
Becoming a CNM offers the opportunity for meaningful work, expanded career potential, and a competitive salary. The U.S. faces a nursing shortage and will need even more advanced practice nurses as the population increases and ages. The Bureau of Labor Statistics (BLS) anticipates an excellent job outlook for nurse midwives in the coming years, projecting a 31% job growth rate for the field between 2016 and 2026 — much faster than the national average for all jobs. Additionally, nurse midwives make an impressive median annual salary of $93,000.
Why Should You Become a Nurse Midwife?
|Certified Nurse Midwife (CNM)||Certified Midwife (CM)||Certified Professional Midwife (CPM)|
|Direct Entry (midwives who are credentialed without training in nursing)|
|Minimum Educational Requirement||
|Certification Organization||American Midwifery Certification Board (AMCB)||American Midwifery Certification Board (AMCB)||North American Registry of Midwives (NARM)|
|Licensure Agency (varies by state)||
|Legal Status (regulated and varies by state)||Licensed in all 50 states, the District of Columbia, and U.S. territories||Licensed or authorized to practice in Delaware, Maine, Missouri, New Jersey, New York, and Rhode Island||Licensed or regulated in 31 states|
|Scope of Responsibility||
|Prescriptive Authority||All U.S. jurisdictions||Maine, New York, and Rhode Island|
|Average Annual Salary||$93,000||$60,000||Charge an average of $2,000-$4,000 per birth, while attending 2-4 births each month|
Source: American College of Nurse-Midwives, PayScale
How to Become a Nurse Midwife
Possess a High School Diploma
The first step to becoming a nurse midwife is graduating from high school. Students must possess a high school diploma to enter a postsecondary educational program.
Earn a Degree in Nursing
Aspiring midwives should earn a degree in nursing. Most programs prefer applicants with a bachelor's degree, but some will accept students with an associate. When researching schools, students should ensure their nursing program is accredited by the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission For Education in Nursing (ACEN). CCNE accredits master's and bachelor's nursing programs, while the ACEN accredits all types of nursing programs, including associate degrees and diplomas. Students who attend unaccredited programs may not be able to transfer their credits to another nursing program, qualify for some nursing jobs, or earn their license in some states.
Become a Registered Nurse
The next step on the path to becoming a nurse midwife is to become an RN. All U.S. states require RNs to hold a nursing license. Nurses must graduate from an approved nursing program and then pass the National Council Licensure Examination. Before taking the exam, candidates must apply for authorization to sit for the test from their state's board of nursing or regulatory board. Other requirements vary by state. Students can find a list of state nursing boards on the National Council of State Boards of Nursing's website. After obtaining licensure, nurses may need to accrue a certain number of hours or years of professional work experience to be eligible for some graduate midwife programs. However, work experience is not a requirement for all nurse midwifery programs.
Earn a Master's Degree in Nurse Midwifery
Aspiring CNMs must also earn a master's in nurse midwifery. Eighty-two percent of CNMs hold a master's degree, according to the American College of Nurse-Midwives (ACNM). However, in 2010, a master's degree was established as the minimum requirement to begin practicing as a CNM. Students should attend a program accredited by the Accreditation Commission for Midwifery Education (ACME) — an accrediting agency for midwifery education programs recognized by the U.S. Department of Education. Attending an accredited program is crucial; students must earn a graduate degree from an ACME-accredited program to seek certification after graduation. Students can find a list of traditional and online programs that hold ACME accreditation here.
Take the National Certification Test
After graduating from a nurse midwife program, students take a national certification test administered by the American Midwifery Certification Board (AMCB). AMCB certification is considered the gold standard, and most states require it for licensure. AMCB provides a step-by-step exam application process on its website. Applicants must submit proof of RN licensure, and their program director must send a letter to AMCB that confirms the applicant's name, date of birth, and program completion date. Applicants have 24 months after they complete their program to pass the exam, and they may take it a maximum of four times. The exam fee is $500, and candidates must pay this fee every time they retake the exam. Candidates take the exam on a computer at one of the 300 designated testing centers throughout the U.S. There is at least one site in every state, and centers are open Monday through Saturday. The exam comprises 175 multiple-choice questions and has a four-hour time limit. Candidates receive an official score report at the testing center. Students can find more specific details about the exam here.
