Certified Nurse Midwife CNM Guide

Debra Riley


A Certified Nurse Midwife (CNM), also called a nurse midwife, is a registered nurse of advanced practice. Their specialty is on childbirth and the reproductive health of women. They focus on preventive and health maintenance practices for women during pregnancy, childbirth, and post-partum.

They also help women with their birth control needs. They may help women with their routine sexual health exams and initiate contraception.

They provide their services to women who are generally healthy and whose births are not high risk.

If a woman’s childbirth or pregnancy is considered high risk, a CNM has to work with a physician. CNMs often work alongside gynecologists or obstetricians.

What Does a Nurse Midwife Do?

The duties of nurse-midwives are different from physicians because they are nurses, highly qualified – but nurses. They provide patients with holistic treatment which means that their focus is on both the physical and mental well-being of patients. The following are some of their responsibilities.

Assisting in Child Birth

According to research conducted by the ACNM, nurse midwives may help expectant mothers to have fewer complications during childbirth. Some of the advantages of having a nurse-midwife during delivery include; reduced need for regional anesthesia, low probability of cesarean delivery, improved rates of breastfeeding, reduced chances of labor induction, and reduction of perineal tears.

Prenatal Education

A nurse-midwife provides their patients with hands-on prenatal education. They help expectant mothers to understand the process. Knowing what to expect may help them to reduce anxiety and prepare for childbirth.

They provide ante partum services which include; confirming pregnancy, testing for possible congenital disabilities, and providing education on nutrition and healthy habits during pregnancy. They also check for high-risk behaviors during pregnancy including drug abuse and domestic violence.

Women’s Health Maintenance

A CNM encourages women to practice health tests to maintain good health. They also provide them with the advice they need to maintain their health. They may provide advice on fertility, sexually transmitted diseases, what to expect during menopause, and how to observe healthy sexual habits.

Family Planning

A certified midwife nurse may help women with their contraception needs. They advise on the appropriate forms of contraception according to the needs of the mother.

Counseling on Unexpected Pregnancies and Menopause

Unexpected pregnancies may be stressful and confusing especially to young mothers. Certified midwife nurses provide them with the right counseling that they need to have successful pregnancies and delivery. They also provide advice on menopause and what to expect.

Intrapartum Period

Intrapartum period – refers to the time period of the complete childbirth, from labor onset right through to delivery of the placenta. Some of the intrapartum services that nurse midwives may provide include; monitoring labor and its progress, helping expectant mothers to deal with complications during labor, and detecting and handling problems during labor. They may also administer treatment for pain.

Facilitating Labor

A nurse-midwife may help expectant mothers during the labor process. They can perform first and second-degree episiotomies and deliver the placenta.

Postpartum Care

After delivery, a nurse-midwife can provide postpartum care. They help new mothers with their physical and mental needs. Some of these services include; helping the mother with a uterine massage after delivery and providing them with information on the changes to expect.


Lactation is important for newborns. A CNM provides new mothers with the knowledge they need to make that transition. They educate them on the importance of lactation and the bodily changes to expect. They may also inform them about safe practices and nutrition during breast feeding.

CNM Nurse Midwife Guide

How to Become a CNM Nurse Midwife

If you are interested in reproductive health and would love to do it for a living, you should consider becoming a certified nurse midwife. The first thing that you should have, even before seeking academic qualifications, is a passion for helping others.

You need to complete an undergraduate program and pass the National Licensure Exam. A Bachelor of Science in Nursing program is one of the best programs to take for the job. According to the ACNM, a Master’s Degree may soon be the primary educational requirement for entry into the profession.

After earning your master’s degree from an accredited program, you need to get certification from the AMCB before you can start practicing.

The summary of becoming a nurse midwife is as follows:

Graduate from high school. If possible, take classes such as chemistry, algebra I/II, psychology, and physics. They help you to prepare for the career.

Even though you can get in the profession with an associate program in nursing, it is wise to pursue a bachelor’s of science in (BSN). This takes a maximum of four years. Most of the programs have limited space for admission every year. Do not give up if you do not get in the first time you try.

After completing your bachelor’s degree, you should get some experience (one year). You can get this experience within your state. The licensure may vary from one jurisdiction to another.

You need to sit for the national exam and pass it to become a CNM. This exam is from the American Midwifery Certification Board (AMCB).

After you get certification, you need to maintain and renew it after every five years.

Certified Nurse Midwife (CNM) Salary

According to the Bureau of Labor Statistics, the average wage for this field is about $99,770 annually. As with all nursing careers this can vary widely from state to state. The following are some of the salary ranges.

  • California $132,950
  • Iowa $125,650
  • Oregon $108,240
  • New Jersey $112,370
  • Massachusetts $112,290

Check our main CNM Salary page for a detailed breakdown of salaries across all states in the U.S.

