Certified Nurse Midwife Career Overview

NurseJournal Staff
by
Updated May 15, 2023
A CNM provides care throughout pregnancy, birth, and beyond. Discover more about how to become a certified nurse midwife and employment prospects for CNMs.
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A mid-adult Caucasian nurse midwife is checking in with an African-American mother and her newborn child. The mother is lying in a hospital bed, swaddling her baby in her arms and smiling. The midwife is wearing light blue scrubs. She is standing over the mother and baby and smiling while she does her health check-in with them.

how long to become

average earning potential

average earning potential$122,450SOURCE: U.S. Bureau of Labor Statistics

What Does a Certified Nurse Midwife Do?

MSN required
certification required


CNMs work in a variety of practice settings including hospitals, community clinics, and birthing centers. While their primary role centers on women’s healthcare during pregnancy, birth, and the postpartum period, CNMs provide primary care, gynecological care, and family planning services for women throughout their reproductive years and menopause. Some CNM responsibilities are listed below:

A female African-American nursing student smiles while taking notes on her laptop during a lecture. She is wearing light blue scrubs. Her classmates are sitting next to her and in the auditorium rows in the background.

Credit: SDI Productions / E+ / Getty Images

Where Do Certified Nurse Midwives Work?

This list describes the various roles performed by CNMs in some of the most common workplace settings.

  1. 1

    Hospitals

    These CNMs work with obstetricians handling vaginal and surgical births. They assist with pain management and provide personal care to pregnant women and infants.

  2. 2

    Birthing Centers

    These CNMs diagnose and treat gynecological conditions and monitor women during pregnancy. They may offer family planning and contraception counseling and treat sexually transmitted diseases.

  3. 3

    Public Health Clinics

    These CNMs diagnose and treat gynecological conditions and monitor women during pregnancy. They may offer family planning and contraception counseling and treat sexually transmitted diseases.

How Is a Certified Nurse Midwife Different From a Direct-Entry Midwife or a Traditional Midwife?

A CNM must hold a graduate midwifery degree, a valid registered nurse (RN) license, and certification through the American Midwifery Certification Board (AMCB). This certification qualifies them to apply for licensure in any of the 50 states.

The direct-entry midwife designation includes both certified midwives (CMs) and certified professional midwives (CPMs). Unlike CNMs, direct-entry midwives may obtain certification without first becoming licensed nurses. While CMs may enter the field without nursing training, not all states allow them to practice. Most direct-entry midwives hold the CPM credential — the only certification that provides training for out-of-hospital deliveries.

Traditional midwives lack formal nursing education but have acquired training through direct experience. These unlicensed midwives, typically working with poor and/or rural populations, rely on their experience, knowledge of traditional (or folk) medicine, and the trust of the communities they serve. However, they might not have a legal right to practice midwifery, though this will depend on the state where they live and/or practice.

How to Become a Certified Nurse Midwife

CNMs must earn both undergraduate and graduate degrees to become a certified nurse midwife, acquire an RN license, and get national certification and licensure in the state where they intend to practice.

Graduate with a bachelor of science in nursing (BSN).

An associate degree takes two years and a bachelor’s degree takes four years to earn.

Pass the NCLEX-RN exam to receive RN licensure.

After earning their degree, students apply for state licensure and register for the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam. State nursing boards use exam results to determine whether nurses have the necessary knowledge to practice.

Apply to an accredited master’s or doctoral midwifery program.

RNs with BSN degrees may enter either master’s or doctoral programs offering midwife specializations. While both degrees prepare graduates for certification, a doctorate can lead to broader career possibilities.

Graduate with your master of science in nursing (MSN) or doctor of nursing practice (DNP) in midwifery.

A master’s takes approximately two years to complete, whereas a DNP requires four years or more. Prospective CNMs should make sure their coursework and clinical hours fulfill state licensure and national certification requirements.

Pass the AMCB exam.

Before entering nurse midwife practice, most nurses obtain CNM certification. This credential requires an RN license, a graduate nursing degree, and a passing score on the AMCB exam.
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How Much Do Certified Nurse Midwives Make?

The average annual nurse midwife salary, as of May 2022, was $122,450. The BLS projects the demand for nurse midwives to grow by 7% between 2021 and 2031. CNMs can expect the highest salaries in major metropolitan areas, where they earn annual average salaries ranging from $191,470 in San Francisco, CA, to $169,190 in Los Angeles, CA.

