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How to become a certified nurse midwife

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Having a baby is a life-changing event. Pregnancy and childbirth not only change a woman’s body, but they also represent a change to her lifestyle. If you’re interested in pursuing a nursing career that allows you to provide holistic care to women across their lifespan — and help patients with topics such as preconception counseling, family planning, nutrition counseling, newborn care, and breastfeeding support, among others — you may find yourself drawn toward a career as a certified nurse midwife (CNM).

As you’re researching the steps toward how to become a certified nurse midwife, you’ll learn that RNs who choose this career path are advanced practice registered nurses (APRNs) who have both graduated from an accredited nurse midwifery program and passed a national certification exam. CNMs provide wellness care, deliver babies, and may aid physicians during cesarean section (C-section) births.

The first step toward pursuing a career as a CNM is to develop the knowledge and skills to be successful. Completing an education, such as an online bachelor’s degree in nursing, can prepare you with the foundational skills to pursue your goal of becoming a certified nurse midwife.

Differences between a CNM and an OB-GYN  

Certified nurse midwives and OB-GYNs both deliver babies and provide gynecological care; however, the professions have several differences. OB-GYNs are medical doctors who have completed their residencies and are licensed to practice medicine. They’re qualified to manage complicated or high-risk pregnancies, such as working with women who are expecting twins, have existing health conditions such as diabetes or high blood pressure, or are over the age of 35. OB-GYNs can also perform C-sections, and almost all doctors with this medical specialty deliver babies in a hospital setting.


A certified nurse midwife, on the other hand, is an APRN who has earned an advanced degree in nurse midwifery. In addition to helping women deliver babies in a clinical setting, CNMs may help their patients deliver at their homes or a freestanding birthing center. They may also assist expectant mothers with natural or water childbirth. Lastly, whereas OB-GYNs manage high-risk pregnancies, certified nurse midwives manage low-risk pregnancies, namely, pregnancies in which there are no fetal or maternal factors that could increase the risk for complications.

Where do nurse midwives work?

Certified nurse midwives work in a variety of settings, such as hospitals, birthing centers, and public health clinics. According to the U.S. Bureau of Labor Statistics (BLS), as of 2019 the largest employers of APRNs (including nurse midwives) were physicians’ offices; state, local, and private hospitals; outpatient centers; state, local, and private educational services; and offices of other health practitioners.


Most CNMs work full time. Professionals employed by physicians’ offices often work normal business hours; however, those in hospitals or other types of health care facilities may need to work nights, weekends, or holidays. CNMs may also need to be on call and available to assist patients who go into labor.

Employment outlook and salary ranges for nurse midwives

Data from the BLS notes that employment of nurse midwives is projected to grow by 12% between 2019 and 2029, which is three times as fast as the average growth for all occupations. The BLS further notes that approximately 500 openings for nurse midwives are expected each year over the next decade. Most openings are expected to result from the need to replace CNMs who retire or transfer to different occupations.


If you’re researching how to become a certified nurse midwife, you may also be interested in learning more about CNM salaries. The BLS reports that as of May 2019, the median annual wage for nurse midwives was $105,030. However, salary ranges can vary based on a variety of factors, such as the CNM’s experience level; whether they work at a hospital, outpatient care center, or physician’s office; and the geographical region in which the job is located.

Steps to become a certified nurse midwife

If you’re interested in becoming a certified nurse midwife, there are several steps you need to take.


  • Earn a bachelor’s degree in nursing (BSN): The first step toward becoming a CNM is to earn a Bachelor of Science in Nursing degree, such as an online BSN or online RN to BSN from an accredited college or university. Most full-time students find they can complete their degree within four years.
  • Pass the NCLEX-RN: Upon completing your undergraduate degree, you’ll need to pass the NCLEX-RN exam to earn your licensure. The exam includes up to 200-plus questions covering four broad categories — health promotion and maintenance, safe and effective care environment, physiological integrity, and psychosocial integrity. Questions are generally multiple-choice, but also include drag-and-drop and fill-in-the-blank formats, among others.
  • Earn an advanced degree: The next step toward becoming a CNM is to earn an advanced degree, such as an online master’s or online BSN to Doctor of Nursing Practice (DNP) that offers a nurse midwifery concentration. Although admission requirements vary by school, most programs require applicants to hold a bachelor’s degree and current RN license. Most full-time students find they can complete their online MSN or online BSN to DNP degree within two years.
  • Become certified: The final step toward working as a certified nurse midwife is to pass a national certification exam. The Certified Nurse Midwife (CNM) exam is offered by the American Midwifery Certification Board (AMCB). Prerequisites to take the exam include graduation from an accredited nurse midwifery program, verification of completion of an education program, and an active RN license. Recertification is required every five years. Certification can be maintained by participating in continuing education or retaking the AMCB Certification Examination.

Join the health care field and become a certified nurse midwife

If you’re interested in a career as a certified nurse midwife, learn more about the field, nursing degree options, and the steps in how to become a certified nurse midwife.


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