How Does an RN Become a Certified Nurse-Midwife (CNM)?

A certified nurse-midwife (CNM) is an advanced practice registered nurse who provides care for patients with uteruses throughout their lifespan, from adolescence through menopause. In addition to providing primary and preventive care, CNMs also offer gynecological services, family planning counseling, and well-person exams. They also provide preconception counseling, assist with labor and delivery, and provide postpartum care. In addition to their clinical duties, CNMs also play an essential role in educating patients and families about health issues. They often serve as a resource for questions about reproductive health, menopause, pregnancy, childbirth, and more. 

When it comes to labor and delivery, CNMs can only care for uncomplicated routine deliveries, which allows them to offer more natural approaches to pain management and childbirth than traditional OB/GYNs. Because of their training and experience, CNMs can provide high-quality care tailored to each patient’s individual needs. In many cases, they can also offer longer appointments and more personalized care than other types of providers. As a result, CNMs play an essential role in providing quality patient care.

It should be noted that CNMs differ from certified midwives in that they are registered nurses who have completed an advanced nurse-midwifery education program. In most states, certified midwives do not need to hold a nursing degree to work in this field. Other types of midwives include direct-entry midwives and lay midwives, who are not often not required to have any education or licensure and have typically gained their skills through an apprenticeship. 

To become a CMN, one must first become a registered nurse (RN). Aspiring CNMs can complete either an associate’s degree in nursing (ADN) or a bachelor’s of science in nursing (BSN). These general education nursing programs provide the framework for entry-level work as a nurse and the background for additional education. RNs who wish to become CNMs should seek work in birth centers or labor and delivery departments to gain hands-on experience in this field. 

After gaining work experience, RNs can complete a CNM education program. This can be a master’s of science (MS), a master’s of science in nursing (MSN), a post-master’s certificate, or a doctor of nursing practice (DNP) with a specialization in midwifery. These degrees can be completed online or in person and take between 18 months and four years to complete. 

Below is a step-by-step guide on how an RN can become a CNM, as well as typical CNM job duties, job outlook, and salaries.

Steps for a Registered Nurse (RN) to Become a Certified Nurse-Midwife (CNM)

Step 1: Gain Work Experience (Timeline Varies)

To determine if pursuing a career as a CNM is the right one, nurses should work in a labor and delivery unit or a birth center. Not only will they gain valuable hands-on experience, but this will help them decide if this is the line of work they wish to pursue. Also, many CNM education programs require that applicants have completed a set number of years of experience with mothers and babies to be considered for admission.  

Step 2: Earn a CNM Degree (Two to Five Years)

To become a CNM, RNs must complete an additional education program. This degree can be either a master of science (MS), a master of science in nursing (MSN), or a doctor of nursing practice (DNP) with a specialization in midwifery. 

If an RN already has a master’s degree in another discipline or field, they may be eligible to complete a post-master’s certification. The length of these programs depends on the level of education pursued and whether the student is attending part-time or full-time. It can take as little as 18 months or as long as four years to complete the necessary education. Students should ensure that the program is accredited by the Accreditation Commission for Midwifery Education, as this is required to obtain certification. 

Step 3: Pass a National CNM Certification Exam (Timeline Varies)

Passing a national CNM certification exam is an excellent way to demonstrate competency in this field. Also, a national certification is required by many, but not all, state CNM licensure boards. The requirements to sit for the American Midwifery Certification Board (AMCB) CNM certification include:

  • Hold a current, active, and unencumbered US RN license
  • Complete an Accreditation Commission for Midwifery Education (ACME) accredited program
  • Verification by the director of the nurse-midwifery program confirming the candidate has met the institutional requirements for a graduate degree and its completion date.
  • An attestation from the director of the nurse-midwifery program that the candidate is performing at a safe, beginning level.

Once eligibility has been verified, candidates can sit for the CNM exam. This exam consists of 175 questions that must be answered in four hours. The cost to take this exam is $500. Topics covered include:

  • Antepartum
  • Intrapartum
  • Postpartum
  • Newborn
  • Well-woman care and gynecology 
  • Women’s health and primary care

Step 4: Apply for State Licensure as a CNM (Timeline Varies)

In all 50 states, CNMs are required to obtain a license to practice. Requirements will vary by state, but all require that applicants complete an educational program. For example, the requirements to be a CNM in Washington include:

  • A current state of Washington registered nursing license
  • Proof of current AMCB CNM certification
  • Official transcript of advanced nursing degree earned
  • If an applicant graduated from their program more than a year ago, they need 250 hours in advanced nursing practice within the last two years 
  • An FBI background check

Job Duties of a CNM

Certified nurse-midwives primarily work in hospitals or stand-alone birth centers, although they may also attend home births in some states. CNMs provide care across clients’ entire life spans, although they tend to focus primarily on labor, delivery, and postpartum care. Day-to-day duties for CNMs can include:

  • Providing prenatal care
  • Delivering babies
  • Managing postpartum care
  • Conducting gynecological exams
  • Prescribing medications and treatments
  • Instructing patients on proper hygiene and nutrition
  • Educating patients on birth control, menstruation, and menopause
  • Maintaining client records

Job Prospects and Earning Potential for CNM

While there is a very high demand in the US for nurse practitioners, CNMs trend much closer to the national average for all jobs. According to the BLS (2022), there will be a 7 percent increase in jobs for CNMs between 2021 and 2031, which is just slightly above the national average of 5 percent. This is due partly to the specialized care provided by CNMs and the steady decline of the national birth rate.

On average certified nurse-midwives earn $114,210 per year. According to the BLS (May 2021), the percentiles for wages are:

  • 10th percentile: $61,500
  • 25th percentile: $96,040
  • 50th  percentile (median): $112,830
  • 75th percentile: $130,450
  • 90th percentile: $166,170
Kimmy Gustafson

Kimmy Gustafson


Kimmy is a freelance writer with extensive experience writing about healthcare careers and education. She has worked in public health, at health-focused nonprofits, and as a Spanish interpreter for doctor’s offices and hospitals. She has a passion for learning and that drives her to stay up to date on the latest trends in healthcare. When not writing or researching, she can be found pursuing her passions of nutrition and an active outdoors lifestyle.

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