Certified Nurse Midwife (CNM)

I. What They Do

Certified nurse midwives ( CNMs) are responsible for providing medical care to women before, during and after pregnancy. They can also provide primary women’s health care for patients in any stage of life. This career is categorized as an advanced practice registered nurse (APRN) role because it requires graduate-level educational and clinical training.

Daily Responsibilities

  • Diagnosing, treating and managing care of pregnant women and new mothers
  • Delivering babies and attending to pregnancy-related issues
  • Counseling and educating female patients from puberty through menopause
  • Conducting physical exams and keeping patient histories
  • Ordering and interpreting the results of diagnostic tests
  • Prescribing treatments and medications (depending on state)

Ideal Candidates

  • Maintain a passion for holistic women’s health and health education
  • Put female patients at ease, communicate effectively and empathetically
  • Interpret medical conditions and situations quickly and accurately
  • Remain calm and controlled in high-pressure situations
  • Inspire trust and confidence in patients and their family members

Specialization Areas

  • Acute Care for Women
  • Women Primary Care
  • Neonatal
  • Antepartum, Intrapartum, and Postpartum Issues
  • Non Surgical Gynecological Care
  • Women’s Health
  • Childbirth and Delivery
  • Reproductive Health
  • Puberty and Menopause
  • Consultation and Education

Work Environment

  • Hospitals
  • Physician’s offices
  • Birth centers
  • Home healthcare providers
  • Community clinics
  • Military bases and hospitals

II. Career Outlook

As with other advanced practice nurses, nurse midwives are taking on more functions of a primary care physician than ever before. And as CNM education and licensing procedures get more rigorous, the industry demand for certified nurse midwives only continues to rise.

Job Growth

BLS projects a period of significant career growth for all advanced practice registered nurses during the years of 2012-2022 across all advanced nursing professions (nurse midwives, nurse practitioners, and nurse anesthetists). The projected job growth of these roles far exceeds the average for all careers in the nation.

Projected job growth for CNMs between 2012-22: 29% (faster than the 19% growth projected for RNs and the 11% average for all positions)

Projected Job Growth for CNMs, 2012-2022

Job Growth Percent Change for Nurse Midwives vs Other U.S. Occupations

Metro Areas with Highest Number of CNMs Employed
Metro Area Number of CNMs Employed
Source: Bureau of Labor Statistics, Occupational Employment Statistics. Accessed May 2014.
Indianapolis – Carmel, IN 330
New York-White Plains-Wayne, NY-NJ 290
Atlanta-Sandy Springs-Marietta, GA 160
Boston-Cambridge-Quincy, MA 150
Minneapolis-St. Paul-Bloomington, MN-WI 130

CNM Salary

The salaries of CNMs will depend on the type of employer, but national salary medians indicate that nurse midwives are among the most highly paid professionals in nursing.

2013 Average Salaries for CNMs, NPs and RNs

Industries Paying the Highest Average CNM Salary in 2013
Industry Average CNM Salary
Source: Bureau of Labor Statistics, Occupational Employment Statistics. Accessed May 2014.
Home Health Care Services $101,420
General Medical and Surgical Hospitals $97,730
Employment Services $95,880
Outpatient Care Centers $94,470
Physician’s Offices $93,170

States with the Highest Average Salaries for CNMs in 2013

III. How to Become One

In order to work as a nurse midwife in the U.S., you must complete an accredited CNM program and then pass the national qualifying exam from the American Midwifery Certification Board ( AMCB).CNM programs are graduate level programs that are only open to licensed RNs who already hold a bachelor’s degree (preferably in nursing). CNM programs grant a master’s or graduate degree. They take a minimum of 24 months to complete.

Education Requirements

CNM candidates need to confirm that their graduate program is accredited by the Accreditation Commission for Midwifery Education ( ACME). Only graduates of ACME accredited programs are eligible to take the national CNA exam.

CNM graduate program entrance requirements:

  • Standard 4-year BA or BS from an accredited college (ideally in nursing or science-related field)
  • A current license as a registered nurse
  • National Council Licensure Exam for Registered Nurses ( NCLEX)
  • Graduate Record Examination ( GRE)

Since there is so much overlap between nurse midwife programs and women’s health nurse practitioner programs, students who complete a CNM program are usually eligible to get certified as both a CNM and an NP without taking additional coursework.

All accredited CNM programs will include a practical component during which a CNM candidate can complete the clinical experience hours required for later licensing.

Certification and Licensing Requirements

Upon completion, graduates will be eligible to take their exam from the AMCB, the only organization in the U.S. that issues CNM credentials. In order to take the CNM exam, applicants must meet the following eligibility requirements, as described in the exam handbook:

  • Proof of RN licensure issued by one’s state of residence
  • Graduate nursing midwife degree accredited by ACME
  • Two letters from the director of the nursing midwife program addressing: the applicant’s graduate program completion date and the applicant’s ability to work in this role safely and professionally

Currently, nursing midwives must renew their credentials every five years in order to continue practicing.

Prospective nursing midwives should keep in mind that while the route to the CNM credential varies slightly state-to-state (especially the education required for one’s RN licensure), the National Council of State Boards of Nursing NCSBN is striving to standardize the credentialing process for advance practice registered nurses on a national level by 2015.

Prospective nursing midwives can check their state’s current standards process by reviewing the NCSBN implementation map or our state nursing pages.