Certified Nurse Midwife Training: Preparing for Career Success

What is a Nurse Midwife

Are you considering a career as a Certified Nurse Midwife and wanting more information about the training that helps Registered Nurses qualify for this highly specialized role? As a growing specialty of nursing, this practitioner training is for those whose interest lies in caring for the overall health and welfare of women.

Imagine the rewards of sharing women’s preparation for birth, participating in the birthing process, and following the mothers and their children throughout their lives. As believers in assisting women through the pregnancy and delivery processes, Midwives work under the supervision of a physician to perform numerous medical procedures and interventions.

The practice of Midwifery dates back to the Greeks and Romans and even the times of the Bible. Meaning with woman from Old English, Midwife was the one who delivered women’s babies in homes in the very early years. During those times formal education and training were non-existent; therefore, the early ones learned from their mothers or others by being apprentices.

For a number of years, a clash existed between Midwives and Doctors. Over time, the profession became regulated; in 1925 the standard used in England and Scotland came to the United States.

How to Become a Midwife

You may have heard that there are different kinds of Midwives, and this is true. However, in the United States, a Certified Nurse Midwife is most common, which requires certain training and degree requirements. The three main categories are Certified Nurse Midwife (CNM), Licensed or Certified Midwife and Lay or Empirical Midwife, which are considered Direct-Entry Midwives.

A CNM must be a Registered Nurse before entering training while a Licensed or Certified Midwife receives their training through a combination of apprenticeship, self-study, formal schooling, and correspondence courses.

A Lay or Empirical midwife acquires their training through a variety of ways. They may be part of a religious group or a specific community. In certain locales they are prohibited by law from charging for their services.

Although a Licensed or Certified Midwife (Direct-Entry Midwife) may enter directly into the education programs without a prior professional credential, the majority of those practicing in the United States are Certified Nurse Midwives (CNMs). Conversely, the majority of Direct-Entry Midwives practice in western European countries and Canada.

As indicated, in the United States, individuals who wish to pursue training, first become Registered Nurses. They must also have earned a baccalaureate degree and have a master’s or advanced degree. Nursing education programs can be found in all fifty states plus the District of Columbia and Puerto Rico.

However, Nurse Midwife programs exist in only twenty-six states plus the District of Columbia, as listed below:

  • California, Colorado, Connecticut
  • District of Columbia
  • Florida
  • Georgia
  • Illinois, Indiana
  • Kansas, Kentucky
  • Maryland, Michigan, Minnesota
  • New Jersey, New Mexico, New York, North Carolina
  • Ohio, Oregon
  • Pennsylvania
  • Tennessee, Texas
  • Utah
  • Virginia
  • Washington, West Virginia, Wisconsin

After completing the training program, individuals must become certified by passing state and national examinations and become licensed in their state.  The American Midwifery Certification Board is the organization that administers certification.

After you pass the certification exam, you will then be expected to present documents certifying that you graduated from an accredited training program. The Midwifery Education & Accreditation Council (MEAC) is the accrediting organization sought by legitimate nursing education programs.

After meeting the various criteria, you will be designated as a Certified Nurse Midwife (CNM). Continuing education to maintain your certification is required, as certification is only good for eight years.

The curriculum for the two-year training program consists of core courses, specialty courses, and electives. A 52-credit sample of classes follows:

Core Courses

  • Theoretical Basis of Advanced Nursing Practice
  • Strategy for Nursing and Health Care
  • Utilization of Nursing Research in Advanced Practice
  • Data Management and Analysis for Advanced Nursing Practice
  • Scholarly Project in Nursing

Specialty Courses

  • Advanced Health Assessment
  • Health Promotion and Risk Reduction Across the Lifespan
  • Advanced Pathophysiology Across the Lifespan
  • Antepartum Care of Normal Women
  • Advanced Primary Care Nursing-Health Problems and Well Women
  • Intrapartum, Postpartum and Newborn Care
  • Nurse Midwifery Integration-The Childbearing Cycle
  • Professional Issues in Nurse Midwifery
  • High Risk Perinatal Nursing


  • Pharmacotherapeutics
  • Other Electives

The American College of Nurse-Midwives (ACNM) certifies that Midwives are qualified to practice and are therefore certified professionals in this specialty. The basis of credentialing is as follows:

  • Completion of education program accredited by a school that is approved by the United States Department of Education;
  • Evidence of proficiency in Midwifery competencies including academic and clinical practice
  • Passage of national certification examination
  • Officially approved to practice Midwifery in state or states

Education programs in this country are endorsed by the United States Department of Education and the Accreditation Commission for Midwifery Education (ACME).

Upon completion of your training, you must pass the American Midwifery Certification Board (AMCB), which is a written examination. It is also a four-hour computer-based exam that asks one hundred and seventy-five multiple choice questions. The test is administered for a fee of $500. There are one hundred and twenty testing centers throughout the United States with at least one testing site located in each state.


The employment outlook for this career field is exceptional; it is anticipated that it will continue to grow since high quality health care for women, especially prenatal care, is a main concern in the field of obstetrics. Additionally, nursing educators will be essential to teach incoming nurses, and administrators will be needed to provide leadership and management of programs, faculty and students.

Since well-educated and experienced Registered Nurses have knowledge and skills that they bring to the this profession, they are able to execute many of the tasks and procedures that physicians perform. Care for pregnant women and their newborn babies in the form of education, support and direct patient services will remain essential.

Additionally, those who retire or leave the profession will require others to take their positions.

Data from the United States Department of Labor indicates indicates that the nursing profession is the largest sector of health care occupations in the nation and is also the sector experiencing the greatest shortage in this country; this scarcity impacts specialties such as Nurse Midwives, which shortage the DOL predicts will expand between twenty-one percent and thirty-five percent within ten years.

Nurse Midwives care for women and focus their practice on pregnancy, childbirth, care of the newborn, postpartum, family planning and other like needs. They address each woman’s specific needs during prenatal appointments and follow her during pregnancy, labor and delivery of her baby.

They are qualified to intercede with medical procedures or drugs if necessary. They have been trained to utilize labor-inducing drugs, pain medications, epidurals and electronic fetal monitoring as well as other techniques.

A sample job description would include the following responsibilities:

  • Counseling and educating on birth control methods
  • Prescribing medications
  • Administering breast exams and pap smears
  • Offering family support
  • Helping pregnant women through prenatal, pregnancy and delivery
  • Providing postpartum care for mothers and babies
  • Educating about personal care and reproductive topics
  • Monitoring the mother and fetus during pregnancy
  • Teaching mothers and families about caring for an infant and nutrition
  • Advocating for public health initiatives
  • Teaching and researching

In addition, these specialized nurses work with Gynecologists and Obstetricians to assess and treat women with chronic and acute conditions. Securing hospital privileges is also critical to a Midwife’s ability to conduct a professional practice. Obtaining hospital privileges enables them to access resources such as the emergency room, lab, and radiology.

They can work anywhere in the world and are in demand in places like New Zealand. The most common settings are hospitals, birthing centers, and clinics. Other locations could be community health centers, private practices, public health departments or health maintenance organizations. In some cases, they actually work in the mother’s home if the birth is to be a home birth; in these cases, conditions must be appropriate for this to occur.

The pay range is slightly more in Gynecology and Obstetrics practices than in hospital settings. The median salary for this position is around $102,390. Of course, geographical areas of the country as well as education and experience impact salaries.

Think this may be the right career choice for you? Imagine the advantages that come from working with women as they bring new life into the world. Think about the personal fulfillment that comes from assisting them during these important times in their lives. The need is increasing; will you choose this option for your next career move?

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