Clinical midwifery has made significant progress since Mary Breckinridge founded the Frontier Nursing Service (FNS) in 1925. The midwifery service focused on providing care to mothers and babies in poor and underserved rural communities. Today, there are more than 6,500 nurses and certified midwives, according to the U.S. Bureau of Labor Statistics (BLS), the government agency that collects employment data.
A nurse midwife is a primary health care provider for pregnant women, offering gynecological exams, prenatal and postnatal care, and health education for women and their families.
Here are four steps to becoming a nurse midwife.
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. CNMs are the only type of nurse midwife trained as registered nurses and make up the majority of midwives in the U.S., according to the American College of Nurse-Midwives (ACNM).
RNs can choose to work in areas such as postnatal care or public nursing to gain early clinical experience with families and infants. The knowledge obtained during a BSN and working as a RN is critical for becoming a certified nurse midwife, as it is the prerequisite 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). ACME ensures that the 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 evidenced-based strategies, enable nurse midwifery students to study and practice identifying the health care needs of patients during their lifetime.
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.
Nurse Midwife Responsibilities
With comprehensive knowledge of women’s health and maternity care, nurse midwives can assist women throughout their pregnancy — labor, delivery, and postnatal care — up to 28 days after delivery. Care may vary based on the method of birthing. Nurse midwives have the experience to assist with natural birthing as well as caesareans and births with epidural anesthesia.
An essential distinction between RNs and nurse midwives is that nurse midwives have prescription 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 disease prevention 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 caesarean operations.
Nurse Midwife Job Outlook
As advanced practice registered nurses, nurse midwives have a higher earning potential than other nursing professionals. In 2017, the average salary for nurse midwives was $100,590, according to the BLS. Nurse midwives who work in the offices of physicians earned $103,270 on average, and those who work in hospitals earned $108,840.
There are great opportunities for individuals who want to become a nurse midwife and make a difference in the lives of expectant mothers and their children. The BLS projects 21 percent job growth — three times the national average — from 2016 to 2026.
ACNM reports that a large percentage of women with vulnerable health conditions are using nurse midwives during their pregnancy and that nurse midwives have contributed to “reducing infant and maternal mortality rates, premature births, and low birth weights rates.”
For students who aspire to an advanced career in nursing, Ohio University’s online MSN program helps them gain the skills and experience necessary to take their nursing careers to the next level. Learn more about Ohio University’s online Master of Science in Nursing.
American College of Nurse-Midwives, “Comparison of Certified Nurse-Midwives, Certified Midwives, Certified Professional Midwives Clarifying the Distinctions Among Professional Midwifery Credentials in the U.S.”