Certified Nurse Midwife

Explore the steps to become a certified nurse-midwife, a rewarding career dedicated to maternal and newborn care, in this comprehensive guide.
Certified Nurse Midwife

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.

What Is a Certified Nurse-Midwife?

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.

What Does a Certified Nurse-Midwife Do? 

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.

Important Facts About Certified Nurse-Midwives

  • CNMs have a Master’s or Doctoral degree in nurse-midwifery.
  • CNMs take part in 9% of all births in the United States.
  • Approximately 95% of births attended by CNMs occur in hospitals.
  • 53% of CNMs identify reproductive care and 33% identify primary care as their main job responsibilities.
  • Nurse-midwives have been found to have lower complication rates for mothers and babies than physician-attended births.
  • According to the American College of Nurse-Midwives, women who use the services of a CNM are less likely to have medical interventions such as C-sections, induced labor, and anesthesia.

What Is the Difference Between a CMN, CM, CPM, and Doula? 

It is easy to get confused when seeing terms like CMN, CM, CPM, and Doula. What are they? How do they differ from one another and what do they mean? The answers are actually pretty simple, but many people have no idea what these terms are. Below, you will find a short explanation of each credential and the differences between them.

Certified Nurse Midwife (CNM)

Certified nurse-midwives are registered nurses who have earned additional certification as a midwife. Holding double licensure as a midwife and registered nurse allows a CNM to provide routine primary care, obstetrical, and gynecological services. CNMs are best known for working with pregnant patients, but they also have much to offer in the areas of the postpartum period, childbirth, pregnancy planning, family planning, prenatal visits, childbirth education, and research.

Certified Midwife (CM)

The primary difference between a Certified Midwife (CM) and a Certified Nurse Midwife (CMN) is that a CM is not a licensed nurse. CMs and CNMs possess the same core competencies, have identical certifications, and have identical scopes of practice, including authorization to prescribe medication.

Certified Professional Midwife (CPM)

Certified Professional Midwives (CPMs) are independent practitioners who are educated in the discipline of midwifery through various education and apprenticeship programs distinct from the discipline of nursing. Certification requirements are less rigorous than that of a CNM/CM and do not require previous nursing or medical training. A high school education or equivalent along with CPR training is sufficient to meet CPM eligibility standards. The CPM credential is the only credential in the U.S. that requires knowledge and experience in out-of-hospital settings.


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

How to Become a Certified Nurse-Midwife

Becoming a Certified Nurse-Midwife involves more than obtaining academic knowledge in nursing school. Nurse-Midwives must develop a combination of advanced nursing skills, clinical experience, and expert knowledge in their areas of practice to succeed in this role. CNM’s must also meet several other requirements to be certified or licensed in the states where they intend to practice. Certified Nurse-Midwives hold dual licensure as registered nurses and midwives, which means they must meet the educational and clinical requirements for each.


Earn a BSN Degree

Start by obtaining a Bachelor of Science in Nursing (BSN) degree to build your foundation in nursing.


Pass the NCLEX-RN Exam

Successfully pass the NCLEX-RN exam to become a registered nurse (RN).


Gain Experience Working as a RN

Acquire experience by working as an RN in various healthcare settings.


Earn an MSN or DNP Degree

Pursue a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) degree to specialize in midwifery.


Pass the National CNM Certification Exam

Pass the national Certified Nurse-Midwife (CNM) certification exam to gain midwifery credentials.


Maintain Your CNM Certification

Stay current by fulfilling ongoing certification requirements to practice as a certified nurse-midwife.

Steps in Detail

1. Earn a Bachelor of Science in Nursing (BSN) Degree

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.

2. Pass the NCLEX-RN Exam

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.

3. Gain Experience Working as a Registered Nurse

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.

4. Earn an MSN or DNP Degree With a Midwifery Focus

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.

5. Pass the National CNM Certification Exam

The Certified Nurse Midwife Certification Examination is an assessment administered by the American Midwifery Certification Board (AMCB). It evaluates an individual’s knowledge and ability to provide safe, effective midwifery care. The computerized exam consists of 175 questions that test your knowledge of clinical topics, professional standards, ethical principles, and other areas relevant to midwifery practice. Candidates who pass this exam are eligible to use the CNM credential and legally recognized to practice as a midwife.

