Certified Nurse Midwife Career Guide: Qualifications, Responsibilities, Salary

Lindsay Smith
Last updated at February 12, 2022

Pregnancy and childbirth are some of life's most consequential junctures for a woman. If you're passionate about childbirth and like the idea of making a career out of helping mothers and babies in need, becoming a certified nurse midwife (CNM) may be your calling. 

While earning the needed qualifications for a career in nurse midwifery takes a lot of time and effort, the high salary, solid career outlook, and personal satisfaction that the role offers more than make up for it.

Understanding the role's responsibilities before learning about the required qualifications is essential before considering a career as a certified nurse-midwife. 

This career guide details everything you need to know about becoming a certified midwife.

What is a Nurse Midwife?

CNMs are highly trained advanced practice registered nurses (APRNs) that provide care to mothers and help them through a significant life transition. Besides providing medical attention to expecting mothers through the postpartum period, nurse midwives provide treatment for women at all stages of life as primary care providers.

In addition to being qualified as a registered nurse, a certified nurse midwife also has a Master of Science in Nursing. Graduating is what enables them to specialize in nurse midwifery.

While most certified nurse-midwives serve an integral role in healthcare teams, some choose to operate independent practices. Advanced practice nursing has seen massive growth in recent years, and midwifery is no exception. This makes becoming a CNM an excellent career choice for someone passionate about childbirth.

What Does a Nurse Midwife Do?

According to a 2014 statistic, midwife-attended births account for 12.1% of spontaneous vaginal births in the US. Certified nurse midwives are involved in 8.3% of all births in the US. Of all the deliveries that nurse-midwives are involved in, 94.2% occur in hospitals, 3% in birth centers, and 2.7% at the patient's home.

So, it's a common thought that midwives only play a role when it comes time to deliver babies. However, that is not the case. Nurse-midwives work to provide care for mothers from pre-conception to postpartum. In addition, these nursing professionals also provide gynecological care and family planning services. 

The responsibilities of a certified nurse-midwife include:

  • Providing prenatal care
  • Educating women on their birth options
  • Creating treatment plans 
  • Writing prescriptions 
  • Working alongside medical doctors and other specialists to provide quality care
  • Assisting new mothers with postpartum care
  • Treat a mother's routine health conditions during pregnancy
  • Providing low intervention birth and pain relief during pregnancy
  • Attending uncomplicated births
  • Providing delivery coaching
  • Ordering and reviewing STD and other tests
  • Performing physical exams
  • Preparing expectant mothers for labor and delivery
  • Educating new parents about infant care
  • Observing patients for complications

Where Do Certified Nurse Midwives Work?

Advanced practice nurses that have midwifery education can work at:

  • Public, private, university, and military hospitals
  • Private practices
  • HMOs 
  • Birthing centers
  • Public health clinics

In addition to birthing centers, many registered nurses in this role also provide in-home birth services. However, it's important to note that certified nurse midwives' employment options often depend on their location and their experience in years.

Nurse Midwife Salary

According to the 2020 report by the US Bureau of Labor Statistics, nurses in this role earn an average salary of $117,670 per year, which works out to $56.57 per hour.

However, certified nurse midwives can earn a higher salary if they move to the right state. If you want to earn a higher salary for your job, you can consider moving to California since the CNMs earn an average salary of $159,590 per year. 

Utah, Mississippi, New York, and Minnesota are other states you can consider moving to. A certified nurse-midwife earns between $123,000 and $133,000 annually in these states.

The salary also depends on the work setting, the hours you work, and the type of care you provide. The benefits also change from workplace to workplace.

Job Outlook

Per the BLS, the demand for nurse midwives will increase by 45% between 2020 and 2030. The demand for these nursing professionals is exceptionally high, with the bureau projecting the need for 121,400 more nurse-midwives by the end of the decade.

If you're looking for a role that offers excellent job security, becoming a certified nurse-midwife is one of the best career options.

How Do I Become a Certified Nurse Midwife?

To become a nurse-midwife, you will need to complete an accredited nurse-midwives program which involves you earning an MSN. You can also optionally earn a doctorate and become a Doctor of Nursing Practice. After you earn the degree, you must pass the nurse-midwife certification exam. 

We've broken down the steps in detail below:

Step #1: Earn a BSN Degree

To become a certified nurse-midwife, you must first earn a bachelor's degree in nursing. BSN programs take four years to complete; unless you've earned an associate's degree (ADN) already. If you have an ADN, enrolling in an RN to BSN program will allow you to earn a bachelor's degree in as little as 20 months.

