All About Certified Nurse Midwife: Salary, Programs, and Prospects

By Sarah Collins

07/9/2022

Certified nurse-midwives are an integral part of women’s health. These advanced practice registered nurses (APRN) specialize in primary women’s health care, focusing on gynecology, reproductive health, childbirth, and newborn care. All of that good work leads to higher than average salaries for nurses in this line. 

But exactly how much is this figure and what influences it? Our guide reveals the answer. 

Keep reading to learn more about certified nurse midwife earnings, including average salary, average salary by state, and all of the steps needed to join one of the most in-demand professions in health today.

Key Takeaways

  • A certified nurse-midwife is an advanced practice registered nurse (APRN) that works as a primary health care provider for women. 
  • According to the Bureau of Labor Statistics, certified nurse midwives make an average annual salary of $115,000 per year. 
  • The American Midwifery Certification Board (AMCB) is an organization that certifies all prospective students interested in nurse-midwifery and midwifery. 

 

All About Certified Nurse-Midwives

What Is a Certified Nurse-Midwife? 

A certified nurse-midwife is an advanced practice registered nurse (APRN) that works as a primary health care provider for women. They focus exclusively on women’s issues, such as reproductive systems, newborn care, preconception, peri-post menopause care, gynecological services, and pregnancy.

Generally, certified nurse midwives offer basic nutrition counseling, perform diagnoses, conduct exams, and write prescriptions, just as a physician would. They also devote large portions of their day to educating and preparing new parents for life with children.

How Many Certified Nurse-Midwives Are in the United States?

According to the American College of Nurse-Midwives, there are close to 13,000 CNMs as of 2019.

What Certifications Must Certified Nurse-Midwives Hold? 

All certified nurse-midwives must graduate from a program accredited by the Accreditation Commission for Midwifery Education (ACME) and pass the American Midwifery Certification Board (AMCB) national certification exam.

In the United States, roughly 40 ACME-accredited nurse-midwifery programs offer a Master of Science in Nursing (MSN) focusing on a Master of Science (MS) in Nurse-Midwifery. You can also achieve dual specialization through Nurse-Midwifery/Women’s Health Nurse Practitioner (NM/WHNP) programs. Both in-person and online programs are available.

All About the AMCB Certification Exam

How Is the AMCB CNM Certification Exam Structured? 

The Certified Nurse Midwife Certification Exam consists of 175 multiple choice questions, each with three or four possible answers. Test takers have no more than four hours to complete it.

Note: the AMCB CNM structure isn’t like the NCLEX-RN exam, which uses a computer-adaptive format to determine the number of questions asked depending on how frequently you select the correct answers.

What Material Does the AMCB Certification Exam Cover? 

As of 1/1/2018, see percentages for each subject covered in the exam below, courtesy of the American Midwifery Certification Board.

Previous Percentages (as of 1/1/2018)Current Percentages (as of 1/1/2022)
Antepartum20.80%21%
Intrapartum21.60%21%
Postpartum16.80%18%
Newborn12%10%
Gynecology16%19%
Primary12.80%11%

What Is the AMCB Certification Exam’s Pass Rate?
In 2019, 77.2% of students passed the exam. Since 2015, passage rates have dropped significantly, with the sharpest decline between 2016 (93.9%) and 2018 (80.8%).What Is the AMCB Certification Exam’s Pass Rate? 

 

What Are Some Ways to Prepare for the AMCB Certification Exam? 

One of our favorite ways to prepare for the AMCB certification exam is to answer as many practice questions as possible. Many third-party test preparation companies offer trial quizzes, with one of the most popular ones being BoardVitals. This service delivers a fresh approach, providing prospective candidates with questions written by midwives nurses.

Another popular test preparation service is StatPearls, which offers more than 1000 questions to replicate the actual exam. They provide in-depth explanations, identify strong and weak areas, and share performance reports for every question.

Do I Have to Renew My CNM Certification After I’ve Earned It? 

