Young certified nurse midwife monitoring an expectant mother

If you love working in women’s healthcare and helping new moms and babies, then being a CNM could be your true calling. CNMs specialize in treating women during the childbearing period and beyond; they assist mothers during pregnancy, labor, delivery, and postpartum.

Certified nurse midwives work with pregnant women and provide primary and preventive gynecological care.

CNMs are Advanced Practice Registered Nurses (APRNs), meaning they hold specialized education in a specialty area. As a result, they have gained additional certification to take on greater responsibility and provide higher care to their patients. 

Becoming a CNM takes several years, as you’ll need a bachelor’s degree in nursing (BSN), a master’s degree in nurse-midwifery, and certification through the American Midwifery Certification Board (AMCB). 

In this guide, we’ll cover everything you need to know about becoming a certified nurse midwife step-by-step.

Read more: What is a certified nurse midwife?

What are the steps to becoming a certified nurse midwife?

Every CNM starts their career as a nurse, but your journey to being a nurse midwife can take different paths based on your education. If you have no prior experience, you’ll start your career by becoming a registered nurse (RN) in your state. 

1. Earn a nursing degree

Nursing is an exciting career in which you can earn one of two degrees to start working – an associate’s or bachelor’s degree. 

RNs with associate’s degrees and bachelor’s degrees are equal in the workforce because they both have the same credential, an RN earned by passing the NCLEX exam. The most significant difference lies in what next steps a nurse can take after completing their degree.

Nurses that want to pursue a specialization, like midwifery, are best earning a bachelor’s of nursing. The BSN degree is the prerequisite for a master’s degree and doctorate of nursing (DNP) programs. 

If you already have your RN, there are RN to BSN bridge programs that can help you further your credentials faster than the typical 4-year bachelor’s track. Nurses who already hold advanced degrees can also use their current education to earn their certification.

The various education paths for certified nurse midwives are:

  • ADN to RN/BSN 

  • RN to BSN

  • BSN to CNM

  • BSN to MSN to CNM

  • APRN to CNM

  • DNP to CNM

2. Pass the NCLEX-RN exam 

If you are not already an RN, then you’ll have to become one after your ADN or BSN program. 

You can earn your RN by passing the NCLEX-RN exam. The NCBSN board administers the NCLEX. It is the only certifying exam for registered nurses earning their licenses in the United States. 

You can prepare for the NCLEX by following test plans, reviewing study guides, and taking a practice test.

The NCLEX is an adaptive exam that adjusts questions across several nursing domains based on your education. The categories of nursing skills will be divided into four main categories:

  1. Creating a safe and effective care environment

  2. Health promotion and maintenance

  3. Psychosocial integrity

  4. Physiological integrity

Each of these areas is divided into various related topics. You’ll receive a pass-or-fail score when the system reaches 95%. After that, your results are sent to your state nursing board. Once you pass, you can complete the board’s application process to earn your license number. 

3. Gain work experience

Once you’re a fully registered nurse, you can start gaining work experience. Nurses benefit significantly from having a diverse background, but you can also begin to specialize in labor & delivery care early on. You could also take on a nursing job in an OB/GYN’s office, where you can work directly with women in your preferred patient population. 

During nursing school, you can look for opportunities to perform clinicals or internships in labor and delivery or obstetrics and gynecology. In addition, having this background may make it easier for you to find nursing jobs in your specialty area right out of nursing school.

3. Apply for a master’s degree or doctorate in nurse-midwifery

Nurse midwifery is a specialty that requires years of dedicated study. You can earn a master’s or doctorate based on your interests. Nurse midwives that want to focus more on research can opt for the DNP program. However, the MSN is the standard educational requirement for aspiring CNMs.

Your CNM program will teach midwifery, women’s health, gynecological care, and obstetrics. In addition, you’ll learn how to care for women throughout the antenatal period (the time from conception to birth) and postpartum (after birth). 

CNMs also specialize in reproductive health and wellness, so they can test and screen patients for sexually transmitted diseases and health conditions that affect the reproductive system. 

4. Pass the CNM exam

Certified nurse midwives must take the Certified Nurse Midwife Certification Examination through the American Midwifery Certification Board (AMCB). The test includes 175 questions that cover a range of clinical subjects, including assessment, professional standards, ethics, and so on.

