How to Become a Certified Nurse Midwife (CNM) Guide

Becoming a Certified Nurse Midwife you will be helping women in one of the most important events of their life, they will look to you for your compassion and understanding. If you enjoy working with women, are concerned about woman’s issues, and help with labor and delivery then this can be the career for you!

Quick Summary

This exciting career can offer you a chance to provide nurse expertise in a more up close and personal way. As a midwife some days you may be assisting with women’s health care needs while other days you will be welcoming newborns into the world at 3:30 am. You will work alongside new mothers and women of all ages.

Many new mothers report their personal experience with midwives is sometimes overall better than what many physicians provide. Merely because they have more time to devote towards each patient thus giving a more personal experience. This is not saying one experience is better than the other. Moreover, it shows this career holds a valuable place among woman’s patient care experiences.

Recommended Degree Level: Master of Science in Nursing (MSN)

License required: Registered Nursing (RN) License

Certification Available: You can obtain certification through the American Midwifery Certification Board (AMCB) and take the Certified Nurse-Midwife (CNM) examination to earn your Nurse Midwife Certification.

How much does a Certified Nurse Midwife earn? The Median annual salary for nurse midwives is $102,670*

What does a Certified Nurse Midwife do?

First, you must ask yourself…

• Can I stay calm in emergencies?
• Do I like babies?
• Does pregnancy even interest me?
• Do I have patience, understanding, and compassion?
• Can I handle unpredictable and sometimes irregular hours?
• Do I have a strong stomach for Labor and Delivery?
• Do I have strong observation skills?
• Am I concerned about woman’s health issues?
• Can I handle physical and emotional challenges?

If you answered yes, then great this just may be the career for you! Read on! Now if you said yes, let us say at least half well still read on. You just may find this to be the career you are looking for.

Many new mothers will look to you as an EXPERT but also as someone who understands them.

There is no better time to follow your dreams and make your mark in the world. Becoming a Certified Nurse Midwife, you may be the patient’s first line of contact that helps them through their time being pregnant. Your role as a midwife may directly affect and shape your patient experience for the better or for, the worse.

Many of your future patients will be dealing with many personal and life-changing events, some patients will have Sexually Transmitted Diseases (STD) and have no clue what to do or where to turn, others will be a first-time mothers with no family support and giving birth alone the list goes on. Women of all ages need positive role models that they feel they can trust and confide in.

There are 3,932,181 (“Births and Natality”, n.d.) births each year, and the Department of Labor predicts Certified Nurse-Midwives (CNM) profession will continue to grow faster than average. This is good news; it shows this career can offer you long-term employment stability as well a chance to embark upon a fulfilling respectable career with job opportunities across the country!

What Is a Midwife?

Well, the best way to explain it is that a Certified Nurse Midwife (CNM) is a specialized nurse that is certified in both nursing and midwifery. Midwifery is a separate profession with its licensing standards just as the nursing practice has separate licensing standards and practices. The term “Midwife” means “with a woman close.” A midwife will assist in family planning, childbirth, and pregnancy. Midwives additionally provide routine health care for a healthy woman as well.

How long have midwives been around?

Midwifery is not a new profession ancient indeed; it stretches back 80 plus years. This occupation has even been mentioned in the Bible. Before the recent inventions of pain medication, hospitals, and medical intervention, for decades, many women gave birth within their homes. These traditional home births were guided by family members, neighbors, or assistants.

The midwifery practice begins to grow and between the years of 1960 and 1970 became a recognized profession. This shift occurred due to consumer demand. The public recognized the value and thus high-quality care midwives provide.

Early midwife’s duties included helping mothers expecting mothers to be with their pregnancy and labor similar to professional nurse-midwives today. First midwives helped deliver babies and educate new mothers and how to care for their newborns. Centuries ago midwives practiced their skills mainly in areas where doctors were unavailable or such as rural areas.

Early midwives additionally offer their skills and expertise to help aid in the delivery of babies whose mothers could not afford to deliver their babies in a traditional hospital. As midwives became more popular in America professional nurse-midwifery became regulated and recognized.

Are Midwives Advanced Practice Nurses?

Yes. Certified Nurse-Midwives are legally recognized as Advanced Practice Registered Nurses (APRN). They have the knowledge and education within two independent professional practices nursing and midwifery.

The nurse-midwife is also known as a certified nurse-midwife that has gradually over the centuries become a recognized member of healthcare teams assisting with family planning, pregnancy, labor, and delivery. Many studies have linked babies delivered by midwives to have been known to experience higher birth weights as well as lower health complications than babies delivered without the help of a midwife.

