Certified Nurse-Midwife (CNM)

What is a Nurse-Midwife?

If you are looking for a rewarding career that allows you to focus on women’s health, from adolescence to menopause, a career as a certified nurse-midwife (CNM) may be a suitable fit for you.

A CNM is an advanced practice registered nurse who goes through comprehensive training, mainly providing care to pregnant women from labor to delivery to postpartum care. Before you get to this point, becoming a certified nurse-midwife involves several steps, including becoming a registered nurse, applying for an accredited nurse-midwifery program, and, after the program, taking the The American Midwifery Certification Board (AMCB) Nurse-Midwifery/Midwifery examination to earn certification. After earning certification, you must apply for state licensure to practice as a CNM in your state.

What’s the difference between a CNM and a CM?

It is important to note that a certified nurse-midwife is different than a certified midwife (CM). A CNM is a registered nurse who graduates from a nurse-midwifery program, while a certified midwife is not a registered nurse. Instead, CMs have a healthcare-related degree or educational background and they graduate from a midwifery program. Both CNMs and CMs take the same certification exam to practice but their professional designations are different.

How to Become a Certified Nurse-Midwife

  1. Become a Registered Nurse (RN)
  2. Apply to a Nurse-Midwifery Program
  3. Take and pass the Certified Nurse-Midwifery Exam
  4. Apply for State Licensure

Step 1: Become a Registered Nurse (RN)

Your first step toward becoming a CNM is to become a registered nurse, which is a requirement that must be met in order to apply to a nurse-midwifery program. To become an RN, you must complete an accredited nursing program and pass the NCLEX-RN examination to earn certification to practice as an RN in your state.

Step 2: Apply to a Nurse-Midwifery Program

Apply to nurse-midwifery programs accredited by the Accreditation Commission for Midwifery Education (ACME). These programs must be at the graduate level and typically require candidates to have a GPA of 3.0. There are some online CNM programs that may offer greater flexibility if you cannot make it to campus.

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Step 3: Take the Certified Nurse-Midwifery Exam

After completing your program, you’ll have to apply to take the certified nurse-midwifery exam, which is administered by the American Midwifery Certification Board (AMCB). You must pass this exam to earn your certified nurse-midwife certification. The exam tests you on your knowledge of antepartum, intrapartum, postpartum, newborn, woman/gynecology and women’s health/primary care subject areas. You must renew your certification every five years. This may involve additional fulfillment of continuing education contact hours.

Step 4: Apply for State Licensure

Once you’ve passed the exam, you must apply for state licensure as a certified nurse-midwife in the state where you plan to practice. Be sure to review your state’s board of midwifery for specific requirements.

Should I enroll in a Certified Nurse Midwife (CNM) Program?

CNMs are registered nurses who receive graduate-level training through programs accredited by the Accreditation Commission for Midwifery Education (ACME). Programs can vary and include nursing and midwifery programs. There are multiple options for completing your degree — you could opt for a two-year master’s program or a longer four-year doctoral degree.

Depending on what institution you choose, nurse-midwife programs, for example, can be completed on a full- or part-time basis. Depending on whether you pursue a masters or a doctorate, on average, the number of credits needed to graduate can range from 30 to almost 80.

Regardless of the program, those training to be certified nurse-midwives will complete coursework in antepartum care, advanced primary care, intrapartum and postpartum care and newborn care. They also complete clinical rotations in professional settings. Generally — and this might vary from program-to-program — students in these programs will complete more than 500 hours of working in a clinical setting. This could be in a large hospital, OB/GYN clinics or private practices, among other locations.

After successful completion of an accredited program, certified nurse-midwives are certified by the AMCB. You must hold a graduate degree and have a valid RN license to sit for the certified nurse-midwife examination.

Online CNM Programs

Sometimes it can be difficult to commit to a full-time, on-site certified nurse-midwife program, especially if you are already working as a registered nurse. Putting your career on pause or uprooting your life to attend an on-campus program might not be an option. Online certified nurse-midwifery programs, on the other hand, offer more flexibility.

But online programs are not all the same. When looking for a high-quality online CNM program, make sure that it has interactive features, such as live classes and excellent placement services that will ensure you gain the hands-on experience necessary to advance in your career.

Some universities offer online programs that are identical to their on-campus programs, allowing students to earn a degree from a reputable university without relocating. You will still need to complete on-site clinical practicum hours as well. Required hours vary per program but typically range from 600 to 1,200 clinical hours.

Online programs make it easier for you to balance studying and the demands of your career. Make sure you find a program that offers extensive peer and instructor support teams — these added support systems ensure you get the help you need when you need it, and they can help you stay on track to graduate.

Certified Nurse Midwife Roles and Responsibilities

Certified nurse-midwife roles and responsibilities involve aspects of women’s health and gynecologic healthcare. Nurse-midwife duties involve aiding women throughout their pregnancy, including prenatal and postpartum treatment. Nurse-midwives care for a woman giving birth by providing her with woman-centered support that emphasizes the normalcy of birth. This extends to the postpartum period as well. They can care for newborns at birth and in those first few months of life.

While mostly associated with care around pregnancy, CNM roles include more general healthcare for women as well. This means that certified nurse-midwives can assess and manage contraceptive and birth control methods, offer general gynecological care, and preventive care. They prescribe medications, medical devices, and treatments. Think of a certified nurse-midwife as a healthcare guide for female patients from adolescence through menopause.