Once you’ve passed your CNM exam, you’re officially certified as a nurse midwife. You can then register with your state nursing board to gain your license number and start practicing.

5. Apply for certified nurse midwife jobs

With your CNM certification, you can begin applying for nurse midwife jobs. You may choose to work locally or transfer to another state. Most CMNs work in outpatient OB/GYN clinics or family health practices. 

Can you become a certified nurse midwife online?

Yes, you can take many courses for CNM programs online. However, some in-person skills laboratories and clinical rotations are mandatory. In addition, all nurses in master’s or doctorate programs have clinicals they must perform in person. Hands-on, direct patient care is essential to a well-rounded education. 

What is the difference between a certified nurse midwife and a registered nurse? 

CNMs are registered nurses with advanced education, skills, and experience in midwifery. They specialize in women’s health, labor & delivery, postpartum care, and reproductive wellness. They also tend to their own patients and can assess and diagnose medical conditions. They can also write prescriptions. 

Registered nurses can also specialize in midwifery or women’s health but act as assistants to physicians, nurse practitioners, and CNMs. They take vitals, perform physical assessments, admit patients, gather medical history, take vitals, and prepare patients for procedures performed by the doctor, NP, or CNM.

What positions can you progress to from being a certified nurse midwife?

Becoming a CNM is the second-highest role you can hold as an APRN. The highest title would be a nurse practitioner. CNMs and NPs are on similar grounds, and the most significant difference between their roles is their specialty and ability to supervise births.

A certified nurse midwife has the legal, medical authority to oversee vaginal childbirths, assisted and unassisted. Nurse practitioners, even those specializing in women’s health, do not. NPs can provide prenatal care, but they cannot oversee a delivery. 

The women’s health nurse practitioner usually works in an office with a doctor (MD or DO) or a CNM who tends to the patient during childbirth. 

If you are interested in treating women for a broader range of health conditions, you could consider earning your nurse practitioner license. It’s also possible to become a women’s health nurse practitioner and CNM together. 

This would give you the most significant opportunity to serve patients throughout every stage of their lives, including adolescence, prenatal and postnatal phases, and pre-and post-menopausal stages.

Do certified nurse midwife qualifications expire?

You must undergo a routine recertification process as a certified nurse midwife. The AMCB requires all CNMs to recertify every 5 years

You can recertify by completing contact hours and professional development courses, or retaking the certification exam no sooner than year 4 of the 5-year recertification cycle.

How much do certified nurse midwives make?

The average certified nurse midwife's salary is $117,216 annually. This figure is based on the latest data from in September 2022. Salaries for CNMs vary, but you can expect to earn around six figures with this certification. As an expert in nurse-midwifery, your education, clinical skills, and experience qualify you for much higher pay than a registered nurse. 

Read more about how much nurses make in the US in our guide.

How long does it take to become a certified nurse midwife?

It takes 6 to 7 years to become a CNM, but it may take longer if you decide to work as a nurse between your degree programs. For example, it’s not unusual for nurse midwives to work as an RN in women’s health for several years before deciding to become a CNM.

The entire education progress is 6 to 7 years, including your BSN and MSN/DNP. 

Read more: How long does it take to become a nurse?

FAQs about becoming a certified nurse midwife

What is the difference between a certified nurse midwife and a midwife?

CNMs are registered nurses with graduate-level or postgraduate degrees in midwifery. They are all certified through the American Midwifery Certification Board. Certified midwives are non-nurses who completed graduate-level coursework in midwifery and have obtained certification through the AMCB. 

Can CNMs deliver babies?

Yes, CNMs can supervise women during labor and deliver babies vaginally. However, no midwife can perform a Cesarean section. CNMs can deliver babies with assisted birthing tools, such as vacuum extractors, and perform and repair episiotomies. However, if a mother requires a C-section, she will be referred to an obstetrician. 

Is a midwife higher than a nurse?

CNMs are advanced practice registered nurses with greater medical authority than an RN. Midwives with no RN can only work in labor & delivery care, but RNs can apply for careers in a wide range of fields, including obstetrics and gynecology, labor & delivery, women’s health, family care, neonatal intensive care, and pediatrics.