Many new mothers will benefit from the aid of having a birth attended by a nurse-midwife due to their proven safety standards and personal touch this will ensure that midwives will become vital links in birthing practices.

Patient care provided by Nurse Midwives has been demonstrated to be reliable and consistent. Nurse Midwives provide care for women of all races, backgrounds, and ethnicity.

The benefit of midwives delivering babies is that they offer high-quality care that is more economically affordable for the mother than the cost of going to a physician or obstetrician for a woman’s entire pregnancy.

The National Center for Health Statistics conducted a study that demonstrated women whose births were attended by midwives compared to women whose births were not attended by midwives showed a significantly lower risk of infant mortality, neonatal mortality, and low birth weights for babies.

Due to patient acceptance as well as midwives’ safety records, deliveries attended by midwives have steadily increased over the years since 1975 and are expected to increase further within the future.

As healthcare budgets are carefully dispersed, and patient care outcomes will be measured more closely, midwives are supposed to play a more consistent role in providing high-quality health care for women around the world.

Certified nurse-midwives (CNMs) are recognized for being primary care providers for women and newborns.

The primary care by midwives will incorporate essential factors of primary care along with case management. This will include but is not limited to evaluations, treatment as required, referrals, and patient assessment.

Midwives are often not the initial contact for healthcare services for women in the United States. Midwives will provide continuous and comprehensive care by first establishing a plan of management for their patient’s ongoing healthcare needs.

Certified Nurse Midwives are responsible for providing indirect and direct patient care, through leadership, research and education. Midwives are carefully trained to perform pap smears, epitomes, and physical examinations. Midwives can also prescribe prescriptions to their patients as needed. Midwives are additionally skilled and prepared to offer counseling services on subjects of infant care to breastfeeding issues for new and current mothers.

If you already have your degree in nursing, your nursing education will give you a solid foundation for being prepared for a fantastic career in nurse-midwifery. Nurse-midwives are also known as advanced practice registered nurses.

A midwife is not just for pregnant women. Midwives also provide services for women in their teens to women that are experiencing menopause. Midwives are health care providers to women of all ages throughout their life span.

Midwives provide a full spectrum of female health issues such as:

• gynecological medical exams
• perform physical exams
• monitor the growth and development of fetuses
• review patient health history
• providing information about proper diet and exercise guidelines for expecting mothers
• healthy weight gains for pregnant women
• recommended lab tests
• prenatal care
• assist during labor
• providing follow-up care for new mothers postpartum
• family planning services as well as prescribing contraceptive methods
• provide advice and guidance for menopausal support

The Nurse midwife may work in conjunction with trained obstetricians. If a midwife has a patient that displays signs her pregnancy may be a high-risk pregnancy the midwife will refer the patient to the appropriate doctor that specializes in high-risk pregnancies.

Depending on where you live within most states, midwives are authorized to prescribe and administer medications and oral contraceptives.

As a nurse midwife, you will be qualified to manage a patient’s prenatal delivery and postpartum care however midwives cannot assist childbirth by artificial, forcible, and or mechanical means.

Therefore, nurse midwives have more independence as nurse practitioners within the practice of nursing, but their scope of work is limited in other areas.

Midwives can also administer emergency assistance for their patients while the physician is called. Complications will need to be referred to the doctor immediately.

By law, nurse midwives’ care will always require the supervision and consultation of the physician, however; the physician’s physical presence is not always necessary.

An important part of midwives’ work is educating their patients

Education is a key and essential responsibility of a midwives job. A key element of the midwives job will be to help educate your patients. Teaching and educating patients to play a significant role for midwives. Some midwives consider their career as being a nurse and midwife a lifelong educator role.

As a nurse midwife, you will help educate your patients about:

• Proper nutrition
• Importance of fitness to maintain a healthy pregnancy
• Various techniques for labor and delivery methods
• Encouragement of a healthy and stress-free lifestyle
• Disease prevention strategies along with treatment plans

As a midwife, you will also counsel new mothers in the postpartum period to help with breastfeeding or parenting concerns for mother and child. In some situations, midwives may need to help counsel family members with any questions they may have about the new baby.

Midwives also provide consultation services for additional issues, including:

• Sexually transmitted diseases and prevention methods
• Spousal and child abuse signs and symptoms
• Social support networks that may be available for new mothers

The job of midwives will involve plenty of writing

The task as a midwife will require good writing skills as well as excellent organizational skills as there will be plenty of writing within the day-to-day activities. Midwives must document everything that goes on along with what they do with patients. This will specifically include what they have done with the patient and an explanation as to why they have done and how they have done it.

