Nurse-Midwife Careers: Education, Jobs, Salaries, Skills

A nurse midwife is an advanced practice registered nurse certified to provide medical services and support to women of varying ages and newborn babies in their first month of life. To become a nurse-midwife, you’ll need to earn an undergraduate degree in nursing, obtain your RN license, complete a nurse-midwife graduate program, and earn certification as a certified nurse midwife.

Nurse-midwives should be compassionate, patient, good listeners, and knowledgeable in the care and needs of women and newborn babies. 

What exactly is a nurse-midwife?

A nurse-midwife, also called a certified nurse-midwife (CNM), is an advanced practice registered nurse who provides comprehensive medical and holistic care and emotional support to pregnant and postpartum mothers to help ensure women have a healthy, safe pregnancy, delivery, and postpartum period. A nurse-midwife conducts physical examinations of a mother and baby at prenatal appointments, attends the birth, and administers afterbirth medical care and support. A nurse-midwife may also provide primary care for premenopausal and menopausal women, and gynecological preventative care services to women of childbearing age and beyond. 

What does a nurse midwife do on a daily basis?

The daily duties and responsibilities of a nurse-midwife may look very different from day to day depending upon factors like where they may work. If an expectant mother is in labor, they attend that birth to deliver the baby and provide any necessary aftercare support.

If there are no births to attend, they may hold office hours meeting with their patients or visit with patients in an OB-GYN clinic or birthing center. A nurse-midwife’s patients may include women of childbearing age, pregnant women, postpartum women, or women going through menopause and beyond. A few daily duties of a nurse-midwife may consist of:

• Educating women on child-birthing options and helping women create birth plans

• Offering emotional support to pregnant mothers as needed

• Monitoring the health of pregnant women and fetuses

• Diagnosing and treating pregnancy conditions

• Prescribing medication when needed

• Offering nutritional counseling, lifestyle suggestions, supplements and vitamins, and other means of holistic care

• Helping women deliver babies naturally, without technological or medical interventions

• Administering emergency medical care if needed within the scope of practice for CNMs

• Offering postpartum support for mother and baby, which may involve in-home visits or scheduled postpartum appointments

• Providing newborn care for babies in their first month of life

Nurse-midwives do not give epidurals or other pain medication, perform C-sections or manage high-risk pregnancies.

Steps to becoming a nurse-midwife

To become a nurse-midwife, you’ll need to become a registered nurse first. Nurse-midwives are advanced practice registered nurses, meaning that you need additional licensure and certification after becoming a registered nurse.

Read more: How Long Does it Take to Become a Registered Nurse (RN)?

Research undergraduate degrees in nursing 

You can earn your Bachelor of Science degree in Nursing (BSN) or Associate of Science degree in Nursing (ASD). However, a BSN may better prepare you for your Master of Science degree in Nursing (MSN), which is a requirement for nurse midwives after obtaining your undergraduate degree. Many employers also prefer a BSN and may make it easier to get into graduate school over an ASN.

When finding a school to earn your undergraduate degree in nursing, consider these preferences and other factors like accreditation, program offerings and structure, school size, and NCLEX pass rate. The program and school you choose should be accredited by a national organization like the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN).

Enroll in the right program for you 

Enrolling in a nursing program that fits your schedule, budget, and future career goals as a nurse-midwife is essential. To prepare, choose an undergraduate degree program that will provide the prerequisites for admittance to a nurse-midwifery graduate degree program. Many MSN programs require a BSN from an accredited nursing school, one year of experience in labor and delivery, satisfactory scores on the GRE, and an active license as an RN. 

You can find online, hybrid, or in-person nursing programs, and community colleges and four-year universities offer financial assistance to help students in need. 

Read more: How to Get Into Nursing School: Your Guide to a Degree

Get registered

After earning your undergraduate degree, it’s time to take the National Council Licensure Examination for Registered Nurses, or NCLEX-RN. 

Before the exam, register with Pearson VUE and pay the test fee, then apply to your nursing regulatory body (NRB) to receive your authorization to test (ATT). ATT is a requirement to take the NCLEX. You can schedule your test once you’ve met these requirements. Test results usually complete processing within six weeks. Passing the NCLEX-RN means you are officially registered to work as RN in your state. 