CNM Career Outlook

The number of midwives has increased significantly in the past few years and is expected to continue improving as their demand increases.

As it is, there are more than 11,000 nurse midwives in the United States. The career is on the rise, so the job openings are always increasing. The job is expected to grow by 29% from 2017 to 2022. The increase is a lot more than the job growth projected for all other occupations in the same period.

The responsibilities of a CNM include; giving care and counseling before conception, after conception, during birth, and after birth. Their health care services are mostly for women, but they also help their families with reproductive health issues.

They may work in hospitals, birthing centers, health clinics, or at home. At present they only handle around 10% of all the standard vaginal births in the United States – this is set to rise significantly. Even though CNMs play an important role in facilitating safe deliveries, most of their job is preventive.

The job can take you in many fields including clinical practice, education, legislation, research administration, and in international public health.

The career outlook for this field is great. This is expected to continue increasing because the United States has a stable birth rate. The demand for CNMs is high in both rural and urban areas.

What to Expect from the Job

As mentioned, nurse midwives have plenty of responsibilities. They are responsible for women’s health before conception, during pregnancy, and after delivery.

Some of their most common responsibilities include; providing women with fertility and reproductive health education, performing check-ups on expectant mothers, delivering babies, helping mothers with their breast feeding and other post-natal problems, and conducting routine check-ups. 33% of them perform primary care as their main responsibility and 53% focus on reproductive care.

The job of a midwife is very fulfilling as it involves helping people every day. If you are looking for a job where you have a direct impact on the lives of people, it is a great choice. Like other jobs in healthcare, you may not work traditional hours. You need to be ‘on call’ to respond to emergency needs. Patients may go into labor at any time, so you always have to be ready.

Certified nurse-midwives require licensure in all the States and the District of Columbia.

There is always a high demand for CNMs. This is because their jobs do not end in hospitals. They may also work with OB/GYN. They help families that are interested in having natural birth experiences before and after delivery. They also provide general health care to promote wellness in women.

What are the Qualities of a Good Nurse Midwife?

  • Like all other professions that require you to care for others, you need to be kind and willing to help.
  • Since the job will require you to work in various fields and interact with patients of different backgrounds, you must be able to get along well with people of broad backgrounds.
  • You must have the emotional and mental strength to empathize with patients while still providing them with treatment or advice they need.
  • You must be able to stay calm in stressful situations. This makes it possible to come up with rational solutions in case of emergencies.
  • You should be a good listener. It is impossible to help your patients unless you understand their problems.
  • You need to have excellent observation skills.

Where Do CNMs Work?

Gynecology Departments in Hospitals

Most ob/gyn departments need CNMs. They provide routine checks and help mothers in labor. They may work in both inpatient and outpatient and outpatient settings. They advise women about fertility and continue their services even after delivery.

Private Practice

Plenty of CNMs work in private practice. Their roles in private practices are similar to what they do in hospitals. They, however, focus on inpatient services because most private practices do not offer outpatient services. They may provide advice for prenatal, natal, and postnatal services too.

Community Clinics

Community clinics are mainly found in rural areas or places where there aren’t enough healthcare facilities. Some of them provide patients with mental health services. Such facilities need the services of CNMs. They help to deal with cases of complications during or after pregnancy.

Non-Profit Women’s Health and Midwifery Programs

Nurse midwives can find employment in programs that concern themselves with women’s health. These programs may be initiated by NGOs, the government, or individuals. They may provide seminars to educate women on fertility, pregnancy, childbirth, or contraception. Nurse midwives may provide them with advice or preventive services.

Birthing Centers

Birthing centers are an excellent option for women who prefer to give birth outside of the traditional hospital setting. The centers are appropriate for women whose pregnancies are considered low risk.

CNMs may work in the center. They may help women to establish whether or not birthing centers are the appropriate choice depending on their needs. If the mothers have complications, they may refer them to specialists.

Who Should Get into the Profession?

The profession of a certified nurse midwife can be just as challenging as it is fulfilling. Caring for women and their children is emotionally rewarding. The fact that you get to share in some of the most exciting moments of a woman’s life can be very fulfilling. On the flip side, the most exciting moments of a woman’s life may turn fatal in case of complications. You also need to share in those situations. If you are okay with this, then the profession may be right for you.

If you do not like working in teams, this job may not be right for you. CNMs work in groups. They may work with physicians when dealing with high-risk pregnancies. In other cases, they work with other members of their department.

It is an excellent choice if you want to work with others who are equally enthusiastic about helping others. You also get to interact with families of your patients and form potentially life-long relationships.

Useful Nurse Midwife Resources:

American College of Nurse Midwives

The American Midwifery Certification Board (AMCB)

National Association of Certified Professional Midwives