Certified Nurse Midwife Specialty: The Ultimate Guide
If you’ve ever wanted to play a pivotal role in bringing new life into this world, becoming a certified nurse midwife may be an excellent career choice for you.
Certified nurse midwives play an essential role in our healthcare system, helping new parents bring their children into the world. That role is only becoming more critical as the demand for midwives has continued to grow over the past two decades.
Becoming a certified nurse midwife requires additional education and certification beyond a registered nurse (RN) license, but it can be a wildly fulfilling career. So whether you’re ready to start nursing school and are looking for a career path or are already working as an RN and looking to make a change, let’s take a look at what’s involved in a midwife nursing career, including how much you can make, job responsibilities, and how to become one.
What Does CNM Mean in Medical Terms?
If you are wondering about the meaning of “CNM” in healthcare, know that CNM stands for “certified nurse midwife.”
It’s important to note that CNMs differ from certified midwives (CMs). CNMs are nurses by trade. Certified midwives are not nurses; they have completed a graduate-level midwife program. Both CNMs and CMs are required to pass certification exams before practicing, but CNMs also must pass an exam for their nursing licenses.
What Is a Certified Nurse Midwife?
A certified nurse midwife is an advanced practice registered nurse (APRN) who has graduated from a graduate-level midwifery program. They are trained to help patients throughout their lives but focus on gynecologic care and family planning services.
CNMs may work with patients during preconception, pregnancy, childbirth, and postpartum care. They’re certified to act as primary care providers during vaginal births. However, medically complicated pregnancies or those requiring cesarean section surgeries will be transferred to a doctor of medicine (MD) instead.
Nurse midwives are often known for taking holistic and “natural” approaches to pregnancy and childbirth. Some consider them more supportive of non-medical pain relief strategies than doctors in a hospital setting, though this always depends on the specific individuals in question.
Current Demand for Certified Nurse Midwives
The demand for certified nurse midwives is high—and it looks like it will only continue to increase.
According to the U.S. Bureau of Labor Statistics, APRN jobs (including those of certified nurse midwives) are projected to grow by 38 percent from 2022-2032. Certified nurse midwife careers alone are expected to have a 6 percent growth from 2022-2032, with 500 new jobs across the country coming into the market.
U.S. News places working as a CNM as the 24th most desirable job in healthcare as a whole, and plenty of patients are turning to midwives. The increased demand is likely due to multiple factors, including the following:
- Home births, which midwives often oversee, have been increasing since 2004; furthermore, they rose 19 percent in 2020 when COVID-19 heavily impacted the US.
- Birth centers—which often employ midwives—have exploded in number, with over 400 centers in the US as of 2021.
- Distrust of conventional hospitals due to historical mistreatment during childbirth may convince women to turn to midwives.
- Midwife-led care can lead to enormous cost savings; a 2019 study from the University of Minnesota estimated that increasing midwife-led care from 9 percent to 20 percent would have cost savings of $2.82 billion for private healthcare plans alone by 2027.
Since working as a CNM is a meaningful career with a positive growth in demand, it’s a great choice to invest in if it’s the right fit for you.
What Is the Average Certified Nurse Midwife Salary?
The average (or mean) certified nurse midwife salary is $122,450, according to the BLS, and the mean hourly wage is $58.87. Furthermore, the median hourly wage is $58.12, and the median annual salary is $120,880, though CNMs in the 90th percentile earn up to $171,230 annually.
Multiple different factors impact your earning potential as a CNM, including the following:
- Your past work experience, including the years of experience and type of work
- Your location, as high-cost-of-living areas typically pay more than low-cost-of-living areas—in Minnesota, for example, CNMs make an average annual wage of $116,780, but they make $169,530 in California
- The type of facility you work at since nurse midwives make an average of $120,120 in a physician’s office and $153,310 in an outpatient facility
Remember that you can always negotiate your nursing salary, especially in a growing and in-demand specialty.
Ready to Earn More? See Our Nursing Salary Negotiation Tips
Where Do Nurse Midwives Work?
Nurse midwives can work in a variety of different settings, including the following:
- Specialized birth centers
- Hospitals
- Offices of other practitioners, including OB-GYNs
- Private practices
- Agencies that help with home births or postpartum care
- Outpatient facilities
Some states allow CNMs to start independent practices, while others require that they work in an office under the supervision of an MD or a doctor of osteopathy (DO). Nevertheless, you can find a position that’s perfect for what you’re looking for in several different settings.
Consequently, your shifts will depend on where you work. Many CNM roles may involve eight or 12-hour shifts, and you may be required to work evening, weekend, and holiday hours. Some organizations may require on-call hours, too.
Certified Nurse Midwife Job Responsibilities
Are you interested in working as a nurse midwife? Your job responsibilities will vary significantly based on where you work and the specific role that you choose. That said, common CNM job duties include the following:
- Performing health screenings and tests
- Diagnosing gynecological conditions, including fertility, sexually transmitted infections (STIs), and vaginitis
- Testing for, confirming, and dating pregnancies
- Providing prenatal care and pregnancy education
- Preparing new parents and birthing partners for childbirth
- Caring for the mother and baby during childbirth, including monitoring both during labor, helping with pain management, and delivering both the newborn and the placenta
- Providing resources and education to parents about infant care
- Assisting with postpartum care, including assessing the mother’s health
- Providing education, training, and resources on breastfeeding
- Screening patients for potential domestic abuse situations and providing them with resources if they’re at risk
- Screening for mental health conditions, including prenatal or postpartum anxiety and depression
Nurse midwives can deliver babies; they’re certified to oversee the entire labor process as the primary care provider. However, if there is a medically complex pregnancy (or a high likelihood of one), nurse midwives will refer patients to a hospital and an OB-GYN doctor who can assist them.
