A Certified Nurse-Midwife (CNM) is a healthcare professional who provides medical care during the childbearing cycle and beyond. The role of the CNM is to provide direct patient care, make recommendations for the management of pregnancy and birth, coordinate services with other health care providers, and provide comprehensive reproductive health care for women throughout their lifespan.
While many are familiar with the role of a Certified Nurse-Midwife (CNM) in providing pre-natal and obstetrical care, few understand the full scope and responsibilities of a CNM. A CNM is an advanced practice registered nurse with specialized training in pregnancy, labor, delivery, and postpartum care. They play a vital role in expanding women’s access to healthcare and reducing maternal morbidity and mortality rates.
CNMs focus their work on women’s health and a woman’s reproductive health care needs, including managing chronic diseases, such as diabetes and heart disease; assisting with gynecological and menopausal issues, such as abnormal bleeding and depression; and educating and counseling patients about issues relating to sexual health. CNMs also provide prenatal care during pregnancy and labor, postpartum care, and newborn care.
Nurse-midwives are a type of midwife who has been trained in both obstetric and gynecological care. In the U.S., nurse-midwives provide prenatal care, labor and delivery services, educate pregnant women, and provide gynecological wellness services.
The most common misconception of a nurse-midwife is that they only deliver babies. Although a nurse midwife does have a focus on prenatal care and labor and delivery, the role of a nurse-midwife is much more extensive than that of traditional midwives. For example, a certified nurse-midwife is able to offer services such as family planning, management of menopause and menstrual disorders, diagnosis and treatment of infertility, gynecological exams, breastfeeding education and support, and screening for breast cancer and ovarian cancer. CNMs can even write prescriptions for certain conditions.
A doula is a person who provides emotional support to the woman during pregnancy and prior to, during, and after delivery. Doulas are also known as birth companions, labor assistants, and pregnancy coaches.
Unlike a CNM, becoming a Doula does not carry the requirement for a nursing or midwifery education and there aren’t any direct legal requirements regarding their practice. Doulas do not provide medical care or treatment. A doula’s most important role is to help the mother feel calm and comfortable before, during, and after the birth of her baby.
Summary of Steps
01
Start by obtaining a Bachelor of Science in Nursing (BSN) degree to build your foundation in nursing.
02
Successfully pass the NCLEX-RN exam to become a registered nurse (RN).
03
Acquire experience by working as an RN in various healthcare settings.
04
Pursue a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) degree to specialize in midwifery.
05
Pass the national Certified Nurse-Midwife (CNM) certification exam to gain midwifery credentials.
06
Stay current by fulfilling ongoing certification requirements to practice as a certified nurse-midwife.
Steps in Detail
In order to become a Certified Nurse-Midwife, you must first be a registered nurse (RN). There are two undergraduate nursing programs that meet the minimum requirements to become a registered nurse – an Associate Degree in Nursing and a Bachelor of Science in Nursing.
Both educational paths meet the minimum education and clinical requirements to be eligible for RN licensure and will provide you with the academic foundation necessary to eventually pursue a graduate-level degree, which is a requirement for CNM certification (see step four). However, a Bachelor of Science in Nursing (BSN) degree program provides a more rigorous education and the necessary prerequisites for taking graduate-level courses.
Once you earn your BSN, you are eligible to take the National Council Licensure Examination, a nationwide exam for the licensing of registered nurses, which is required by all 50 states to begin working as an RN.
The NCLEX-RN is a computerized exam that consists of a series of questions representative of the types of situations that nurses encounter in clinical practice. It tests your nursing knowledge and ability to provide safe and effective nursing care, as well as your ability to use critical thinking skills to make nursing decisions. Nurses who pass the NCLEX-RN are considered to be prepared and qualified for entry-level nursing practice.
In most cases, a registered nurse must have at least one year of experience working as an RN before they meet the criteria for acceptance into a graduate nursing program. The nature and extent of your work as an RN is important because you must obtain a level of clinical knowledge and experience that prepares you for the rigor of graduate school and the responsibilities of a CNM.
Exposure to various aspects of women’s health, including gynecological exams and other duties related to reproductive/obstetric care, will help you develop the necessary clinical skills to take the next step in your academic and professional career.
In order to make the transition from Registered Nurse to Certified Nurse-Midwife, you must earn a graduate degree from a midwifery program accredited by the Accreditation Commission for Midwifery Education (ACME). The most common graduate degree earned by certified nurse-midwives is a Master of Science in Nursing (MSN), which typically takes 18-24 months to complete. A Doctor of Nursing Practice (DNP) is also a common degree type for CNMs and typically takes 3-4 years of full-time study to complete.
Students enrolled in a midwifery program will take advanced courses such as prenatal and postnatal care, family planning, preconception health, gynecology, reproductive physiology, and pathophysiology. During their course of study, students will typically complete a clinical externship in a birth center, labor and delivery unit, or women’s health clinic.
Certified Nurse-Midwives must continue to demonstrate competence and engage in continuing education throughout their professional careers in order to maintain their CNM credential. The primary purpose of certificate maintenance is to ensure that CNMs possess the highest levels of knowledge in all areas of midwifery practice, including current standards of practice in areas such as obstetrics, gynecology, newborn, and primary care.
There are two options that meet the requirements for CNM certificate maintenance:
Nurse-midwives earn a competitive base salary and have the potential to increase their earning power with continued education and experience. According to data published by the U.S. Bureau of Labor Statistics (BLS), nurse-midwives earned an average annual salary of $122,450 as of May 2022, which is the equivalent of $58.87 per hour.
The annual wage earned by nurse midwives has grown substantially in the past eight years. The average nurse-midwife salary in 2015 was $93,610, or $45.01 per hour. This represents an increase of $28,400 over five years. This rate of growth (30%) is much higher than the average for all occupations.
State | Hourly Mean Wage | Annual Mean Wage | 90th Percentile Wage |
---|---|---|---|
California | $81.50 | $169,530 | $221,800 |
West Virginia | $79.70 | $165,780 | $179,860 |
Hawaii | $75.01 | $156,020 | $170,700 |
Massachusetts | $69.17 | $143,870 | $188,590 |
Oregon | $65.46 | $136,150 | $175,590 |
Washington | $65.28 | $135,780 | $168,220 |
Maine | $64.64 | $134,440 | $229,990 |
New York | $62.31 | $129,610 | $156,440 |
Ohio | $59.89 | $124,560 | $159,550 |
Illinois | $59.23 | $123,200 | $131,860 |
The journey to becoming a midwife involves years of education and clinical preparation. But, it is a rewarding and fulfilling profession that offers great job opportunities for individuals with strong clinical skills and an interest in women’s health. Besides the everyday reward of helping women and their families achieve healthy pregnancies and deliveries, Nurse-Midwives also enjoy many advantages that other healthcare professionals do not.
Here are five reasons why Nurse-Midwives enjoy an extraordinary career:
Additional Resources
Certified Nurse-Midwives earn a competitive base salary and enjoy numerous opportunities for bonuses, incentives, and salary increases. According to wage data published by the Bureau of Labor Statistics, CNMs earn an average annual salary of $122,450 – the equivalent of $58.87 per hour. CNMs in the top 10% of all earners reported salaries higher than $171,230 which makes them among the highest-paid nursing professions in the United States.