Certified Nurse-Midwife (CNM)

^{Sources: AMCB Candidate Handbook (October 2026); AMCB, Why AMCB Certification?; ACNM, Certified Midwife Credential.}

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. To become an RN, you complete a nursing program, pass the NCLEX-RN licensure exam offered by the National Council of State Boards of Nursing (NCSBN), and receive your license from your state's nursing regulatory body, usually called the board of nursing. Many midwifery programs require applicants to already be RNs, but according to ACNM, some programs let students with a bachelor's degree in another field complete accelerated nursing coursework first and then continue into graduate midwifery study.

Step 2: Apply to a Nurse-Midwifery Program

Apply to graduate nurse-midwifery programs accredited by the Accreditation Commission for Midwifery Education (ACME). ACNM notes that all ACME-accredited programs require a bachelor's degree for entry and that each program sets its own admission requirements, so check prerequisites with each school. Some programs are offered online, which may offer greater flexibility if you cannot make it to campus.

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. According to the AMCB Candidate Handbook (October 2026), the exam tests your knowledge of antepartum, intrapartum, postpartum, newborn, well woman/gynecology and women’s health/primary care subject areas. AMCB certification is valid for five years, and you renew it through AMCB's Certificate Maintenance Program, either by completing three certificate maintenance modules and 20 contact hours of approved continuing education during the cycle or by retaking the certification exam.

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. AMCB notes that state licensure provides the legal basis for practice and is not automatic after the exam. Depending on the state, the licensing agency may be the board of nursing, the board of medicine, a board of midwifery or nurse-midwifery, or the department of health, according to ACNM, so check your state's requirements with that agency.

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). According to ACNM, all ACME-accredited midwifery programs award a master's degree, a Doctor of Nursing Practice (DNP) or a Doctor of Midwifery (DM), and several offer post-graduate certificate options for advanced practice nurses who already hold a graduate degree.

Depending on what institution you choose, nurse-midwife programs can be completed on a full- or part-time basis; ACNM notes that many programs allow part-time study. Credit requirements vary by program and degree, so compare the curriculum of each program you consider.

Regardless of the program, those training to be certified nurse-midwives must master the same entry-level skills, which ACNM sets out in its Core Competencies for Basic Midwifery Practice. Programs prepare graduates for the AMCB exam, which, according to the AMCB Candidate Handbook (October 2026), covers antepartum, intrapartum, postpartum, newborn, well woman/gynecology and women’s health/primary care. Students also complete clinical education with midwifery preceptors; ACNM notes that all ACME-accredited programs teach the conduct of birth outside the hospital setting and offer clinical learning experiences in community settings.

Completing an accredited program makes you eligible to take the AMCB certification exam, but you earn the CNM credential only after you pass it. According to the AMCB Candidate Handbook (October 2026), you must hold a graduate degree from an ACME-accredited (or pre-accredited) program and an active U.S. 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 it offers interactive features, such as live classes and strong placement services, to ensure you gain the hands-on experience necessary to advance your career.

According to ACNM, there are many fully and partially distance-based midwifery programs, which let students earn a degree without relocating. You will still need to complete in-person clinical hours, and the number required varies by program. ACNM notes that distance programs require you to complete your clinical education with a practicing CNM or CM in or near your own community.

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 include assisting women throughout their pregnancies, including prenatal and postpartum care. 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. According to ACNM, they also care for healthy newborns during the first 28 days of life.

While mostly associated with care during pregnancy, CNM roles also include general healthcare for women. This means that certified nurse-midwives can assess and manage contraceptive and birth control methods, offer general gynecological care, and preventive care. Think of a certified nurse-midwife as a healthcare guide for patients from adolescence throughout the lifespan.

You can find certified nurse-midwives working nationwide — from major hospitals to private practices, clinics and birth centers. ACNM lists homes among the settings where midwives provide care, so some certified nurse-midwives also attend home births.

Certified Nurse Midwife Salary

According to the U.S. Bureau of Labor Statistics (BLS), nurse midwives in the United States had a median annual wage of $134,040 in May 2025, or $64.44 per hour. The middle half earned between $116,510 (25th percentile) and $157,400 (75th percentile). These BLS figures cover nurse midwives at all experience levels, so they are not starting pay.

Pay varies by state. When we ranked the published May 2025 BLS median annual wage estimates for nurse midwives in the 39 states with data, California had the highest, at $203,840, followed by Hawaii ($170,110) and Massachusetts ($159,800).

Ranking the 41 metropolitan areas with published May 2025 median annual wage estimates the same way, Riverside-San Bernardino-Ontario, CA had the highest ($218,760), followed by San Francisco-Oakland-Fremont, CA ($212,630) and Los Angeles-Long Beach-Anaheim, CA ($202,850).

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.