A Certified Nurse-Midwife (CNM) is a healthcare professional who provides medical care during the childbearing cycle and beyond. The role of the CNM is to provide direct patient care, make recommendations for the management of pregnancy and birth, coordinate services with other health care providers, and provide comprehensive reproductive health care for women throughout their lifespan.
The CNM provides care to women of all ages and backgrounds. Nurse-midwives treat and manage conditions and complications of pregnancy, labor, and the postpartum period. They also provide primary care and preventive health services, as well as gynecological care in their role as primary or specialty providers.
Five Steps to Become a Certified Nurse-Midwife
Becoming a Certified Nurse-Midwife involves more than obtaining academic knowledge in nursing school. Nurse-Midwives must develop a combination of advanced nursing skills, clinical experience, and expert knowledge in their areas of practice to succeed in this role.
CNM’s must also meet several other requirements to be certified or licensed in the states where they intend to practice. Certified Nurse-Midwives hold dual licensure as registered nurses and midwives, which means they must meet the educational and clinical requirements for each.
Below, we’ve outlined the general steps involved in becoming a Certified Nurse-Midwife.
- Earn a Bachelor of Science in Nursing Degree
- Pass the NCLEX-RN Exam
- Gain Experience Working as a Registered Nurse
- Earn an MSN or DNP Degree With a Midwifery Focus
- Pass the National CNM Certification Exam
1. Earn a Bachelor of Science in Nursing (BSN) Degree
In order to become a Certified Nurse-Midwife, you must first be a registered nurse (RN). There are two undergraduate nursing programs that meet the minimum requirements to become a registered nurse – an Associate Degree in Nursing and a Bachelor of Science in Nursing.
Both educational paths meet the minimum education and clinical requirements to be eligible for RN licensure and will provide you with the academic foundation necessary to eventually pursue a graduate-level degree, which is a requirement for CNM certification (see step four). However, a Bachelor of Science in Nursing (BSN) degree program provides a more rigorous education and the necessary prerequisites for taking graduate-level courses.
2. Pass the NCLEX-RN Exam
Once you earn your BSN, you are eligible to take the National Council Licensure Examination, a nationwide exam for the licensing of registered nurses, which is required by all 50 states to begin working as an RN.
The NCLEX-RN is a computerized exam that consists of a series of questions representative of the types of situations that nurses encounter in clinical practice. It tests your nursing knowledge and ability to provide safe and effective nursing care, as well as your ability to use critical thinking skills to make nursing decisions. Nurses who pass the NCLEX-RN are considered to be prepared and qualified for entry-level nursing practice.
3. Gain Experience Working as a Registered Nurse
In most cases, a registered nurse must have at least one year of experience working as an RN before they meet the criteria for acceptance into a graduate nursing program. The nature and extent of your work as an RN is important because you must obtain a level of clinical knowledge and experience that prepares you for the rigor of graduate school and the responsibilities of a CNM.
Exposure to various aspects of women’s health, including gynecological exams and other duties related to reproductive/obstetric care, will help you develop the necessary clinical skills to take the next step in your academic and professional career.
4. Earn an MSN or DNP Degree With a Midwifery Focus
In order to make the transition from Registered Nurse to Certified Nurse-Midwife, you must earn a graduate degree from a midwifery program accredited by the Accreditation Commission for Midwifery Education (ACME). The most common graduate degree earned by certified nurse-midwives is a Master of Science in Nursing (MSN), which typically takes 18-24 months to complete. A Doctor of Nursing Practice (DNP) is also a common degree type for CNMs and typically takes 3-4 years of full-time study to complete.
Students enrolled in a midwifery program will take advanced courses such as prenatal and postnatal care, family planning, preconception health, gynecology, reproductive physiology, and pathophysiology. During their course of study, students will typically complete a clinical externship in a birth center, labor and delivery unit, or women’s health clinic.
5. Pass the National CNM Certification Exam
The Certified Nurse Midwife Certification Examination is an assessment administered by the American Midwifery Certification Board (AMCB). It evaluates an individual’s knowledge and ability to provide safe, effective midwifery care. The computerized exam consists of 175 questions that test your knowledge of clinical topics, professional standards, ethical principles, and other areas relevant to midwifery practice. Candidates who pass this exam are eligible to use the CNM credential and legally recognized to practice as a midwife.