You can find certified nurse-midwives working nationwide — from major hospitals to private practices and health and birthing centers. Certified nurse-midwives also attend and assist with home births.

Certified Nurse Midwife Salary

A certified nurse-midwifery career can be lucrative and rewarding. The Bureau of Labor Statistics (BLS) reports that the average hourly wage of a certified nurse-midwife is $55.55, as of May 2020 from the Occupational Employment Statistics – Nurse Midwives report. Additionally, the average annual wage in the United States is $115,540.

Of course, a CNM salary varies state-by-state. The BLS shows that California stands as the highest-paying state for certified nurse-midwives, with an average annual wage of $159,590. After California, Utah is the second highest-paying state, where CNMs can earn up to $133,680.

The BLS also reports that the Los Angeles-Long Beach-Anaheim, CA metropolitan area pays most competitively, with an hourly wage there is $92.04. The Los Angeles area is followed by Riverside-San Bernardino-Ontario, CA where the average hourly wage is $82.21 and the average annual wage is $171,700.

Certified Nurse Midwife FAQs

What do certified nurse midwives do?

Certified nurse midwives provide care for women who are pregnant—including prenatal,  labor and postpartum. They may also care for newborns and infants during the first few months of life.

Where do certified nurse midwives work?

CNMs may be found working in hospitals, clinics, private practices, birthing centers or in the home of a patient.

Can I become a certified nurse midwife without becoming a nurse?

In short, no. You must have an active RN license to become a certified nurse midwife after passing the ACMB examination. Becoming a certified midwife, however, does not require becoming a nurse first.

What is the certifying body for nurse-midwifery candidates?

The American Midwifery Certification Board (AMCB) is the U.S. certifying body for certified nurse-midwives (and certified midwives).

What certifications can candidates pursue through the AMCB’s nurse-midwifery/midwifery examination?

Candidates that take and pass the nurse-midwifery exam will earn certification and the professional designation of a certified nurse-midwife.

What is the certification process for candidates interested in becoming a CNM?

The certification process involves submitting an application and passing a computer-based certification examination.

What are the eligibility requirements for candidates to sit for the nurse-midwife exam, specifically

Candidates interested in becoming a CNM must meet the following AMCB requirements to sit for the nurse-midwife exam:

  • An active RN license
  • Completion of a graduate degree accredited by the ACME
  • Verification that the candidate has met requirements for a graduate degree
  • Verification that the candidate is performing as a safe, beginner practitioner
What is the fee for the AMCB nurse-midwife exam?

The fee for the AMCB nurse-midwife exam is $500 as of October 2021.

What are the guidelines around renewing CNM certification?

The certificate of a CNM expires December 31 of the fifth year following the issue date of the certificate. Individuals must complete the AMCB Certificate Maintenance Program (CMP) to renew their certificate. The CMP is designed to ensure CNMs (and CMs) remain educated, knowledgeable and competent practitioners.

Is a midwife a doctor?

Although a CNM may hold a doctoral degree in nursing, a midwife is not a medical doctor. A CNM is an advanced practice registered nurse who completes graduate-level training through programs accredited by the ACME.
In contrast, a physician practicing within the specialties of obstetrics, gynecology, or both (OB-GYN) has met the requirements to practice medicine in these specialties—which includes undergraduate education, a degree from a medical school, medical licensure, and 3 to 7 years in internship and residency programs.
However, both CNMs and OB-GYN physicians provide comprehensive medical care throughout a woman’s lifespan—including pregnancy and childbirth. They diagnose, treat, and help prevent diseases women may experience, especially those affecting the reproductive system.

What is the difference between a midwife and a doula?

With the advanced education, training, and licensure they possess, midwives provide comprehensive health care services throughout a woman’s lifespan—including primary care; gynecologic care; and care during pregnancy, childbirth, and the postpartum period. They may also provide care for a normal newborn during the first 28 days of life.
A doula is a “a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible.” Although doulas may be certified, they do not have the same educational and licensure requirements as CNMs.

Can certified nurse midwives practice independently?

Determining whether a CNM can practice independently depends upon state-level regulations, since every state has a designated practice environment for CNMs: independent, collaborative, or supervisory. CNMs can practice with full autonomy and prescriptive authority in an independent practice state. However, other states require CNMs to enter a collaborative or supervisory agreement. Such agreements designate which practices require additional consent or supervision of a partnering physician. Additionally, hospital systems may further regulate CNMs beyond this scope of practice.

What is the career outlook of a CNM?

Employment for CNMs is projected to grow 11 percent from 2020 to 2030—which is a much faster pace than the average for all occupations, according to the BLS report on nurse anesthetists, nurse midwives, and nurse practitioners. An increased demand for healthcare services is expected to drive this growth, due in part to an increased emphasis on preventive care and the fact that advanced practice registered nurses (APRNs) such as CNMs can perform many of the same services as physicians. As states embrace expanded practice authority for APRNs, CNMs will be allowed to perform more services independently to meet growing healthcare needs.

For more graduate programs, check out the list of online MSN degree programs.

For other specialized programs related to women’s health, check out the list of WHNP programs.

Last updated October 2021.