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Nurse Midwife vs. OBGYN: What’s the Difference?

NurseJournal Staff
Updated August 29, 2023
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Review the similarities and differences between nurse midwives and OBGYNs regarding their roles and responsibilities, education and certification, and salary and career outlook.
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Nurse midwives and obstetrician-gynecologists (OBGYNs) both focus on providing reproductive care to women throughout most of their lives. While their roles overlap, the two positions have distinct responsibilities and purposes.

Discover the different responsibilities, educational paths, and career outlooks for certified nurse midwives (CNMs) and OBGYNs to help you determine which role is best for you.

Nurse Midwife and OBGYN Key Similarities and Differences

What Is a Nurse Midwife?

CNMs are advanced practice registered nurses (APRNs) who specialize in a broad range of reproductive services for women from adolescence through their menopausal years. They mainly offer preconception, pregnancy, childbirth, postpartum, and family planning services.

Many focus on holistic types of nursing care using natural reproductive techniques. Their primary responsibility is to ensure the safety of both the pregnant person and child before, during, and after delivery.

What Is an OBGYN?

OBGYNs are doctors who have advanced training in obstetrics and gynecology. They specialize in diseases, disorders, and conditions that impact a woman’s reproductive health.

As an obstetrician, they provide both medical and surgical prenatal and postpartum care. OBGYNs can treat conditions that impact women, including menstruation, pregnancy, and childbirth. They can also perform checkups on internal/external reproductive organs.

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Nurse Midwife vs. OBGYN

While certified nurse midwives and OBGYNs have similar responsibilities, the latter are certified and trained to provide more advanced care. Both roles focus on educating new or soon-to-be pregnant persons, providing checkups, assisting during vaginal deliveries, ordering pregnancy-related screenings, and interpreting the results.

Unlike nurse midwives, OBGYNs can treat more complicated cases requiring more advanced medical procedures or monitoring. Therefore, if a woman needs surgery concerning their pregnancy (e.g., Cesarean section), they need an OBGYN.

In contrast, if the pregnancy is routine and there are no signs indicating there will be a complicated delivery, women can opt for a CNM.

Points to ConsiderCertified Nurse MidwifeOBGYN
Degree RequiredMaster of science in nursingDoctor of medicine
Certification OptionsCertified professional midwife, certified midwife, certified-nurse midwifeGynecologic oncology, critical care medicine, complex family planning, female pelvic medicine and reconstructive surgery, maternal-fetal medicine, reproductive endocrinology, infertility
Duties and Responsibilities
  • Provide prenatal and postnatal care
  • Educate parents on proper health practices
  • Monitor fetal growth and maternal health
  • Communicate with doctors and specialists
  • Prepare pregnant patients for the birthing process
  • Care for women with multiple medical issues
  • Perform gynecologic surgeries (e.g., hysterectomy, ovarian cystectomy, and Cesarean section)
Average Annual Salary$114,210$296,210

Duties and Responsibilities

CNMs and OBGYNs share many of the same duties and responsibilities. However, due to their advanced training, OBGYNs can perform surgical procedures and work with patients who are undergoing uncommon reproduction issues. While their duties often overlap, both positions are unique.

What Does a Nurse Midwife Do?

Certified nurse midwives provide reproductive healthcare in a variety of settings. They deliver primary, gynecological, and family planning services for women before, during, and after childbirth.

Whether working in hospitals, clinics, or birthing centers, their core responsibilities remain similar from one setting to the next.

  • Assesses, diagnoses, and treats
  • Prescribes related medications
  • Advises on proper health practices
  • Educates new parents
  • Prepares pregnant individuals for labor and delivery
  • Performs prenatal and postnatal exams
  • Monitors the condition of the fetus
  • Delivers and/or assists in delivery

What Does an OBGYN Do?

OBGYNs are physicians who specialize in the reproductive health of women. They are responsible for diagnosing, treating, and preventing medical conditions that may affect women before, during, and after childbirth.