Patient information that will be recorded by midwives will include however not limited to filling out:

• Review lab results along with ultrasound results
• Recommended current and future lab tests.
• In-depth review of the patient’s health history
• Filling out a birth certificate for a newborn

Midwives also are responsible for maintaining patient records, keeping them up to date, accurate, and checking for any inaccuracies that may be in the patient’s file.

Not all midwives are certified nurse-midwives

Some states will recognize additional categories of midwives such as direct-entry midwives.

What are Direct Entry Midwives?

A direct-entry midwife is someone who practices in a patient’s home or helps to deliver babies in an out-of-the-hospital birth center setting they cannot prescribe medication for their clients.

Many direct-entry midwives find satisfaction with starting their independent midwifery practice. Prospective students have reported they chose to become certified nurse midwives due to the legal issues and salary decrease that may hinder direct-entry midwives.

Direct entry midwives are not required to be a nurse to practice as a midwife in some states direct-entry midwives are considered illegal. However, 29 states legally recognize direct-entry midwives who obtain licensing and certification through their state.

Lay midwives

Lay midwives do not hold a certification or license because they lack the necessary experience, education, or due to the fact they engage and nontraditional childbirth techniques. Some lay midwives practice primarily as part of a religious community. Within some states, the laws have made it illegal for lay midwives to charge a fee for their services.

How much do Midwives make?

The salary a Nurse Midwife will make can offer you a prosperous high paying career. Certified Nurse Midwife makes an average wage of  $102,670 annually per the Department of Labor and Statistics data.

Deciding where you want to work as a nurse-midwife can directly influence your income. Midwives who are employed by larger hospitals tend to earn a higher annual income compared to midwives who are employed by smaller hospitals, birthing centers, or community clinics.

Midwives who gain more experience, including midwives in supervisory, administrative, and director positions tend the have the highest earnings. Midwife salary can also vary depending on which region of the U.S a midwife is employed and whether they gain employment within the public or private sectors.

Midwives are generally offered generous benefits packages, paid sick time, and possible annual bonuses, however, this can vary.

Most midwives work full 40-hour workweeks while these 40 hours may not reflect the typical 40-hour workweek. Midwives have reported irregular hours including nights and weekends, as labor can be unpredictable.

Who will hire me?

A midwife with proper experience primary place of employment is in a hospital.

Additional areas midwives have reported working are:

• Office environments
• Clinic settings i.e. family planning clinics
• Physician practices

What are midwives’ work environments like?

Midwives will often try to make their birthing areas and offices as peaceful and serene as possible. They may do this by playing soft music in the background and offering plenty of magazines for their patients to read.

Some offices may be decorated to mimic a child’s nursery. The Bureau of Labor and Statistics reports nurse midwives are expected to grow 45% from years ranging from 2020 to 2030. The United States Department of Labor predicts that all registered nurses’ employment will grow much faster than average

How can I advance my career as a midwife?

Once you gain more experience, you can advance into supervisory roles. This could be at hospitals, family planning centers, or other facilities. Midwives can choose to continue their education from MSN to Ph.D., With a Ph.D. a midwife can take on director positions and opt to move away from the day-to-day patient operations.

Midwives with a doctorate can take on positions of doing research or teaching roles in academic settings.

You also can choose to write for nursing journals and or magazines. Finally, some midwives may advance their career utilizing their experience and education towards other areas in a hospital or medicine.

How to Become a Midwife?

To become a Certified Nurse Midwife you will need the following Education, Licenses, and or Certifications.

1. Associate of Science Degree in Nursing (ADN)
2. Bachelor’s Degree in Nursing (BSN)
3. Registered Nurse Licensure (RN)
4. Master’s Degree (MSN). This will need to be an authorized Nurse-Midwifery program by the American College of Nurse-Midwives.
5. Certified Nurse-Midwife (CNM) Certification

Some Preferred Requirements – Employers May Require:

1 to 3+ years of Midwifery experience in a clinical setting

Do I have what it takes to be a midwife?

You will need skills that are not always taught within midwifery programs. You will need to be prepared that this job may require long irregular hours to care for their patients. There will be physical and emotional challenges and families, and mothers will look to you for your support and guidance.

Midwifery has been looked upon as a calling, not just a profession. Many practicing midwives report that being a midwife is an honor that allows them to witness a newborn’s birth experience and be a part of it.