All CNMs must renew every five years upon completing the Certificate Maintenance Program. You can perform this renewal through various AMCB certificate maintenance modules focusing on three critical areas of practice:

  • Antepartum and Primary Care of Pregnant Women
  • Intrapartum, Postpartum, and Newborn
  • Gynecology and Primary Care for the Well-Woman

 

Another way to renew CNM certification is to retake the CNM exam by the fourth year of their five-year certification period. It requires intensive reasoning and a $500 test fee.

Certified Nurse Midwife Salaries

How Much Do Certified Nurse-Midwives Earn? 

According to the Bureau of Labor Statistics, certified nurse midwives earn an average annual salary of $115,000 per year. However, entry-level nurses usually make under $100,000, and nurses with 5+ years of experience can clear the $140,000 mark, depending on the state, hospital setting, and specializations.

What Does the Job Outlook Look Like for Certified Nurse-Midwives?

There are currently no official stats on the job outlook for certified nurse midwives, but the nursing profession looks extremely promising. The US Bureau of Labor Statistics (BLS) projects growth in the field to be around double-digits each year through 2029.

These solid prospects are due to the aging general population and baby boomers leaving the workforce. With more than 50% of nurses ages 50 years or older, expect exponential growth in the need for nurses as we get close to the decade’s end.

How Much Do CMNs in Each State Earn? 

See our breakdown below for salaries earned by CMNs in each state, courtesy of the Bureau of Labor Statistics (May 2019) :

StateHourly mean wageAnnual mean wage
Alaska$44.75$93,080
Arizona$58.43$121,530
California$76.72$159,590
Colorado$51.10$106,280
Connecticut$50.10$104,200
Delaware$46.20$96,090
District of Columbia$41.22740
Florida$32.47$67,530
Georgia$44.63$92,840
Idaho$34.69$72,150
Illinois$52.55$109,310
Indiana$54.09$112,510
Iowa$49.44$102,830
Maine$57.23$119,030
Maryland$51.77$107,670
Massachusetts$54.76$113,910
Michigan$49.94$103,870
Minnesota$59.42$123,600
Mississippi$61.52$127,960
Missouri$54.48$113,320
New Hampshire$55.65$115,760
New Jersey$56.29$117,070
New Mexico$50.95$105,980
New York$60.47$125,780
North Carolina$49.05$102,020
Ohio$50.94$105,960
Oregon$50.77$105,600
Pennsylvania$49.63$103,230
Rhode Island$51.69$107,510
Tennessee$45.04$93,690
Texas$52.65$109,510
Utah$64.27$133,680
Vermont$46.75$97,240
Virginiaunavailableunavailable
Washington$54.00$112,310
West Virginia$59.35$123,450
Wisconsin$53.07$110,380

What Are the Top Paying States for CMNs?

According to the Bureau of Labor Statistics, California ($154,500) offers the highest annual mean salaries, followed by Minnesota ($121,980), New York ($120,380), Mississippi ($119,640), and Maryland ($118,240)

What Are the Top-Paying Cities for CMNs?

According to the Bureau of Labor Statistics, the highest paying metro areas include the following:

  • Los Angeles, CA: $163,020
  • San Francisco, CA: $156,450
  • San Diego, CA: $130,140
  • Toledo, OH: $129,360
  • Minneapolis, MN: $122,080
  • Atlanta, GA : $118,780
  • Salt Lake City, UT: $118,720
  • Baltimore, MD: $118,570

Do Average Salaries for CNMs Differ Based on Where They Work? 

Yes. Here is the average annual salary for CNMs working in different medical settings.

  • Community Health Clinics: $153,280
  • Outpatient care centers: $123,620
  • Medical/surgical hospitals: $110,180
  • Physicians’ offices: $106,760

What Are the Different Types of Midwifery Credentials? 

There are three midwifery credentials in practice today:

  • Certified professional midwife (CPM)
  • Certified Midwife (CM)
  • Certified nurse-midwife (CNM)

 

What’s the Difference Between a Certified Professional Midwife (CPM), a Certified Midwife (CM), and a Certified Nurse-Midwife (CNM)?