Step #2: Pass the NCLEX-RN 

After you earn your bachelor's degree, the next step is to apply for and pass the National Council Licensure Examination (NCLEX) for Registered Nurses. Passing this exam will allow you to apply for state licensure, and then you will be ready to begin practicing as a registered nurse.

Step #3: Gain Experience

To qualify for midwifery programs, you will first need to work in the field for at least a year as a registered nurse. You must try to gain experience in women's health, preferably in the labor and delivery department. Registered nurses with prior nursing experience are considered to have the required foundation to become nurse-midwives when they graduate.

Besides, graduate schools require nurses to have a few years of experience before they can consider their application to nurse practitioner programs.

Step #4: Earn an MSN from an ACME-Approved Program

Earning a Master's degree of Science in Nursing is the next step to becoming a certified nurse-midwife. Ensure that you enroll in a program accredited by the Accreditation Commission for Midwifery Education. It will make it easier for you to pursue further education if you decide to. Earning a graduate degree will take you between 18 and 24 months. 

While nurse midwives commonly earn a master's degree and begin practicing, you can also obtain a Ph.D. by enrolling in the appropriate ACME-approved program. Earning a doctorate requires between two and three years of full-time education.

It's important to note that a midwifery program has a limited number of seats, so there is a chance that you will not get in the first year you apply. It rarely speaks on your ability, so do not lose your spirit and keep applying.

Step #5: Pass the National Certification Exam and Become an Advanced Practice Registered Nurse

After earning a graduate degree, all you have to do is pass the national certification exam. As an advanced practice registered nurse (APRN), you can then begin working as a nurse midwife. The American Midwifery Certification Board (AMCB) offers the exam.

Since the exam offered by the is a criterion-referenced test, the passing score is not fixed. The test will have 175 multiple-choice questions that you must answer in four hours.

Candidates must pass the exam offered by the American Midwifery Certification Board within 24 months of earning their MSN program and have four attempts at the test in that period. 

If you fail to clear the exam within 24 months, you will need to complete one of the other accredited nurse midwife programs and repeat the exam. 

Step #6: Begin Practicing and Continuing Education

After you get certified, you will officially be a CNM and can join the workforce. To keep your certificate valid, you must earn continuing education units periodically. Taking continuing education classes is mandatory to ensure that the workforce keeps up with the advances and trends in midwifery.

Different states have different continuing education requirements. Therefore, you must consult your state's nursing board to determine how many CEUs you need to earn and how often. 

How Many Years Does it Take to Become a Certified Nurse Midwife?

Earning a BSN and MSN is a hard requirement before becoming a CNM. You can expect to be in school for six to eight years to earn the required qualifications for this role. Additionally, after earning your BSN, you will need to practice nursing for a year before enrolling in an MSN program. It can take up to nine years to become a nurse-midwife.

However, if you choose to earn a Doctor of Nursing, it will take you a couple more years to become a nurse-midwife. That said, earning a DNP will give you a career boost. 

Education Options for Certified Nurse Midwife (CNM)

There are various education options available to you, depending on your current level of education. 

Nurses with an associate's degree can enroll in an RN to MSN program (better known as a bridge program) and earn an MSN directly. 

On the other hand, if you have a BSN, you can join an MSN program directly and earn a graduate degree. 

Online Programs

You can earn an MSN by enrolling in an online, campus-based hybrid program. These are available across the country and are designed with the schedules of working nurses in mind. Joining these programs will give you the flexibility to take classes part-time in these programs.

Many of the courses in these programs are scheduled at nighttime and on the weekends, so you can balance work, family, and studies more effectively. But bear in mind that you will need to spend time completing the required hands-on training in a medical setting.

Financial Aid

There are many sources of financial aid you can apply to and reduce the financial burden of getting the education you want. Filling out the Free Application for Federal Student Aid must be your first step if you want financial aid. Applying for grants and scholarships is the next step, and you can also consider getting a private loan.

Career Paths for CNMs

Besides working in clinical settings such as birth centers and hospitals, CNMs can transition into administrative roles. Some CNMs also play a role in setting public policies. 

In addition to clinical practice and administration, certified midwives can play roles in education, research, and legislative affairs. 

But you must bear in mind that moving into leadership and management roles will be easier if you have a Doctor of Nursing Practice. It is the highest level of education in the field of nurse midwifery.

Conclusion: Should You Become A Nurse Midwife?

Becoming a certified nurse midwife (CNM) is the right career option if you're passionate about playing a role in women's health. With the demand for nurse midwives increasing rapidly, you will not have problems finding a job in your career. Furthermore, the high pay in nurse midwifery will make the time spent getting educated worth it.