Work in the real world

At least one year of professional nursing experience is necessary if you’re on the pathway to becoming a nurse-midwife, preferably in labor and delivery or gynecology. This real-world experience is a requirement for enrolling in a master’s program for nurse-midwives.

Graduate School is a Good Next Step

You’re ready to apply to a nurse-midwifery graduate program when you’ve earned your BSN, passed the NCLEX-RN, and worked for at least one year in women’s health. Choose a graduate program accredited by the Accreditation Commission for Midwifery Education (ACME).

Programs will vary by school, sometimes offered as a Master of Science degree in Nursing (MSN) focusing on nurse-midwifery or a Master of Science degree (MS) in Nurse-Midwifery. Hybrid, online, and in-person programs are available depending on the school.

Coursework unit examples

The average Master of Science degree in Nursing (MSN) focused on a nurse-midwifery program consists of 60 to 70 credits that include a mix of coursework and clinical experience. A few examples of the curriculum you may see as a nurse-midwifery graduate learner include: 

• Midwifery care during birth and labor 

• Gynecological health 

• Psychiatric mental health concepts 

• Nurse-midwives in the health care system 

Take the midwifery certification exam.

Once you’ve completed your graduate coursework, you’re ready to take the nationally certified nurse midwife certification exam administered by the American Midwifery Certification Board (ACME). When you pass this exam, you officially receive national certification as a certified nurse-midwife (CNM). Certifications renew in five-year cycles. 

Your final step in becoming a certified nurse midwife is to apply for an advanced practice registered nurse (APRN) license in your state and then maintain your licensure per state guidelines. 

Stay certified and do CPD.

Certification renewal occurs in cycles of five years. To maintain your certification as a CNM, you’ll be required to either retake the current ACME national certification exam in the fourth or fifth year of your certification or complete three certificate maintenance modules with at least 20 hours of AMBC-approved continuing education (CE) courses. 

Where do nurse-midwives work?

Nurse-midwives work with women of varying ages and, most often, with women of childbearing age and their babies. Nurse-midwives typically work in health care settings where women seek primary gynecological or prenatal care. Some nurse-midwives may work independently, owning their own practice, but independent practices are not allowed in all states.

A few examples of where a nurse-midwife may work are:

• Public, private, university, and military hospitals offering gynecological care, prenatal care, and more

• HMOs, private practices, and birth centers delivering babies and offering pre and postnatal care

• Public health clinics

• In a woman’s home offering birthing and afterbirth care and support 

How much does a nurse-midwife make?

In the US, a nurse-midwife makes an average annual salary of $114,210, or $54.24 an hour [1]. The top-paying industries for nurse-midwives are outpatient care centers, surgical hospitals, general medical facilities, and physicians’ offices. 

Entry-level nurse-midwives may earn an average of $61,500, which is the lower 10 percent of all earners, as calculated by the US Bureau of Labor Statistics. Mid-level nurse-midwives are likely to earn the median salary, while the top earners with more experience and expertise can earn as much as $166,170 or more [1]. 

Typical career progression roles for nurse-midwives

A nurse midwife may enter the profession through several educational pathways, some with associate degrees, bachelor’s degrees, or a mix of the two via bridge programs. Once you’ve completed those core academic requirements in nursing and hold an RN license, you have options. As a nurse-midwife, you are considered an advanced practice registered nurse or APRN. If you want to work in other APRN roles, likely, all you’ll need to do is gain a new certification in that area. 

For example, nurse-midwives may also be able to work as nurse anesthetists or nurse practitioners, which are also advanced practice registered nurses. To move into one of these jobs, you’ll need to pass a certification exam and gain state licensure, but you’re halfway there with your RN and graduate degree already completed as a nurse-midwife. Other APRN roles include clinical nurse leader and clinical nurse specialist.

Advancing your career as a nurse-midwife

To practice, certified nurse-midwives must earn a Master of Science degree in Nursing (MSN). Those who want to advance further might consider a Doctor of Nursing Practice (DNP) degree.

You can find nurse-midwives working in clinical settings, but these are not the only roles available to certified nurse-midwives who want to advance their careers. Nurse-midwives may move into managerial positions, jobs in education, or research. 