Several factors contribute to this favorable employment outlook. Hospitals and clinics hire nurse midwives to handle low-risk pregnancies and assist in nonsurgical births to lower costs and reduce complications. The demand for midwives has also grown as more women choose natural childbirth and birth center options.

Top-Paying States for Certified Nurse Midwives
Top-Paying StatesAverage SalaryTotal Number of Certified Nurse Midwives
California$169,530910
West Virginia$165,780N//A
Hawaii$156,020 490
Massachusetts$143,870290
Oregon$136,150150
Source: BLS
Top-Paying Metropolitan Areas for Certified Nurse Midwives
Top-Paying Metropolitan AreasAverage SalaryTotal Number of Certified Nurse Midwives
San Francisco — Oakland — Hayward, CA$191,470180
San Jose — Sunnyvale — Santa Clara, CA$184,18070
Sacramento — Roseville — Arden-Arcade, CA$182,44080
Charleston, WV$180,890Data Not Available
Los Angeles — Long Beach-Anaheim, CA$169,190250
Source: BLS
Top-Paying Industries for Certified Nurse Midwives
IndustryAverage Salary
Outpatient Care Centers$153,310
General Medical and Surgical Hospitals$129,960
Local Government (excluding schools and hospitals)$121,430
Offices of Physicians$120,120
Colleges, Universities, and Professional Schools$111,580
Source: BLS

Frequently Asked Questions About Certified Nurse Midwives


question-mark-circleDo nurse midwives deliver babies?

CNMs who typically work with pregnant individuals experiencing low-risk pregnancies may deliver babies in hospital and out-of-hospital settings such as home births and birthing centers. Nurse midwives do not induce labor and try to avoid pain medication during the birthing process. In hospital settings, they assist obstetrics and gynaecology (OB-GYN) doctors who manage both low-risk and high-risk pregnancies.

question-mark-circleWhat are the benefits of earning a doctorate for nurse midwives?

The nursing profession has begun to advocate for the DNP as the terminal degree for advanced practice nurses, including nurse midwives. Earning a DNP not only enhances career prospects in administrative and educational roles but also boosts salary. The nursing field recognizes the relationship between doctoral-level training and improved healthcare delivery, quality, and safety.

question-mark-circleHow long does it take to become a certified nurse midwife?

BSN graduates may earn a master’s in two years or less or a BSN-DNP in approximately 3-4 years. Those entering the field with only an RN can choose RN-to-MSN or RN-to-DNP programs that may take longer. Direct-entry programs for students with non-nursing undergraduate degrees may require between 2-4 years of study, including prerequisites and clinical requirements.

question-mark-circleWhat skills are important for nurse midwives?

Nurse midwives acquire specialized nursing and technological training in reproductive and gynecological healthcare and the skills needed to provide primary care through pregnancy and childbirth. CNMs also need “soft skills” to work with diverse populations, or the ability to function in high-stress situations, strong communication skills, leadership qualities, and a caring and compassionate approach to patient care.

Resources for Certified Nurse Midwives

  • American College of Nurse-Midwives

    This professional organization represents CNMs and CMs in the United States. Members receive discounted registration fees to the annual ACNM meetings and a subscription to the Journal of Midwifery & Womens Health. The association promotes education, research, and networking through an online news site, weekly newsletters, and an online discussion forum.
  • Midwives Alliance North America

    Established in 1982, MANA provides resources for advocacy, research, and professional education for midwives from diverse backgrounds. The organization offers membership to midwives, students, and other healthcare providers and consumers. Benefits include liability insurance discounts, subscriptions to professional journals, and continuing education opportunities. MANA midwife members may join the Mothers Naturally registry.
  • American Midwifery Certification Board

    AMCB, the leading national certification agency for the profession of midwifery, manages the certification program for nurse midwives who have graduate-level degrees accredited by the Accreditation Commission for Midwifery Education. The organization develops and administers the national certification examination, awards initial CNM and CM certificates, and administers the certification maintenance program for certificate renewal.
  • Association of Womens Health, Obstetric and Neonatal Nurses

    AWHONN supports RNs caring for women, newborns, and their families through research, education, and policy initiatives. The association, through its legislative action center, advocates for laws and regulation that improve healthcare for women and newborns and strengthens the nursing profession. Members benefit from professional development opportunities, awards and scholarships, podcasts, and collaborative industry and community partnerships.


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