How to Become a Nurse Midwife

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Written by Morganne Skinner, BSN, RN Content Writer, IntelyCare
Nurse midwife caring for a pregnant patient

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 who cares for women during their reproductive years, pregnancy, and childbirth. They may also be called a certified nurse midwife (CNM).

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.

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 obstetrician and gynecologist (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.

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.

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.

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. Become a RN

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 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 accelerated 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.

Which route is best for you? It depends on your goals, time commitment, flexibility, availability, financial situation, and preferences. At a minimum, you will need at least an ADN. 

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, so don’t skip this step!

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 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 started your nursing career with an ADN, you’ll need to obtain a BSN. This is one of the requirements for entering your CNM program.

While we listed this step as number 4, you don’t technically have to complete this step in this order. For example, some of you may have begun your nursing education in a BSN program and can skip this step. For those who do not yet have a BSN, you’ll have to obtain yours before you can apply to nurse midwife programs.

5. Enroll in a Nurse Midwife Program

You have two major options for degree programs here: choose 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). This ensures the program you complete is of high-quality and will meet the requirements necessary to later receive your certification and license.

6. Earn a Certified Nurse Midwife (CNM) Certification

All of the previous steps were preparing you to be eligible for this certification. Now we can tell you exactly how to become a certified nurse midwife.Why do you need an additional certification if you are already a RN? Practicing legally as a CNM requires both an additional nursing certification and license.

How do you 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.

Remember, a nurse midwife is an advanced practice registered nurse. They have skills and responsibilities outside of the scope of practice of a RN, so they must have an additional certification to prove they possess that extra knowledge, and an additional licensure to hold them accountable.

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, you’re ready to start working as a nurse midwife. The majority of nurse midwives work in physicians offices, such as an OBGYN’s office.

For a higher-paying job, check out outpatient care centers, such as birthing centers, as they rank as the top industry for the profession. Alternatively, you could also search for nurse midwife jobs in the top five highest paying states: California, West Virginia, Hawaii, Massachusetts, and Oregon.

9. License Renewal

To keep your license active, you will need to recertify 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
  • Compassionate, caring, and empathetic
  • 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?

Nurse midwives can 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 gynecologists office
  • Public health clinics
  • Private practice

What Does a Nurse Midwife Make?

The average nurse midwife salary is $122,450 annually. Certified nurse midwives who work in outpatient care centers can expect to make more — around $153,310. Whereas certified nurse midwives who work in offices of health practitioners (meaning not doctor’s offices) can expect to make around $71,580.

Start on the Path to Becoming a Nurse Midwife Today

If learning how to become a nurse midwife has inspired you to pursue this career path, IntelyCare can help you manage your work schedule with your schooling. Learn more about our flexible job opportunities and apply today.