The significant differences between CPMs, CMs, and CNMs lie in education level, credentials, and scope of practice.

CPM holders are graduates of Midwifery Education Accreditation Council (MEAC)-accredited midwifery education programs, with the CPM credential granted by the North American Registry of Midwives (NARM).

Unlike certified midwives, certified professional midwives do not need a higher education degree.

A CM is a non-nurse who has completed a graduate-level midwifery degree program and the American Midwifery Certification Board’s national certification exam.

On the other hand, a CNM is a nurse with the same credentials as a CM (passing a graduate-level nurse-midwife program and the American Midwifery Certification Board’s exam.

What Percentage of CNMs Have Their Practice? 

According to Medscape, 6% of all CNMS have private practices. Many CNMs often move to states where they can legally operate independently of supervising physicians, enjoying greater flexibility and job satisfaction.

 

What Are Some Misconceptions About Certified Nurse-Midwifery?

Here are three popular myths about certified nurse-midwives.

No Formal Education: Nurse-midwives have far from primary education, as candidates must earn a master’s or doctor’s in nurse-midwifery to practice. Most nurse-midwives often start as registered nurses before completing their professional degrees.

Home Births Only: A popular misconception of nurse midwives is that they only perform home births and use natural remedies. This misbelief features heavily in movies and TV shows, hence their popularity. Today, nurse midwives work in a variety of health care settings, including hospitals, outpatient centers, and clinics, free to suggest natural remedies and prescribe medications.

Nurse-Midwives and OB-GYNs Don’t Mix: Both are equally important in women’s reproductive health.

However, there are differences in educational backgrounds, with OB-GYNS being actual medical doctors who have completed four years of medical school, extensive residency program, and fellowship with certification from the American Board of Obstetrics and Gynecology (ABOG)

On the flip side, nurse-midwives have a nursing degree with a primary focus on pregnancy, childbirth, and postnatal care.

What Other Advanced Practice Nurses Exist Besides Nurse-Midwives?

There are dozens of advanced practice nurse specialists. Here are some of the more popular specialties:

  • Nurse Practitioner
  • Adult-Gerontology Nurse Practitioner (AGNP)
  • Pediatric Nurse Practitioner (PNP)
  • Neonatal Nurse Practitioner (NNP)
  • Women’s Health Care Nurse Practitioner (WHNP)
  • Psychiatric-Mental Health Nurse Practitioner (PMHNP)
  • Emergency Nurse Practitioner (ENP)
  • Clinical Nurse Specialist (CNS)
  • Certified Registered Nurse Anesthetist (CRNA)

 

Becoming a Certified Nurse Midwife

What Nurse-Midwifery Degree Program Options Can I Explore? 

There are four options for nursing students to become nurse-midwives.

Direct entry or graduate-entry programs: This encompasses the BA/BS degree to CNM path, ideal for Bachelor’s degree earners with no registered nursing license.

Bridge programs: One of the more popular bridge program types is the ADN to CNM path. Registered nurses with an associate’s nursing degree can pass credits on to an eventual Bachelor’s or Master’s degree in CNM.

Master of Science in Nursing (MSN) or a Master of Science (MS) in Nurse-Midwifery: BSNs can continue their education to earn one of these two Master’s degrees.

Doctor of Nursing Practice (DNP): Master’s educated nurses can go on to obtain a DNP degree in CNM.

What Scholarships Are Available to Nurse-Midwifery Degree Students? 

Many scholarship and loan programs are available to students interested in becoming nurse-midwives.

Here are three highly reputable options:

Name: ACNM Foundation

Description: Awarded to ACNM members

Award Amount/Number of Awards: Six $200 to $4000 scholarships each year

Website: http://www.midwife.org/Foundation-Scholarships-and-Awards

Name: Edith B. Wonnell CNM Scholarship

Description: Eligible candidates are nursing students enrolled in an ACME-accredited basic midwifery education program who plan to work in a home or midwifery practice after graduating.