As a midwife, you will need the ability to listen to patients’ needs with the capacity to respond appropriately. You will need to have strong observation skills as well. These observation skills will be a valuable skill that will help you become in tune with a patient’s needs during labor and delivery. You as a midwife will have to interact with family members, physicians, and other hospital staff with the ability to stay calm and keep your patients calm in emergencies.

Midwife Education

How long will it take to become a Certified Nurse Midwife?

About six years or less. Nonetheless, this will depend on several factors, such as if you are attending school full time or part-time, whether you pass your NCLEX-RN on the first try, or you’re your CNM certification on the first try.

Besides, the school you attend to some schools will give credit for previous military experience earned; some schools have accelerated BSN programs while others may not.

Students have reported doubling up on classes and obtaining their degrees at a much more accelerated rate. The time will vary from student to student and will vary state-to-state.

Why become a Certified Nurse Midwife?

There are many routes to becoming a midwife, however dedicating, committing towards education as a Certified Nurse Midwife can pay for itself, and many practicing Certified Nurse Midwives are happy they chose to invest their education.

By obtaining your BSN and then your MSN, your yearly salary can dramatically increase along with many opportunities to advance within your new career as a Midwife.

Becoming a Nurse Midwife will open up a wide arrange of jobs and CNM can work in local clinics, postnatal wards, neonatal units, GP surgeries, woman’s clinics, and much more.

Below is your Education Overview of what you will study to become a Certified Nurse Midwife:

Associate Science Degree (ADN) – Sample course overview.

An Associate of Science Degree in Nursing can typically take full-time student two years to complete. Successful completion of a two-year Associate of Science Degree in Nursing will allow prospective students the eligibility to sit and take the NCLEX-RN exam and become registered nurses.

Courses covered in an Associate’s Degree in Nursing Program from Becker College

Becker College Example Curriculum from their Associate of Science in Nursing Degree Program

Freshman Year

• Anatomy & Physiology I
• Microbiology
• Nursing II
• Fundamentals of Nursing
• English Composition I

For a total of 71 credit hours to obtain your Associate’s Degree in Nursing

Bachelor of Science Degree (BSN) – Sample curriculum overview.

To become a Certified Nursing Midwife you will need to obtain a Bachelor of Science Degree in Nursing (BSN).

Depending on what Bachelor’s degree program you choose to enroll in, a typical BSN degree can take four years to complete.

If you previously have credits or an Associate’s Degree earning your BSN can take two years or less to complete.

A Bachelor of Science Degree program will give you the standard preparation for the nursing practice. Students can complete a majority of this degree online or within a traditional classroom setting.

Bachelor of Science Degree Curriculum from San Diego State University – School of Nursing

• Medical Ethics
• Pediatric Nursing
• Community/Public Health
• Psychiatric/Mental Health
• Maternal/Infant
• GE Exploration
• Fundamentals of Nursing

Nursing students who complete the degree program and pass the NCLEX-RN will then be qualified for several nursing positions such as in hospitals, schools, and healthcare agencies.

If you are already a registered licensed nurse, you can obtain a Bachelor of Science at a faster rate by enrolling in an RN to BSN program.

The RN to BSN program can take anywhere from 12 months to 2 years to complete depending on if you attend full-time or part-time.

If you already have a bachelor’s degree in an unrelated field, and you are interested in obtaining your BSN, then you should consider what is known as an Accelerated BSN program, depending on which university you attend they should be able to give you credit for credits previously earned.

This program can take 12 months to 20 months to complete. Accelerated BSN programs may have strict prerequisites and will focus mainly on nursing.

Accelerated BSN Pr-Requisites at the Mount Saint Mary’s University in Los Angeles

• Chemistry or Physics w/lab
• Human Nutrition
• General Psychology
• Oral Communication/Public Speaking
• Philosophy
• Lifespan/Developmental Psychology

The Accelerated Bachelor of Science (AccBSN) program at Mount Saint Mary’s program can be completed in 1 year.

Master’s Degree Program (MSN) – Sample program overview.

To become a Certified Nurse Midwife (CNM), you have to have a graduate degree. According to the American Midwifery Certification Board website, the prerequisite to be able to sit for the national examination to become a Certified Nurse Midwife, you will need to be a graduate of a Master’s or Doctoral degree program that has been accredited by the commission board ACNM.

New York University’s program is highlighted for their Master of Science program in Nurse-Midwifery.

The program can and will offer innovative clinical preparation as well as academic training. This will include care for women throughout the lifespan that will be based upon the ACNM education core competencies. This will include a clinical component for the primary care of women including a full broad range of clinical experiences for medical centers, local and state hospitals, and birth centers along with home settings.