Maintain and Renew Certification
CNM certification lasts for five years. Nurse midwives must complete the AMCB Certificate Maintenance Program to renew their credential. Midwives have two options for maintaining their certification. The first option is to complete three AMCB certificate maintenance modules during the five-year certification cycle, obtain 20 contact hours of approved continuing education units, and pay a $70 annual fee. The second option is to retake the national examination by the end of the fifth year of the certification cycle, which includes a $500 exam fee.
Factors to Consider When Choosing a Nurse Midwife Program
Students need to consider and research a variety of factors to choose the right certified nurse midwife master's program. Prospective applicants should look into a program's accreditation status, admission requirements, cost, faculty credentials, and available coursework and concentrations before making their decision about where to earn their CNM degree.
Prospective CNM students should make sure they enroll in an accredited program. Accreditation is a process that schools and academic programs undergo to prove their academic rigor and quality. This designation demonstrates that programs have experienced faculty members, an appropriate curriculum for the discipline, and other attributes indicative of a high-quality education in that field. Earning a degree from an accredited CNM program is crucial for prospective midwives — graduates cannot work as CNMs unless their degree was awarded by an accredited program.
An independent accrediting agency run by ACNM, ACME evaluates in-person and online nurse midwife programs. To become a certified nurse midwife in any state, students must graduate from an ACME-accredited nurse midwife program. Prospective learners can search for accredited CNM programs here.
Online nurse midwife programs usually contain a list of educational and licensure requirements that applicants must meet to gain acceptance. Generally, applicants must hold an active RN license in their state of residency. They also must possess a bachelor's degree with a minimum 3.0 GPA from an accredited college or university. Although most programs prefer applicants to hold a bachelor of science in nursing, some accept RNs with an associate degree in nursing or a diploma in nursing.
Some programs will accept students with a bachelor's degree in a field other than nursing, but these students typically need to provide transcripts that demonstrate specific and relevant courses, such as human anatomy and statistics. These programs may allow bachelor's degree holders without an RN license to enroll in an accelerated nursing education program before entering the midwife portion.
Benefits of Online Learning
Online nurse midwife programs offer many benefits for students, including convenience, affordability, and flexibility. Rather than attending class at a specific time and place, distance learners in asynchronous CNM programs complete coursework, take exams, and watch lectures at their convenience. This allows learners to more easily juggle work and other personal responsibilities, making online CNM programs especially appealing to working RNs.
Students can sometimes complete their CNM degree more quickly online by choosing an accelerated or intensive program. Online nurse midwife programs may also be more affordable, cutting down on costs related to commuting or living on campus. Some online CNM programs even offer in-state tuition to distance learners, regardless of where they live.
What to Expect From a Nurse Midwife Program
Nurse midwife programs generally include 50-60 credits and take about two years to complete. Program length is typically longer for part-time students, who may take three or more years to complete the necessary coursework and clinical experiences.
A program's learning format can also affect a student's degree completion time. Some programs offer cohort structures, which means learners complete coursework alongside their peers. This structure is beneficial for students who learn best in a community setting, though it also reduces flexibility when it comes to scheduling classes.
Self-paced nurse midwife programs allow students to choose their own course schedules. The number of clinical experience hours a student can/must complete each semester can also influence a program's length. Programs may require students to complete up to 1,000 clinical hours before they can graduate; therefore, students should stick to a strict clinical schedule each semester to graduate in a timely manner.
The courses that CNM students take differ depending on their school and concentration. However, many programs share common courses, including those listed below.
- Well-woman Gynecology Students learn how reproductive and gynecological well-being impact women physically, emotionally, and mentally throughout their lifespan. The course also explores the development of appropriate patient education.
- Breastfeeding, Postpartum, and Newborn Care This class gives students a practical and theoretical understanding of breastfeeding and the postpartum period up to six weeks after giving birth. CNM majors explore how cultural and family dynamics can impact the postpartum period and learn about pathophysiology.