Award Amount/Number of Awards: Varies

Website: http://www.midwife.org/Foundation-Scholarships-and-Awards

Name: National Health Service Corps (NHSC) Scholarship

Description: Loan repayment program for nurse-midwives covering up to four years worth of tuition, fees, room & board, and other incidentals. It also comes with a monthly stipend. Also, scholarship recipients must promise to work in a federally designated health professional shortage area for at least a year.

Award Amount/Number of Awards: Varies

Website: http://nhsc.hrsa.gov

 

How Do I Become a Certified Nurse-Midwife?

Here are all of the steps required to become a certified nurse-midwife.

Enroll in an Accredited Nursing Program: Look for accredited nursing programs by the Accreditation Commission for Education in Nursing or the American Association of College of Nursing.

Apply for a License: Upon graduation, apply for a license through your state’s licensing board.

Pass the NCLEX exam:  Administered by the National Council of State Boards of Nursing (NCSBN), the NCLEX exam allows students in the United States, Canada, and Australia to become working nurses. It covers all items learned during nursing school within the following eight subfields.

  • Management of Care – 20%
  • Pharmacological and Parenteral Therapies – 15%
  • Physiological Adaptation – 14%
  • Reduction of Risk Potential – 12%
  • Safety and Infection Control – 12%
  • Health Promotion and Maintenance – 9%
  • Psychosocial Integrity – 9%
  • Basic Care and Comfort – 9%

 

Receive Your Temporary/Permanent License:  This process takes a few days to several weeks, depending on the state.

Apply to a Certified Nurse Midwife Program:  This step requires a Master’s or higher degree in Nurse-Midwifery. Look for Accreditation Commission for Midwifery Education (ACME) schools. You may choose an in-person or online program.

Some graduate schools expand upon Master’s programs by offering dual specialization programs like the Nurse Midwife/Women’s Health NP (NM/WHNP) program.

Pass the Certified Nurse-Midwifery Exam:  After completing the Certified Nurse Midwife program, sit in for the exam, with the American Midwifery Certification Board (AMCB) overseeing its administration. It covers all aspects of nurse-midwifery, including gynecology, reproductive health, newborn, and antepartum methods. 

Apply for State Licensure:  Refer to your state’s nursing board after passing the Certified Nurse-Midwifery exam. Expect to complete an APRN-CNM application, pay a state licensing fee, and submit proof of graduation and current CNM certification.

Maintain CNM Certification: The work isn’t over after becoming certified as a nurse-midwife.

All nurse-midwives can maintain CNM designation in two ways:

The first is by completing 3 AMCB Certificate Maintenance Modules during each five-year certification cycle with a minimum of 20 contact hours of approved continuing education units. This approach is subject to annual fees.

The alternative is to pay a $500 fee to retake the AMCB certification exam; there aren’t annual fees attached to this approach.

What is the American Midwifery Certification Board (AMCB)?

The American Midwifery Certification Board (AMCB) is an organization that certifies all prospective students interested in nurse-midwifery and midwifery. This label ensures you meet all core competencies required for primary midwifery education and guarantees a seat in the Certified Nurse-Midwifery exam once you pass all courses.

How Many Attempts Do I Have to Pass the Certified Nurse-Midwifery Exam Successfully? 

All students have a maximum of 4 attempts to pass the exam within 24 months after completing their coursework. Therefore, we highly advise taking the test as quickly as possible after graduation to maximize this timeframe should you fail once or twice.

Who Isn’t Eligible to Take the Certified Nurse-Midwifery Exam? 

The AMCB doesn’t permit the following candidates to take the Certified Nurse-Midwifery exam.

  • Felony conviction
  • Nursing license suspension or revocation due to malpractice
  • Misrepresentation of coursework and experience during the application process
  • Discipline actions related to nursing

Can I Become a Certified Nurse-Midwife Without a Registered Nurse License?

No, all certified nurse-midwives must have an active registered nursing license. Note: You don’t need real-world nursing experience before becoming a certified midwife.

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