Sample Courses from New York University Master of Science in Nurse-Midwifery Curriculum

• Midwifery Management and Practicum I/Health Assessment and Gynecology
• Primary Care for Woman
• Professional Issues and Role Development in Midwifery
• Midwifery Management Practicum I-IV
• Across the Lifespan I

Program Requirements: 48 credit hours with an additional 1,080 clinical hours.

What License Will I need to practice as a Certified Nurse Midwife?

You will need to pass the NCLEX-RN examination. For you to become a Certified Nurse Midwife (CNM), you will need to provide proof you have passed NCLEX-RN and obtained your nursing license.

Without having obtained your registered nursing licensure, this will make you ineligible to sit for your Certified Nurse Midwife examination.

According to the American Midwifery Certification Board applicants who wish to obtain certification to become a Certified Nurse Midwife, will need to provide current a Registered Nurse license.

What Certification will I need?

The examination provided by the American Midwifery Certification Board will test you on your knowledge and skills of a newborn, well woman’s, postpartum, and a few more areas to see if your skills and competence meet the state’s entry-level standards.

This ensures the patients are getting high-quality care that is above all safe. Once you pass and complete your examination, you will be able to practice as a legally recognized Certified Nurse Midwife.

The Certification Examination is provided on a computer consisting of 175 questions and has a time limit of approximately 4 hours. Testing centers are located at H&R Block. There are currently 120 testing sites throughout the U.S and some parts of Puerto Rico.

Within this dedicated portion of H&R Block, The American Midwifery Certification Board has teamed up with a company called Applied Measurement Professionals (AMP).

The AMP has a computer program that will provide the certification exam for the computer. Located within each exam center (H&R Block) there will be cameras and a live person to help assist with any questions.

Once you have completed the exam, the front desk attendant will print out your results. You will then know whether you passed or failed.

If you do not pass, you can reapply and retake the test after 30 days have elapsed. You are allowed a maximum of four attempts and each re-attempt will cost an additional $500. The cost of the initial Certified Nurse-Midwife certification is $500.

5 Top Benefits of obtaining your Certified Nurse Midwife Certification

1. Your certification shows employers, and patients know that you have met any national standards for midwifery care.
2. Many employers look at The American Midwifery Certification Board as the leader for nurse-midwifery certification and often require this certification for employment.
3. By obtaining your certification will provide you a legal basis to practice as a Certified Nurse Midwife. You must check with your particular state to get exact state requirements.
4. By getting your CNM certification, you can use the CNM trademark within your name. You are looked upon and respected as an expert in your field.
5. The CNM certification is currently accepted by all states inside the U.S.

Places you can work as a midwife include:

• Teaching
• Research
• Management
• Hospitals
• Clinics
• Gynecologist Offices

As a Nurse-Midwife, you can decide to specialize in a particular area of perinatal care, once you choose a specific field, you can further study for qualifications.

Opportunities do exist for the teaching aspects of being a Nurse Midwife if you can find employment at a university for future students who wish to become midwives.

You can also use your skills to become a consultant and provide clinical leadership for maternity services within the healthcare field.

11 Outstanding Midwife Career and Education Questions and Answers you ought to know

Career Outlook

Midwives who work in a hospital or part of a physician’s practice will work indoors within a professional and clean environment. The nurse-midwife will consult with doctors coupled with other health care members, family members, and insurance representatives throughout the day. There are no gender requirements for nurse-midwifery; however, women primarily dominate this profession.

Some midwives operate their birthing centers with a small percentage of midwives working independently specializing in home birth delivery services.

New and current mothers’ interest in natural birthing methods has steadily increased since the 1970s. Reported studies have indicated midwives assisting with delivery is often safer for mother and child.

Economic factors. Midwives’ cost is dramatically lower than going to a gynecologist or obstetrician for services and appear to be overall cost-effective for a woman. In return making the job outlook for CNM particularly bright.

References

Births and Natality. (n.d.). Retrieved from https://www.cdc.gov/nchs/fastats/births.htm

Stone, S.E. “The evolving scope of nurse-midwifery practice in the United States,” Journal of Midwifery and Women’s Health, 200011/12

Avery, M.D. “High-tech skills in low-tech hands”, Journal of Nurse-Midwifery, 199303/04

The Bureau of Labor and Statistics Occupational Handbook

Read also – How to Become Licensed Practical Nurse (LPN/LVN) Guide

Check out our other Nursing School Guides.

References

https://www.census.gov/