A Nurse Midwife (CNM or Certified Nurse Midwife) is an Advanced Practice Nurse who receives specialized training to help care for mothers and their babies. This field of nursing has a great number of opportunities for interested nurses.
The nursing profession is one of the fastest growing careers in the industry. With over a 20% increase in jobs expected over the next decade, it is no wonder so many people are choosing to enter the nursing profession. Some nurses choose to increase their income potential and marketability by becoming one of many types of Advanced Practices Nurses.
This article will provide a comprehensive overview on midwifery. If you would like to read more articles on this topic, please visit our Midwife career section.
The History of Certified Nurse Midwife (CNM) Nursing
The Nurse Midwife profession was officially established during the early 1920s. Unofficially, many midwives attended the births of babies since American colonization. The rate of maternal and infant mortality was so high during this time in America that this professional field of nursing was established to fulfill the need. Mothers, nurses, and obstetricians to address the need created the Maternity Center Association (MCA).
The MCA wanted to find excellent models for maternal and infant care so they looked to professionals outside of the United States who displayed excellent material child health records to provide the organization with a model. The Nurse Midwife was the prominent figure used in other countries. This discovery was the answer to America’s problem with maternal child health issues, but this specialized area of nursing was not established in the United States at the time.
A pioneer nurse named Mary Breckinridge created the Frontier Nursing Service (FNS) in Kentucky around the same time the MCA began its quest to solve the maternal child health problem in America. Isolated areas such as the Appalachian Mountains were out of reach for proper nursing care. FNS provided these families with health services by providing them with public health nurses who were sent into these rural areas on horseback to provide medical care. Early Nurse Midwives provided nursing care in many different settings, and they helped to solve the growing mortality rate for women and infants—especially in under-served areas.
Breckinridge traveled to England and France for a first-hand experience with maternity care nurses in other countries. By 1929, she convinced a few British Nurse Midwives to come to America to practice this specialized area of nursing. They contributed to American health care by providing help for those patients in remote areas.
For more than 70 years, Nurse Midwives have provided their services in the United States. The first school to offer nurse midwife training was established during the late 1920s at the Maternity Center Association, and the first class graduated in 1933. The profession gained popularity during the 1970s and 1980s and continues to gain popularity as a specialized area of nursing. Thanks to the work of Mary Breckinridge and others, midwives practice in all 50 states.
What is a Certified Nurse Midwife (CNM)?
A Certified Nurse Midwife (CNM) is a type of Advanced Practice Nurse who receives special training and education in midwifery and nursing. These healthcare providers provide medical care for women and their babies who are considered healthy and are not high risks. These individuals can prescribe treatments, medications, diagnostic and therapeutic measures, and medical devices in all states.
The scope of practice for Certified Nurse Midwives varies by the practicing state. The basic scope of their practice includes caring for females from puberty through menopause, including care for newborns, intrapartum, postpartum, antepartum, and nonsurgical gynecological care. In certain cases, Certified Nurse Midwives provide care for male patients in relation to reproductive health and sexually transmitted diseases of their female partners.
Many women enjoy the benefit of having a nurse midwife in attendance throughout their high-risk pregnancies. Although Certified Nurse Midwives do not provide direct care for women who are at high risk for complications during pregnancy, they can work with the patient’s doctor to provide care. These nurses collaborate with Gynecologists and Obstetricians providing assistance for women with complex medical histories or who develop complications.
How to Become a Certified Nurse Midwife (CNM)
Before becoming a Nurse Midwife, it is necessary to earn a bachelor’s degree in nursing before enrolling in a master’s program in nursing. Some students choose to earn a diploma or an associate’s degree in nursing before earning the bachelor’s degree in nursing. It is important to find a bachelor’s program that accepts the credits from the diploma or associate’s degree program before enrolling. It generally takes 4 years to earn a bachelor’s degree, but it is possible to earn the bachelor’s degree in nursing in less time.
Nursing professionals must earn the registered nurse credentials before trying to pursue an Advanced Practice Nursing degree. The nursing board determines the requirements for earning the registered nurse credentials. Nurses must take the NCLEX-RN test to become a registered nurse.
Most states require that nurses have 1 to 2 years of nursing experience before receiving acceptance into the master’s degree program in nursing. Nurses should check with their state nursing board for the requirements for the practicing state to determine the specific eligibility requirements. Nurses can also check with the American College of Nurses Midwives (ACNM) for the state requirements.
It is important to make sure that the nursing school is accredited before pursing the master’s degree in nursing. Courses that nurses can expect to take include obstetrics, embryology, gynecology, breastfeeding, neonatology, and family planning.
Upon completing the nursing program, a nurse should take a certification examination to become a Certified Nurse Midwife. The American Midwifery Certification Board (AMCB) is one of the most notable certifying bodies for the Certified Nurse Midwife credential. The North American Registry of Midwives (NARM) is another popular certifying body that offers the nurse midwife certification. The names of the certification examinations vary by the certifying body. Advanced Practice Nurses can take certification examinations to become Certified Nurse Midwives (CNMs), Licensed Midwives (LMs), or Certified Professional Midwives (CPMs).
How to Study for the Certified Nurse Midwife Exam (AMCB & NCC Exam)
In order to prepare for the Midwifery exam, administered through AMCB or NCC, it is recommended that you use a study guide. Many Nurse Midwife study guides strictly focuses on material you will be asked on the exam regarding midwifery. In addition, the study guide provides practice questions with rationales.
