Advanced Practice Nursing

How to Become a Certified Nurse Midwife

How to Become a Certified Nurse Midwife
A certified nurse midwife is an advanced practice registered nurse who assists in pregnancy, childbirth, and postpartum care. These nurses can earn over $100,000 annually. Image from Unsplash
Suzanne Wentley profile
Suzanne Wentley October 29, 2019

A nurse midwife guides patients through pregnancy, right up to (and even after) childbirth. Nurse midwives participate in about 7 percent of all births in the United States, a number that is on the rise.

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More and more women are turning to nurse midwives to assist them with their pregnancies and deliver their babies. And why not? These advanced practice nurse practitioners are both supportive and knowledgeable, and they produce results: according to studies, midwife-assisted births reduce the need for expensive medical interventions, including cesarean sections.

According to the Nurse Journal, certified nurse midwives handle 7 percent of all births in the United States, with 97 percent of those births taking place in a hospital, 2 percent in birthing centers, and 1 percent at home. Besides deliveries, these professionals also offer:

  • Gynecological appointments
  • Reproductive health work
  • Care after menopause

As part of their practice, they:

  • Answer questions
  • Plan a delivery
  • Provide emotional support
  • Help with lactation concerns

Certified nurse midwifery requires a graduate degree, and it pays accordingly. estimates that the average certified nurse midwife earns $108,447 a year.

Becoming a certified nurse midwife means empowering women to exert more control over their pregnancies. That, perhaps, is the profession’s greatest benefit both to patients and practitioners.

In this guide, we’ll discuss:

  • How to become a certified nurse midwife
  • Coursework for nurse midwifery programs
  • Educational requirements for becoming a certified nurse midwife
  • Certification for certified nurse midwives
  • Kinds of certified nurse midwife careers

How to become a certified nurse midwife

Before you pursue a career in midwifery, consider the following qualities of an effective certified nurse midwife:

  • Flexibility: Since this kind of registered nurse works primarily with pregnant women, you never know when you’ll be needed. A midwife is often on call, so it’s crucial to have a flexible schedule.
  • Supportiveness: Like all labor and delivery nurses, a midwife is responsible not just for assisting in the birthing process but also providing emotional support. You’ll need to be able to answer questions, soothe fears, and be a trustworthy partner at one of the most important times of a woman’s life. A good bedside manner is paramount for midwives.
  • Empathizing with women: Having a working knowledge of history and psychology from a woman’s viewpoint will strengthen the foundation of your career. That’s why some nurse midwives pursue women’s studies, sociology, or psychology degrees as undergraduates. Though not a requirement, being a woman probably helps too: 99.5 percent of nursing midwives are women, according to the Integrated Postsecondary Education Data System (IPEDS) Completions.

In the United States, the American College of Nurse-Midwives serves as midwifery’s chief professional organization. The organization’s website is an excellent resource for information about the profession of midwifery, midwifery education, other online resources on midwifery, and how to find a midwife in your area.

Educational requirements for becoming a certified nurse midwife

Becoming a certified nurse midwife requires graduate-level training leading to certification through examination. It is common for schools to have a limited number of spaces for midwifery students; the faculty-to-student ratio is usually low. Prospective students sometimes have to apply more than once before being accepted.

Before pursuing midwifery certification, you will need to earn a bachelor’s degree. Some, but not all, midwifery programs require that you earn your license as a registered nurse (for which you’ll need to pass the NCLEX-RN exam) and work for at least one year before commencing training. Most midwifery programs take a full-time student three years to complete.

In the United States, the Accreditation Commission for Midwifery Education (ACME) accredits midwifery programs. The organization currently accredits 37 American institutions. Among them are:

Different midwifery programs award different degrees. All ACME-accredited programs confer either a master’s degree or a Doctor of Nursing Practice (DNP) degree, or both. Graduation from an ACME-accredited program qualifies you to sit for the American Midwifery Certification Board (AMCB) qualifying exam. Passing this exam is the final requirement for earning certification and becoming a certified nurse midwife.

The International Confederation of Midwives (ICM), founded in the early 1900s, sets international standards for midwifery education. The organization—which is dedicated to encouraging an evidence-based practice of healthcare for women, newborns, and growing families—also accredits midwifery programs around the world. Before choosing a school for training, be sure the curriculum is accredited by the ICM.

The ICM assesses midwifery programs based on their effectiveness in:

  • Nurturing trust in midwifery and midwifery education
  • Pursuing continuous improvement in instruction and practice
  • Fostering the integrity of the profession
  • Promoting the autonomy of midwifery education and the midwifery profession

Coursework for nurse midwifery programs

Midwifery programs offer courses covering prenatal care, the birthing process, and postnatal treatment for child, mother, and family. Coursework can also include the history of midwifery and the study of legal, social, and political issues particular to women, both in America and around the world.

Typical graduate-level midwifery courses include:

  • Human Pathophysiology
  • Global Health Care and Missions
  • Advanced Pharmacology
  • Advanced Health Assessment/Promotion/Disease Prevention
  • Professional Issues for Nurse Midwives
  • Reproductive Physiology
  • Labor and Birth
  • Newborn Assessment and Management
  • Primary Care for Women
  • Intrapartum Management
  • Care of the Childbearing Family
  • Clinical Epidemiology
  • High-Risk Family
  • Health Informatics
  • Policy Implications for Healthcare
  • Roles and Business of the APRN
  • Applied Ethics

Certification for certified nurse midwives

To work as a certified nurse midwife, you must not only complete the educational and clinical requirements but also pass a licensure exam. The American Midwifery Certification Board administers the exam; the cost is $500.

Once you pass the exam, you’ll need to renew your certification every five years. You must complete 20 hours of continuing education in order to recertify. This requirement can be met by:

  • Publishing a paper in a peer-reviewed journal, or a chapter in a peer-reviewed textbook
  • Serving as a peer reviewer for a journal or textbook
  • Offering a formal presentation on a pre-approved subject at a pre-approved venue
  • Completing certain clinical rotations
  • Pursuing additional graduate-level coursework

Kinds of certified nurse midwife careers

As a certified nurse midwife, your career isn’t just limited to hospitals. These trained and experienced midwives can also be found:

  • Running their own private practices
  • Working at birth centers
  • Treating patients at health clinics

Certified nurse midwifery is just one of over 100 different nursing specialties. Specialization almost always adds value and, accordingly, typically results in higher wages or salary.

So, is nurse midwifery the specialization for you? The role requires significantly more training than is required to work as a registered nurse. The recertification requirements are demanding and costly, and you’ll have to endure them every five years as long as you practice. The job, by most accounts, is fairly stressful, especially when things go wrong.

In return, you’ll earn an excellent living. More important, though, you will form relationships with mothers. You’ll assist them throughout their period of pregnancy, and you’ll be present at the happiest moment in most parents’ lives. No wonder nurse-midwife Lizzi Brink calls it “truly the best job in the world.”

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About the Editor

Tom Meltzer spent over 20 years writing and teaching for The Princeton Review, where he was lead author of the company's popular guide to colleges, before joining Noodle.

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