How to Become a Nurse Midwife
Are you passionate about caring for women? Do you have strong clinical skills? Are you eager to provide patient-centered, holistic care? If so, a career as a nurse midwife may be the perfect choice for you. We will explain how to become a nurse midwife, what they really do, and where they work.
What Is a Nurse Midwife?
A nurse midwife is an advanced practice registered nurse (APRN) who cares for women during their reproductive years, pregnancy, and childbirth. They may also be called a certified nurse midwife (CNM). They have skills and responsibilities outside of the scope of practice of a registered nurse (RN), which requires additional certification and an additional licensure.
The word midwife comes from the Mid-English word, “Mid-wîf,” which means “with woman.” What we really mean is someone who is with a woman during childbirth. To this day, the notion has not escaped the practice. In fact, a study interviewing midwives found they emphasize how important being “with woman” is to their practice and identity. It is a central construct.
What Does a Nurse Midwife Do?
While most people likely think that a nurse midwife only delivers babies, the truth is they provide care to women across their lifespan. This includes reproductive health, family planning, preconception, pregnancy, childbirth, postpartum, and menopause. CNMs may work alongside labor and delivery nurses, obstetricians, doulas, and other members of the healthcare team.
Practically speaking, a nurse midwife may perform these duties:
- Perform pelvic exams and pap smears
- Educate about nutrition, fertility, and pregnancy
- Assist with childbirth, home births, and newborn care
- Provide breastfeeding support
What Are the Nurse Midwife Education Requirements?
If you’re thinking about how to become a nurse midwife, you probably wonder what type of education you’d need. You can choose from a variety of paths, with varying education requirements, but we’ve broken it down the steps to become a certified nurse midwife (CNM) for you here.
1. Complete a Nursing Degree
Your very first step is to become a registered nurse. You have two main routes for this: selecting an associate degree in nursing (ADN) or bachelor’s of science in nursing (BSN) program.
An ADN program typically takes about two years to complete, although you can find accelerated programs that can be completed in just 16 months. A BSN program takes about four years to complete, but there are direct-entry program options for this as well, which can shorten the time to 11 months to 2 years. The latter is usually only available to those with a bachelor’s degree in another field.
2. Pass the NCLEX-RN
After completing your nursing program, you’ll need to take the NCLEX-RN exam to obtain your registered nurse license. You cannot legally practice as a nurse without this license.
The NCLEX-RN exam is very challenging — the purpose of nursing school (besides preparing you to care for patients) is to prepare you for this exam. Give yourself plenty of time to study, take practice exam questions, and study some more before sitting for this exam. Need help? Check out these NCLEX-RN preparation tips.
3. Gain Nursing Experience
Start practicing as a RN and gain nursing experience. You can technically start in any nursing field that accepts new graduate nurses — but you may want to start in maternal child health or another related specialty.
Many nurse midwife programs strongly encourage one to two years of nursing experience in labor and delivery jobs before starting their program. It might even be a wise investment on your part, so you can gain experience in this specialty, before you commit to more years of nursing education to pursue that advanced degree.
4. Obtain a BSN (If You Don’t Already Have It)
If you started your nursing career with an ADN, you’ll need to obtain a BSN. This is one of the requirements for entering a CNM program.
5. Enroll in a Nurse Midwife Program
You have two major options for degree programs here: a master of science in nursing (MSN) or doctor of nursing practice (DNP) nurse midwife program. The minimum requirement for a CNM program is a MSN degree, but some nurses choose to pursue a DNP instead. The choice is yours.
A MSN program will take around two years to complete. A DNP program will take around three to four years to complete. Ensure that the program you choose is accredited by the Accreditation Commission for Midwifery Education (ACME).
6. Earn a Certified Nurse Midwife (CNM) Certification
All of the previous steps were preparing you to be eligible for this certification, which provides specialty instructions on how to become a certified nurse midwife. In order to practice legally as a CNM, you need both an additional nursing certification and license.