- Maternal-fetal-newborn Physiology This course introduces physiological mechanisms of the fetal life, maternal experience, and neonatal period. Students focus primarily on normal maternal/fetal/newborn issues, but they also explore common complications.
- Disparities in Women's Health Students learn to critically analyze women's health disparities — currently and historically. This course explores institutional misogyny and racism, and how these impact health outcomes for women across their lifespan.
- Health and Social Policy in the Context of Practice This class looks at social, political, and legal factors that influence health status in the U.S. Students learn how nurses can impact policy and improve health outcomes.
What Can You Do with an Online Nurse Midwife Degree?
CNMs provide primary care to newborns and women. While labor and delivery nurses specifically help women during the birthing process, CNMs are advanced practice nurses that serve women throughout their lifespan. They provide pregnant women with prenatal, labor, and postpartum care. They also provide health education, counseling, and gynecological care to women of all ages. Their role in healthcare is especially important because they help close the gap in primary care for women in rural and inner-city areas.
CNMs work in various settings, including private practices, health maintenance organizations, hospitals, health departments, outpatient care centers, and birthing centers. According to the BLS, the states employing the most nurse midwives in 2018 were California, New York, Georgia, Florida, and Pennsylvania.
Nurse midwives typically enjoy high-paying jobs, and their salaries increase as they gain experience in the field. The median salary for CNMs is more than $92,000, according to PayScale. Entry-level CNMs earn about $87,000 annually, while midcareer professionals bring in about $92,000 each year.
A nurse midwife's salary also depends on where they work. Those who work in ambulatory care or in a surgery center report the highest earnings at around $102,000. Alternatively, average pay is lowest among nurse midwives employed in the military or by private practices; these professionals earn about $93,000 annually.
Certified Nurse Midwife Salary by Hospital Setting
|Physician's Office/Private Practice||CNMs who work in private practices may hold very high levels of independence, working for themselves or with other midwives. CNMs that work at a physician's office typically work closely with one or more physicians. They provide prenatal and postpartum care and deliver babies. They may also offer routine gynecological exams.|
|General Hospital||CNMs that work in general hospitals typically deliver babies in uncomplicated births. For births with complications, or those that need C-sections, patient care transfers to a physician.|
|Ambulatory Care/Surgery Center||Most CNMs do not work in ambulatory care/surgery center environments. When they do, they typically provide nursing care to patients undergoing surgery by a physician.|
|Community/Home Health||CNMs that work in community or home health settings provide routine gynecological, prenatal, and postpartum care and help deliver babies.|
|Military||CNMs who work in the military typically practice at hospitals. They offer routine gynecological, prenatal, and postpartum care to military patients and deliver their babies.|
Paying For Your Online Nurse Midwife Program
Most students qualify for some type of financial aid to help pay for their nurse midwife master's program. Students should fill out the Free Application for Federal Student Aid (FAFSA) as soon as possible to determine their eligibility for federal student loans, grants, and work-study opportunities.
Many state, private, and college grant/scholarship programs also require applicants to demonstrate financial need by submitting the FAFSA. Because of this, all students should fill out this form — even if you do not think you will qualify for federal aid. Additionally, many scholarship and grant programs specifically target nursing students, including the opportunities described below.
Scholarships for Nurse Midwives
Midwives of Color-Watson Midwifery Student Scholarship
Who Can Apply: ACNM awards this scholarship to help increase the number of certified midwives and certified nurse midwives of color. The scholarship committee considers applicants' academic performance, leadership potential, and financial need.
Edith B. Wonnell Certified Nurse Midwife Scholarship
Who Can Apply: ACNM offers this scholarship to student midwives who plan to work in an out-of-hospital environment. This includes student midwives who want to work in birth centers or attend home births. Applicants must demonstrate leadership potential, financial need, and academic excellence.
March of Dimes - Graduate Nursing Scholarship
Who Can Apply: The March of Dimes offers a scholarship to graduate nursing students pursuing a career in maternal-child nursing. Applicants must be RNs and a member of one of the following organizations: the Association of Women's Health, Obstetric, and Neonatal Nurses; ACNM; or the National Association of Neonatal Nurses.
Find Online Nurse Midwife Programs
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