The majority of OBGYNs find employment in outpatient clinics and hospitals where they perform the following duties:

  • Diagnoses and treats conditions that impact a woman’s health (for example, breast/cervical cancer and menopause)
  • Provides counseling on family planning, sexual health, and disease prevention
  • Cares for women before, during, and after pregnancy
  • Performs medical and surgical gynecological procedures
  • Supervises team assigned to patients
  • Conducts research in gynecology and obstetrics
  • Provides specialized care

Education and Certification

One of the key differences between CNMs and OBGYNs is their level of education and certification. CNMs are trained and certified as APRNs, whereas OBGYNs earn their medical degree. Despite these differences, both roles require each to have earned an undergraduate and graduate degree to become licensed and certified to practice.

How to Become a Nurse Midwife

To become a CNM, prospective midwives must initially become registered nurses (RNs) by earning either an associate degree in nursing (ADN) or a bachelor of science in nursing and then passing the National Council Licensure Examination. Most graduate-level nursing programs require RNs to have one or more years of clinical experience before enrollment.

While those with an ADN can apply to an APRN program, most prefer applicants with a bachelor’s. Therefore, those with an ADN looking to be a CNM may need to enroll in a nursing bridge program.

After earning a master’s or doctoral degree in nurse midwifery, graduates must pass the national qualifying exam, which the American Midwifery Certification Board administers.

How to Become an OBGYN

The first step in becoming an OBGYN is earning a bachelor’s degree in a science-related field that includes courses in anatomy, physiology, biology, and chemistry. Upon graduation, prospective medical students must score well on the Medical College Admission Test to enroll in medical school.

The first two years of medical school typically consist of science and general courses in medicine. Years three and four include hands-on training at a medical facility. This training will typically require a rotation in gynecology and obstetrics.

Students then apply to and complete a four-year residency program in gynecology and obstetrics to gain the necessary experience and training. Upon completion of their residency program, students must pass the medical licensing exam and two board exams administered by the American Board of Obstetrics and Gynecology.

Salary and Career Outlook

The amount of education and training needed to become either a CNM or an OBGYN directly influences the average yearly salary for both positions. While it typically takes CNMs eight years to complete the requirements, it can take OBGYNs up to 12 years.

The additional schooling required for OBGYNs is reflected in their annual salary. However, the projected growth in employment for CNMs is higher than OBGYNs.

Average Annual Nurse Midwife Salary

Average Annual OBGYN Salary

Nurse Midwife Salary and Career Outlook

According to the U.S. Bureau of Labor and Statistics (BLS), certified nurse midwives earn an average yearly salary of $114,210 with a projected job growth rate of 45%. This is higher than the 8% national average.

There are many factors that can impact the pay of a nurse midwife. Salary can range from $61,500 for the bottom 10% to 166,710 for the top 10%. Practice setting and geographic location are the main factors that can influence a CNM’s pay.

The top-paying industries include outpatient care centers ($146,430), general medical and surgical hospitals ($119,900), and physicians’ offices ($113,920). Geographically, CNMs earn the most in West Virginia ($163,190), Utah ($143,890), and California ($137,070).

OBGYN Salary and Career Outlook

The BLS reports that OBGYNs earn an average annual salary of $296,210. Their overall pay is also influenced by geographic location and practice setting. While the BLS does not provide specific salaries by location, they do note that OBGYNs earn the most in Colorado, Maryland, and Nevada.

Regarding practice settings, the highest-paying industries include physicians’ offices ($309,210), outpatient care centers ($290,320), and colleges, universities, and professional schools ($94,650).

Unlike the anticipated growth for CNMs, the BLS projects a 3% growth rate for all doctors and surgeons, including OBGYNs.

Nurse Midwife vs. OBGYN: Which Career Is Right for Me?

CNMs and OBGYNs both provide vital services in reproductive health; it can be difficult to determine which to pursue. Differences regarding education, responsibilities, salary, and job growth can help determine the right fit.

Although CNMs do not earn as much as OBGYNs, they can enter the field much earlier, allowing for more working years. The position also benefits from a job growth rate that is much higher than OBGYNs, translating to more employment opportunities.

One of the main benefits of choosing to become an OBGYN includes the high earning potential, as they can earn an average salary more than twice that of CNMs. As medical doctors, OBGYNs also have more responsibilities. They can perform medical and surgical procedures, fulfill leadership roles, and conduct research to help advance the field.

Page last reviewed August 18, 2022

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