A recommended study guide to help prepare you for this exam is called: “Midwifery and Women’s Health Nurse Practitioner Certification Study Question Book“. This Study Question Book has three hundred additional questions divided according to content area and includes answers, and rationales. This study guide was prepared by board certified nurse practitioners, the questions are representative of those found on the American Midwifery Certification Board (AMCB) exam or Women’s Health Nurse Practitioner exam from the National Certification Corporation (NCC).
Here is what the study guide looks like:
Employment Setting for a Certified Nurse Midwife (CNM)
The practice of nurse midwifery is permitted in each of 50 states as well as the District of Columbia. Certified Nurse Midwives provide childbirth and women’s health care for those who lack proper healthcare services. Certified Nurse Midwives may practice in military, public, university, and private hospitals. Additionally, they can work in private practices, birth centers, health maintenance organizations, and public health clinics.
Many Nurse Midwifes also have the opportunity to work in international health programs to assist with improving the health of babies and mothers around the world. Since Certified Nurse Midwives have such a broad range of settings in which they can practice, there will continue to be a growth in the demand for these professionals.
A diverse group of people makes up the Certified Nurse Midwife profession. The skill set that these individuals have are as diverse as their backgrounds. Since the likelihood of cesarean sections has risen over the past few decades and many of the pregnancies are high risk, Nurse Midwives add a valuable element to the birthing environment. They offer of healthy alternatives to women and their babies for a successful birthing. Nurse midwives must be certified to practice in all fifty states, or they may be limited to the states in which they can practice.
Nearly 95% of Nurse Midwifes attend hospital birthing. Many hospitals across the country are beginning to offer midwifery practices to their patients who want personalized attention that midwives can offer. The great thing about choosing the hospital as the birthing area is that there is access to medication should the healthcare provider need medical interventions. Working in a hospital is a collaborative experience between members of the medical team.
Home births and birthing centers are other environments in which Certified Midwives can work. These Nurse Midwives are more flexible, and they offer a highly personalized experience for their patients. Certified Nurse Midwives can offer a safe environment that is comparable to the low risk, conventional hospital birthing experience. Either a single midwife or a small number of midwives operate birthing centers so it is necessary to network to maintain a successful business.
Nearly one-third of all Certified Nurse Midwives work in community health organizations or private practices providing care for mothers and their babies. They also work in conjunction with midwife teams and doctors. They are not governed by as many rules that apply for those working in hospitals.
Certified Nurse Midwife (CNM) Salary
Becoming a Certified Nurse Midwife comes with a great level of responsibility and experience as well as a substantial salary. The nursing profession has some of the highest paying positions of all employment opportunities. The median annual salaries for Certified Nurse Midwives working in the United States are $90,119.
The lowest 10% to 20% of CNMs earned annual wages of $76,765 – $83,069. The middle 50% of Certified Nurse Midwives earned annual wages of $83,070 – $98,225 while the top 75% to 90% earned wages of $98,226 – $105,604 annually. The highest salaries for Certified Nurse Midwives are in the following states: Massachusetts, Connecticut, New York, Alaska, Delaware, Ohio, Maryland, New Jersey, Colorado, and Illinois.
Many other factors affect the salary in which Certified Nurse Midwives earn other than location. The employment setting is one of the greatest factors that influence the salaries of CNMs. Although CNMs can work in environments ranging from private clinics and hospitals, those working in non-profit organizations earn higher wages than those in local government agencies.
The previous work experience can also affect the nurse midwife salary tremendously. Certified Nurse Midwives have the potential to make well over $80,000 per year with at least 5 years of work related experience in nursing. CNMs can only expect their incomes to increase as their education and experience continue to increase.
Nurse midwifery is truly one of the best areas of nursing to enter for nursing professionals who want to make high wages. The median annual salaries for Certified Nurse Midwives only come second to Certified Registered Nurse Anesthetists (CRNAs) so those entering this area of nursing can be proud of their exceptional salaries.
Certified Nurse Midwife (CNM) Job Outlook
Certified Nurse Midwives have a very promising future ahead of them. The nursing profession has some of the best opportunities for those who want to become nurses or advance their current nursing careers. Over the next decade, positions for Certified Nurse Midwives are expected to grow faster than the average of all other professions. Over a 20% increase is expected in Certified Nurse Midwife positions so those who choose to become this type of Advanced Practice Nurse should not have any difficulty when it comes to seeking employment.
Advanced Practice Nurses such as Certified Nurse Midwives are in high demand because they can perform many of the tasks that a doctor performs. These individuals are highly trained and skilled, and they provide the medical facilities with a cost-effective solution to their medical needs. These individuals are in high demand by many nursing professionals who choose to advance their careers in the nursing field.
One of the factors that have lead to the increase in the need for Nurse Midwives is the advancements in medicine. Many women are faced with the option to utilize fertility treatments option in order to conceive. Since many of these treatment methods often cause medical complications during delivery, midwives are needed to provide their medical care to the mother and her baby. Many mothers are also having multiple babies as a result of methods to conceive so Certified Nurse Midwives are needed.
The best opportunities for Certified Nurse Midwives are in rural areas of the United States where patients may not have access to proper medical treatment. Additionally, doctors’ offices and outpatient clinics provide a great number of opportunities for Certified Nurse Midwives.
Certified Nurse Midwives provide specialized care to mothers and their babies. This position is one of the top two nursing positions in the nursing profession. Becoming a CNM has never been easier. Nurses can increase their knowledge on nursing and earn higher wages with more responsibilities and opportunities.