If you earn your doctoral degree in nursing (DNP), you may be eligible to work as a nursing professor. Other requirements will vary by school, including experience working as a nurse-midwife. A doctoral degree is also necessary if you want to move into management and leadership roles like the director of a nursing program. 

Becoming a research nurse will likely require a doctoral degree. Research nurses can work on clinical trials conducting patient screenings as clinical research nurses or maybe research nurse supervisors or principal investigators, depending upon experience and education level. 

Nurse-midwife programs and career progression 

Several pathways exist to progress your career as a nurse-midwife. For someone interested in coming into nurse-midwifery,  more “non-traditional” programs allow someone to become eligible to work as a certified nurse-midwife.  

BSN to MSN programs in nurse-midwifery

This is considered the more “traditional” route to becoming a nurse-midwife. You earn your bachelor of science degree in nursing (BSN), take the NCLEX-RN to become a registered nurse, and then enroll in a master of science in nursing (MSN) program. Most MSN programs prefer a BSN to an associate of science degree in nursing (ADN), so this pathway may be a smoother transition based on the schools. 

Bachelor’s to MSN programs in nurse-midwifery 

Suppose you have your bachelor’s degree in another field other than nursing. In that case, you can enroll in an accelerated BSN program or an entry-level BSN program that can prepare you for the NCLEX-RN so that you can apply for a Master of Science degree in Nursing (MSN) in nurse-midwifery programs. This option is for anyone with a four-year undergraduate bachelor’s degree in other areas of study aside from nursing. Not all schools offer this option, and not all graduate programs accept students who complete accelerated BSNs, so be sure to check program requirements. 

RN to MSN programs in nurse-midwifery 

An RN to MSN is a type of nursing bridge program that allows a registered nurse (RN) who holds an Associate of Science degree in Nursing (ADN) to enroll in an MSN program while still earning the equivalent of a BSN degree. An MSN degree from an accredited program will be required to work as a nurse-midwife or any other advanced practice registered nurse. 

Post-MSN certificate programs in nurse-midwifery 

After graduating with your MSN degree, you may wish to pursue a post-graduate certificate program in place of a doctor of nursing practice (DNP) degree. For future nurse-midwives, you can choose to specialize in nurse-midwifery. You may choose this path if you want to switch specialties (for example, from a nurse practitioner to a nurse-midwife).

BSN to DNP CNM programs 

The standard track to becoming a certified nurse-midwife is BSN to MSN, and then you can pursue a doctor of nursing practice, DNP degree from there. The BSN to DNP track allows RNs with a bachelor's degree in nursing to bypass that intermediate step of earning a master’s degree. Requirements and coursework will vary by school. 

Post-Master’s to DNP CNM programs 

If you already have your MSN and want to become a nurse-midwife and earn your DNP simultaneously, one way to accomplish this is to earn a companion post-graduate degree program like the post-masters to DNP CNM program. This program would be for an APRN in another area to transition to gain CNM certification and possibly work in a leadership position or a broader scope of work with their DNP. 

Alternative jobs working with babies and children

It’s a common misconception that nurse-midwives only attend and assist in natural labor births. Nurse-midwives are certified to work with newborn babies and women of childbearing age through postmenopause. A nurse-midwife can offer primary gynecological care to all women of all ages. This scope of care may include performing preventative services like pap smears, conducting diagnostic STD testing, or treating various gynecological problems that may occur at any age in a woman’s lifetime.

A few other jobs of a nurse-midwife aside from working with babies and children may include: 

• Treatment of males for infertility issues or STDs

• Wellness education and nutritional counseling as it pertains to hormonal health for both men and women

• Provide reproductive services for individuals seeking hormonal support

• Offer nutritional advice and eating plans as needed for pregnant women or women needing hormonal support 

Tips to help you choose your career route

Careers in nursing can offer a lot of mobility as you can move into various nursing roles through additional certifications, training, education, and years of experience. If you know that you want to work in nursing, and possibly as a nurse-midwife, consider why you want to be a nurse and where you want to work.

The University of Minnesota’s Integrative Nursing Specialization provides both practicing nurses and nursing students the foundation to employ evidence-based integrative therapies in their professional practice. 

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