To become certified, you have to take the national exam offered by the American Midwifery Certification Board (AMCB), which is similar to taking the NCLEX-RN to become a RN. This test assesses your knowledge, skills, and abilities to practice midwifery. To be eligible to sit for the exam, you must have completed nurse midwifery schooling and possess a current, unencumbered RN license.
You might also consider becoming certified through a Neonatal Resuscitation Program (NRP) or a Basic Life Support (BLS) course. Some employers may require these additional certifications.
7. Apply for Your APRN License
Receiving your nurse midwife license as an APRN is not automatic — you must apply for it. Once you’ve passed your certification exam, you can then apply for your nurse midwifery license through your state’s board of nursing.
Each state has its own rules and regulations for applying for an APRN license, but in general you will need:
- Active RN license
- Active CNM certification
- Meet all education requirements (some states require transcripts)
- Pay application fee (amount varies based on state)
8. Find a Job
Once you’ve received your license and certification, update your midwife resume and cover letter. Make sure to pay attention to the skills that employers require in their job description for a CNM — feature those skills in your application materials. Now you’re ready to start your search for nurse midwife jobs.
9. License Renewal
To keep your license active, you will need to re-certify every five years. As part of your license renewal, you may have to complete a continuing education course module or take a test to demonstrate competence.
You have two renewal options:
- Maintenance Module: Complete three AMCB modules during five-year renewal period; complete 20 contact hours of continued education; pay annual fees; and complete renewal application.
- Reexamination: Take CNM exam by the fourth year of the five-year renewal period; pay certification fee (instead of annual fees); and complete renewal application.
What Skills Do Nurse Midwives Need?
In addition to the standard nursing skills as RNs possess, a nurse midwife should have these skills:
- Strong, effective communication
- Knowledge of surgical aseptic technique
- Ability to perform obstetric procedures, like an episiotomy
- Ability to perform ultrasounds and
- Critical thinking and teamwork
- Compassion, caring, and empathy
- Robust evaluation skills
How Long Does It Take to Become a Nurse Midwife?
As you ponder how to become a nurse midwife, naturally you wonder how long it will take. On average, it takes six to eight years. The exact amount of time for you will depend on your degree choice and route.
Where Can a Nurse Midwife Work?
The majority of nurse midwives work in physicians offices, such as an obstetrician and gynecologist (OB-GYN) office. Nurse midwives can also find themselves working in a variety of settings from the delivery room in a hospital to a person’s home in the community. Common workplaces includes:
- Hospitals
- Birthing centers
- Obstetric and gynecologist offices
- Public health clinics
- Private practices
What Does a Nurse Midwife Make?
The average nurse midwife salary is $131,570 annually. Certified nurse midwives who work in outpatient care centers can expect to make more — around $164,080. Whereas certified nurse midwives who work in offices of health practitioners (meaning not doctor’s offices) can expect to make around $88,340.
Location can also affect your salary. The highest-paying states for midwives are:
Nurse Midwife vs. OB-GYN
A nurse midwife is a women’s health practitioner trained in the nursing model. They attend low-risk, uncomplicated births and may work alongside obstetricians.
An OB-GYN is a physician trained in the medical model. They attend all types of births, including those requiring surgical interventions like a C-section. There are also OB-GYN nurses — registered nurses who work with the healthcare team during and after birth.
Certified Nurse Midwife vs. Auxiliary Nurse Midwife
Depending on where you live, you may hear other terms used to describe the professional role of a midwife. In the United States, registered nurses who pursue higher education can become a certified nurse midwife — meaning they’ve completed extra education on top of the standard nursing education. There are also midwives who are not nurses, called certified midwives.
The term “auxiliary nurse midwife” is commonly used in India and South Asia. They are unlicensed health workers with specialized knowledge of maternal and newborn care, labor and delivery, pregnancy, and postpartum care. Because they are not nurses, they are not trained in the nursing model, and lack professional training in nurse decision making. Other countries may refer to these health workers as community health nurses, village health workers, lay midwives, or rural health workers.
Start on the Path to Becoming a Nurse Midwife Today
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