How to Maintain Your CNM Certification
Certified Nurse-Midwives must continue to demonstrate competence and engage in continuing education throughout their professional careers in order to maintain their CNM credential. The primary purpose of certificate maintenance is to ensure that CNMs possess the highest levels of knowledge in all areas of midwifery practice, including current standards of practice in areas such as obstetrics, gynecology, newborn, and primary care.
There are two options that meet the requirements for CNM certificate maintenance:
- AMCB Certificate Maintenance Module Method
- Reexamination Method
AMCB Certificate Maintenance Module Method
Nurse-Midwives who select this option must successfully complete three Certificate Maintenance Modules approved by the AMCB during a five-year certification cycle and acquire an additional 20 hours of AMCB-approved continuing education courses. A minimum of one maintenance module must be completed in each of the following practice areas: Intrapartum, Postpartum, and Newborn; Antepartum and Primary Care of the Pregnant Woman; and Gynecology and Primary Care for the Well-Woman.
Reexamination Method
Certification for CNMs can also be maintained by taking the current AMCB Certification Examination between the fourth and fifth years of the five-year certification cycle. The exam can not be taken sooner than the fourth year and must be passed by the end of the fifth year. The criteria for passing the exam are the same as those for first-time test takers.
Helpful Links
How to Become a CNA in 4 Steps
How to Become a Critical Care Nurse in 4 Steps
How to Become a Registered Nurse in 5 Steps
Five Reasons to Become a Midwife
The journey to becoming a midwife involves years of education and clinical preparation. But, it is a rewarding and fulfilling profession that offers great job opportunities for individuals with strong clinical skills and an interest in women’s health. Besides the everyday reward of helping women and their families achieve healthy pregnancies and deliveries, Nurse-Midwives also enjoy many advantages that other health care professionals do not.
Here are five reasons why Nurse-Midwives enjoy an extraordinary career:
- Meaningful Work
- Autonomy and Independent Practice Authority
- A Holistic Approach to Care
- Advanced Education and Training
- Active, Hands-On Experiences
Meaningful Work
Working as a Nurse-Midwife gives you the privilege of being a member of the health care team during one of the most special times in a woman’s life. These special and intimate moments with women and their families provide Nurse-Midwives with a unique opportunity to make an enormous difference in the lives of their patients.
Autonomy and Independent Practice Authority
In many states, Nurse-Midwives enjoy full practice authority, which means they can provide care for patients without having to work under the supervision of a physician or under a collaboration agreement with other health care providers. These practice conditions give Nurse-Midwives a great deal of flexibility and the ability to provide personalized care to their patients.
A Holistic Approach to Care
Nurse-Midwives view their patients as unique and whole people, and they provide care that meets the physical, emotional, social, and spiritual needs of women throughout all stages of life. This comprehensive and holistic approach to care emphasizes healthy lifestyles, encourages preventive care, and always considers the family’s personal values and priorities.
Advanced Education and Training
Nurse-Midwives are experts in women’s health and enjoy years of advanced education, clinical training, and mentorship that prepare them to practice with the highest levels of safety and quality. The nature of Nurse-Midwives’ advanced education and training affords them great respect and trust from patients and colleagues, and Nurse-Midwives’ expertise is always highly valued.
Active, Hands-On Experiences
The daily work of Nurse-Midwives is very active and about as far removed from “desk work” as one can get. Nurse-Midwives spend most of their time on their feet or on the road, visiting women in their homes, meeting them at community health care centers, and attending births in local hospitals. This is an ideal career for anyone who is physically active, enjoys being on the move, and doesn’t like the idea of being restricted to an office environment.
How to Become a Midwife- FAQ
It can take at least eight years to become a Nurse-Midwife, which includes four years of full-time study for a BSN degree, a minimum of one year obtaining experience as a registered nurse, and three years in a graduate Nurse-Midwifery program.
Certified Nurse-Midwives earn a competitive base salary and enjoy numerous opportunities for bonuses, incentives, and salary increases. According to wage data published by the Bureau of Labor Statistics, CNMs earn an average annual salary of $115,540 – the equivalent of $55.55 per hour. CNMs in the top 10% of all earners reported salaries higher than $179,770, which makes them among the highest-paid nursing professions in the United States.
The journey to becoming a Nurse-Midwife is challenging and long, requiring years of education and clinical preparation. But the rewards of practicing Nurse-Midwifery make all the hard work and sacrifice worth the effort. Nurse-Midwives enjoy one of the highest levels of job satisfaction among all health care professionals and earn excellent salaries to match.