How to Become a Nurse Midwife

May 10, 2022

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An adult’s hands hold the soles of an infant’s feet. Clinical midwifery has made significant progress since 1925. That’s when Mary Breckinridge founded the Frontier Nursing Service (FNS), one of the first organizations in the U.S. to educate and employ nurse-midwives. The midwifery service focused on providing care to mothers and babies in poor and underserved rural communities.

Today, the role of the nurse-midwife has evolved into acting as a primary health care provider for pregnant women; offering gynecological exams, prenatal and postnatal care, and health education for women and their families.

According to the U.S. Bureau of Labor Statistics (BLS), more than 7,100 nurses and certified midwives are employed in the U.S. The BLS predicts this number will increase through 2030. That translates to plenty of potential opportunities in the field; excellent news for those who have decided that the type of nurse they want to be involved in guiding patients through one of life’s most cherished stages.

Steps to Becoming a Nurse Midwife

It’s important to understand how to become a nurse-midwife prior to pursuing the role. Adhering to the following steps is crucial to achieving success in the profession.

Step 1: Earn a Bachelor’s Degree

A certified nurse-midwife (CNM) is one of three types of midwives — others include a certified midwife (CM) and a certified professional midwife (CPM). To become a CNM requires earning a Bachelor of Science in Nursing (BSN) and then passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to enter the workforce as a registered nurse (RN). After successfully completing the NCLEX-RN, RNs must also obtain a state license to begin working in their preferred nursing field.

According to the American College of Nurse-Midwives (ACNM), CNMs are the only type of nurse-midwife trained as registered nurses and make up the majority of midwives in the U.S. The ACNM also states that CNMs are the only type of midwife licensed in all 50 states, plus the District of Columbia and U.S. territories.

RNs can choose to work in areas such as postnatal care or public nursing to gain early clinical experience treating families and infants. Earning a BSN and working as an RN are critical to becoming a certified nurse-midwife, as they are both prerequisites for moving on to the second step: earning a master’s degree.

Step 2: Earn a Master’s Degree

Certified nurse-midwives are advanced practice registered nurses (APRNs). They must have graduate-level education — a Master of Science in Nursing (MSN) with a concentration in midwifery, for example — from an institution accredited by the Accreditation Commission for Midwifery Education (ACME). The ACME ensures coursework meets minimum core competencies in early child development, women’s reproductive health, and advanced clinical pharmacology.

As primary care providers, CNMs provide health assessments that are critical to the diagnosis and subsequent treatment plans of their patients. MSN programs, using evidence-based strategies, enable nurse-midwifery students to study and practice identifying the health care needs of patients through all stages of life.

Step 3: Gain Work Experience

Often, master’s programs require nursing students to have experience as an RN before applying to a midwifery program. With few exceptions, gaining this experience is a critical step in becoming a nurse-midwife.

During the master’s program, nurse-midwifery students are required to complete a minimum number of clinical hours to graduate. Students may be permitted to work as an RN while gaining clinical hours in pursuing their degree. These clinical hours reinforce the knowledge obtained through a nurse’s BSN and MSN programs, enhancing their skills to provide high-quality care to patients.

Step 4: Become Certified

Midwives of all types or classifications must pass a national certification exam to obtain a state license to practice. CNMs take the examination issued by the American Midwifery Certification Board (AMCB). Some certification organizations require midwives to get recertified every three to five years to ensure that their knowledge and abilities keep pace with advancements in the field.

What Does a Nurse Midwife Do?

With comprehensive knowledge of women’s health and maternity care, nurse midwives can assist women throughout labor, delivery, and postnatal care up to 28 days after delivery. Some of the common functions during this process include conducting physical exams, ordering and interpreting diagnostic and laboratory tests, and helping build treatment strategies. Care may vary based on the method of birthing.

Nurse-midwives have the experience to assist with natural birthing as well as cesareans and births with epidural anesthesia. Nurse-midwives can also assist patients with family planning strategies and preconception care. Additionally, they may be tasked with treating a patient’s male partners for sexually transmitted infections.

An essential distinction between RNs and nurse midwives is that nurse-midwives have prescriptive authority in most states. Nurse-midwives can prescribe intervention medications, such as birth contraceptives or treatment antibiotics for sexually transmitted diseases. They also provide ongoing wellness care and health education to patients and their families, including discussions about preventing diseases through positive lifestyle choices.

Nurse-midwives can work without physician supervision in most situations. They can help with repairing lacerations and hemorrhaging due to delivery, but a physician will still be required for cesarean operations. Nurse-midwives can work in a wide range of environments, such as hospitals, birth centers, ambulatory care clinics, and public health systems.

Nurse Midwife Salary and Job Outlook

As advanced practice registered nurses, nurse midwives have a higher earning potential than other nursing professionals. In 2020, the BLS reported the average salary for nurse midwives was $111,130.

The BLS also reports that nurse-midwives who work with local government agencies such as community health programs earn an average annual salary of $158,210. Nurse-midwives working in outpatient centers earn an average annual salary of $142,010, while those in physician’s offices take home an average salary of $116,440, per BLS records.

Great opportunities are plentiful for individuals who want to become nurse-midwife and make a difference in the lives of expectant mothers and their children. The BLS projects 11% job growth from 2020 to 2030, which is more than the 8% growth the BLS projects for the job market as a whole

Provide More Than Care

Salary and job outlook aren’t the only measures of the importance of nurse-midwives to society. The work of nurse-midwives can be crucial to saving lives around the world. A 2020 study published by the journal The Lancet Global Health projects that using more midwife services could potentially lead to 280,000 fewer maternal deaths, 2 million fewer newborn deaths, and more than 2 million fewer stillbirths annually by 2035.

Nurse-midwives are trained to deliver quality care for mothers and infants. On a deeper level, their work helps guide patients through a life event marked by constant change. This guidance can add layers of comfort, security, and trust to the patient/provider dynamic, putting the patient at ease throughout their journey. This makes the role of the nurse-midwife one of the most satisfying in health care.

Ohio University’s online Master of Science in Nursing (MSN) can equip you with the foundation to succeed in this crucial career. Our program is designed to cultivate expertise in core nursing concepts, and it’s also built to give you the confidence to apply that expertise in real-world scenarios.

Learn how we can help you successfully reach your career goals in nursing.