Nurse Midwife vs. Nurse Practitioner: The Differences
Nurse midwives and nurse practitioners can both specialize in gynecological work, offering essential healthcare services to women. While they are both APRNs, there are a few crucial differences.
These are the most significant differences between nurse midwives and nurse practitioners:
Scope of Practice
Nurse midwives are certified to oversee labor and delivery as the leading providers. They cannot act as general primary care providers, though they can provide women with several essential reproductive care services.
Nurse practitioners cannot oversee women in labor or births as the providers in charge. They can, however, act as primary care providers to patients while operating under a supervising physician and often see patients throughout their lives and not just during their fertile and reproductive years.
Education
While both nurse midwives and nurse practitioners must complete master’s degrees and obtain licensure to practice, there are core differences in their education.
Certified nurse midwives complete graduate-level programs dedicated entirely to midwifery. Their clinical hours are specialized, and they must take an exam specific to the midwifery certification.
Nurse practitioners, however, typically receive a more general nursing education. They can choose from multiple specialties, including those that have little to do with women’s healthcare. Their clinical hours may not even include gynecological care.
Standard Job Duties
Nurse practitioners typically act as primary care providers in women’s health if they work in the OBGYN specialty. They can see women and girls of all ages, including those outside reproductive years. They’re more likely to be the practitioners you see for well-women and general diagnostics than nurse midwives. And while they can oversee pregnancies, they can’t deliver babies during childbirth.
On the other hand, nurse midwives can offer a broad range of reproductive services but focus predominantly on pregnancy, labor and delivery, family planning, and postpartum care. Many nurse midwives choose to work almost exclusively with patients before, during, and immediately following a pregnancy.
How Can I Become a Certified Nurse Midwife (CNM)?
To become a certified nurse midwife, you must first get the proper education. You’ll need to complete an accredited graduate-level program—either a Master’s or a Doctorate of Nursing Practice (DNP)—specific to midwifery nursing.
Many programs require an active RN license and a Bachelor of Science in Nursing (BSN) to apply. Bridge programs, however, allow RNs without a BSN to apply, allowing you to earn your BSN during the graduate program. Regardless, you must have passed the NCLEX-RN and have an active nursing license to apply to CNM programs.
Once you graduate from your midwifery program, you must apply and test for certification. The American Midwifery Certification Board (AMCB) offers the certification exam. To take the exam, you must submit proof of licensure as an RN or nurse practitioner and evidence that you’ve completed an accredited midwifery program.
If you pass the exam, the AMCB will mail your certificate to your home address and add your information to the AMCB’s online database. Your certification will be valid for five years.
All CNMs must hold state licensure, so make sure you keep your license and certifications active to continue practicing.
How Long Does It Take to Become a Certified Nurse Midwife?
The time it takes to become a certified nurse midwife depends on where you’re at in your career and the specific choices you make.
If, for example, you’re already a licensed RN with a BSN, it’s realistic that you could apply for and complete a midwifery program and pass certification within two to three years. Most midwifery Master’s programs take around two years to complete, though a DNP in midwifery may take three to four years.
If you haven’t started your nursing career yet and plan to become a nurse midwife, the most common path is first to complete your BSN, which takes an average of four years. You’ll then apply to the graduate program of your choice, which may take another two to four years, taking a total of six to eight years.
Additionally, accelerated midwifery programs are available, which are particularly common with bridge programs. These programs may have shorter completion times but may be more time-intensive than other programs.
Alternatively, nurses also choose to complete their midwifery programs while working as RNs. Therefore, they may go to school part-time and take longer to complete the program.
Why Choose a Certified Nurse Midwife Career
There are many reasons why nurses—especially those considering advanced practice licensure—should consider becoming certified nurse midwives.
The first reason is simple: CNM medical jobs can be highly rewarding. You’re getting to work with patients during one of the most exciting and often joyful times of their lives as they bring new life into the world. For many nurses, there’s nothing better, and if you want to play an active role in birthing infants (which other types of nurses and nurse practitioners cannot do), nurse midwifery could be a great option.
While CNMs sometimes have to deliver bad news to patients, they often refer medically complex patients (or those with any health concerns) to physicians. Anything can go wrong in pregnancy or childbirth, but this reduces the number of emotionally challenging cases and losses CNMs experience day-to-day.
Certified nurse midwives also have high earning potential, as previously mentioned. Any APRN has the potential to earn more than their RN counterparts, and a boost in income is always welcome.
While working as a CNM can also be emotionally challenging (just like any nursing specialty), it can also be incredibly rewarding. It’s up to you to determine if the emotional challenges of working with patients in severe pain and sometimes challenging scenarios—including those related to potential domestic abuse or dangerous emergencies—are worth the positives.
Is a Career as a Nurse Midwife Right for You?
If working with patients through family planning, preconception, pregnancy, birth, and postpartum periods sounds like a perfect fit for you, you may want to consider CNM jobs in the future—especially with so much projected growth in this specialty.
If you’re working as an RN and are considering becoming a CNM but are unsure, consider working in a related field. Working in labor and delivery or the OBGYN specialty can give you valuable work experience, and you may even get to work alongside or under certified nurse midwives. The exposure to the specialty can help you determine if it’s right for you.
And if you’re still unsure, take a look at different nursing specialties and see what appeals to you.