6. Maintain Your CNM Certification

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:

AMCB Certificate Maintenance Module Method

Nurse-Midwives who select this option must successfully complete three Certificate Maintenance Modules approved by the AMCB during a five-year certification cycle and acquire an additional 20 hours of AMCB-approved continuing education courses. A minimum of one maintenance module must be completed in each of the following practice areas: Intrapartum, Postpartum, and Newborn; Antepartum and Primary Care of the Pregnant Woman; and Gynecology and Primary Care for the Well-Woman.

Reexamination Method​

Certification for CNMs can also be maintained by taking the current AMCB Certification Examination between the fourth and fifth years of the five-year certification cycle. The exam can not be taken sooner than the fourth year and must be passed by the end of the fifth year. The criteria for passing the exam are the same as those for first-time test takers.
29 K+
Job Openings Per Year
38 %
Job Growth
$ 122450
Mean Annual Wage

Certified Nurse-Midwife Salary 

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.

Highest Paying States for Nurse-Midwives

The salary earned by a Certified Nurse Midwife can vary significantly by location, with some CNMs earning substantially more than others with the same job description in a different state. For example, Nurse-Midwives in California earn $169,530 annually on average, whereas CNMs in Florida earn $97,690 per year.
StateHourly Mean WageAnnual Mean Wage 90th Percentile Wage
West Virginia$79.70$165,780$179,860
New York$62.31$129,610$156,440

Five Reasons to Become a Midwife

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:

Meaningful Work

Working as a Nurse-Midwife gives you the privilege of being a member of the health care team during one of the most special times in a woman’s life. These special and intimate moments with women and their families provide Nurse-Midwives with a unique opportunity to make an enormous difference in the lives of their patients.

Autonomy and Independent Practice Authority

In many states, Nurse-Midwives enjoy full practice authority, which means they can provide care for patients without having to work under the supervision of a physician or under a collaboration agreement with other health care providers. These practice conditions give Nurse-Midwives a great deal of flexibility and the ability to provide personalized care to their patients.

A Holistic Approach to Care

Nurse-Midwives view their patients as unique and whole people, and they provide care that meets the physical, emotional, social, and spiritual needs of women throughout all stages of life. This comprehensive and holistic approach to care emphasizes healthy lifestyles, encourages preventive care, and always considers the family’s personal values and priorities.

Advanced Education and Training

Nurse-Midwives are experts in women’s health and enjoy years of advanced education, clinical training, and mentorship that prepare them to practice with the highest levels of safety and quality. The nature of Nurse-Midwives’ advanced education and training affords them great respect and trust from patients and colleagues, and Nurse-Midwives’ expertise is always highly valued.

Active, Hands-On Experiences

The daily work of Nurse-Midwives is very active and about as far removed from “desk work” as one can get. Nurse-Midwives spend most of their time on their feet or on the road, visiting women in their homes, meeting them at community health care centers, and attending births in local hospitals. This is an ideal career for anyone who is physically active, enjoys being on the move, and doesn’t like the idea of being restricted to an office environment.

Additional Resources

Certified Nurse-Midwife FAQ

Can a CNM deliver a baby?

CNMs specialize in maternal and newborn care. They provide prenatal care, labor and delivery services, and postnatal care. This includes delivering babies and providing medical care for the new mother. CNMs are similar to doctors in this way, but CNMs are not qualified to provide all of the services that a doctor can.

Can midwives do C-sections?

Obstetricians are emergency physicians who treat complications of pregnancy and childbirth as well as perform C-sections. Although nurse-midwives are qualified to perform many labor and delivery procedures, they are not trained to perform C-sections.

Is a midwife an RN?

Being a midwife does not mean you are a nurse-midwife and becoming an RN does not make you the equivalent of a midwife. To be clear, certified nurse-midwives are registered nurses who have earned a degree from a graduate-level nurse-midwife program and have been certified by the American Midwifery Certification Board (AMCB). Midwives are non-nurses who have completed a graduate-level nurse-midwife program and have been certified by the American Midwifery Certification Board. Midwives are holders of the title Certified Midwife (CM).

How long does it take to become a midwife?

It can take at least eight years to become a Nurse-Midwife, which includes four years of full-time study for a BSN degree, a minimum of one year obtaining experience as a registered nurse, and three years in a graduate Nurse-Midwifery program.

How much does a midwife make an hour?

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.

How hard is it to become a midwife?

The journey to becoming a Nurse-Midwife is challenging and long, requiring years of education and clinical preparation. But the rewards of practicing Nurse-Midwifery make all the hard work and sacrifice worth the effort. Nurse-Midwives enjoy one of the highest levels of job satisfaction among all health care professionals and earn excellent salaries to match.

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