How to Become a Nurse Midwife

If you're interested in how to become a nurse midwife, the information below will guide you through the necessary steps to attain your goal, including the education and certifications necessary, along with the type of salary you can expect as a nurse midwife.

How to Become a Midwife in 8 Steps

Step 1: Decide what type of a midwife you would like to be:

Certified Midwife (CM): an individual educated in the discipline of midwifery, who has received a certificate upon completion of an accredited program, according to the requirements of the Accreditation Commission for Midwifery Education (ACME).

Certified Nurse-Midwife (CNM): an individual educated in the two disciplines of nursing and midwifery, who has received a certificate upon completion of an accredited program, according to the requirements of the American College of Nurse-Midwives.

Certified Professional Midwife (CPM): a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM), and is qualified to provide the midwifery model of care. The CPM is the only midwifery credential that requires knowledge about and experience in out-of-hospital settings.

Direct-Entry Midwife (DEM):an independent professional educated in the discipline of midwifery through self-study, apprenticeship with an experienced and licensed midwife, a midwifery school, a college, or university-based program distinct from the discipline of nursing. A direct-entry midwife is trained to provide the Midwives Model of Care to healthy women and their newborns throughout the childbearing cycle primarily in out-of-hospital settings. Licensed Midwives (LM) and Registered Midwives (RM) are examples of direct-entry midwives.

Step 2: Find a program or midwife to apprentice with that "nurtures you the way you want to nurture women,"

Do you have a science or nursing related degree? Would you like to facilitate women giving birth in a birthing center, or assist a natural birth in a hospital setting? Perhaps...

Are you interested in helping women give birth at home?

Perhaps a Direct-Entry Midwife (DEM), such as a Licensed Midwife (LM) or a Registered Midwife is more your style; these types of midwifery certifications, your hands on training through an apprenticeship and self-study are the primary learning modalities for this midwifery licensure.

A Certified Professional Midwife (CPM) may also provide homebirth services as a midwife, and receive their training through a school accredited by the Accreditation Commission for Midwifery Education (ACME).

Here are some resources that will help you along your way to discovering what type of midwife pathways are best for you:

Step 3: Interview the midwife you intend to apprentice with or the school you intend to attend.

Just as mothers are very discerning about where and whom they choose to give birth with, so too should you be discerning about where you plan to study and learn. Be sure the path you choose will take you to where you intend to help women give birth, and that your pathway suits your learning style.

If you plan to apprentice with a midwife, ask her how long she's been a midwife, how did she obtain her midwife licensure and what type of license does she have? How does she determine her client load, and handle her practice when she is sick? Does her philosophy and approach to women and birthing match what you would like to emulate in your own practice in the future?

If you intend to enroll in a school, determine whether they are an accredited school according to the requirements of the American College of Nurse-Midwives. Determine whether they have prerequisites prior to applying to the program. will this course of study take you to helping women in the way you desire to help woman giving birth?

Step 4: Complete all prerequisites

Save yourself a great deal of time, headache and money by being prepared and knowing exactly what courses you need to take in order to prepare you for your studies. With so many emerging midwifery programs out there, it important to be sure you are on board with and in top of what your program or coursework will require of you.

Step 5: Make time in your schedule

If you are apprenticing, you will be required to travel wherever and whenever you are needed, and that means being flexible at the last minute. If you already have a family, you need to have multiple avenues for childcare in case your first and second options do not work out. Many people who apprentice neither have the time, nor flexibility to have another job, meaning you will have to be prepared to have income from another source. If you are taking courses through an accredited school, know your school schedule, and your work schedule; set yourself up for success by creating stellar studying habits

Step 6: Complete your apprenticeship or school training to receive your certification

This may vary depending upon what state or municipality you live in.

Step 7: Apply for licensure according to your state or municipality or according to the requirements of the American College of Nurse-Midwives.

Step 8: Enjoy your Practice of Midwifery!

What is a Nurse Midwife?

A nurse midwife usually has an RN and some labor and delivery experience before getting his or her graduate degree in nursing with a specialization in nurse-midwifery. After attaining an advanced degree, the nurse midwife usually undergoes a year-long apprenticeship, after which he or she will take a nurse midwife certification exam offered by the American Midwifery Certification Board (AMCB).

Nurse midwives usually work under the supervision of a doctor, and alongside other nurses, nurse midwives, doulas, and birthing coaches to offer care during birth, as well as prenatal care during pregnancy and postnatal care after birth. In this video, midwives talk about what it means to be a midwife:

Areas of emphasis for nurse midwives include:

  • Midwifery
  • Obstetrics
  • Maternal-newborn nursing
  • Gynecology
  • Women’s health care (primary care for women)
  • Contraception
  • Newborn care

Nurse Midwife Job Description

The scope of practice for nurse midwives includes a full range of primary health care services for women from adolescence beyond menopause. These services include primary care, gynecology, family planning, preconception, pregnancy, childbirth and the postpartum care.

As a midwife, you may practice in a variety of settings, including client's homes, birth centers, hospitals, and clinics.

The International Confederation of Midwives (ICM) has developed the Essential Competencies for Basic Midwifery Practice in 2010. This document provides seven core competencies for midwives and the basic knowledge and skills associated with each. In addition to these competency standards, the ICM has also developed other documentation to assist in midwifery. These include:

Requirements for Becoming a Nurse Midwife

General requirements for becoming a nurse midwife include:

  • Licensure as an RN
  • Graduate degree in nursing
  • Year-long midwifery apprenticeship
  • ACNM certification examination
  • Experience in labor and delivery

Education Requirements

Certified Nurse Midwives are advanced practice nurses who hold a graduate degree from a program accredited by the American College of Nurse-Midwives (ACNM). The ACNM oversees the Accreditation Commission for Midwifery Education (ACME), which is the programmatic accrediting agency for nurse-midwifery education programs in the U.S.

In addition, each state sets the requirements for licensure for advanced practice nurses. In most states, RN licensure is required in order to continue licensure as a certified nurse-midwife. In many states, an associates degree in nursing will allow you to sit for your RN. However, in many instances, this will only qualify you for entry level positions as an RN, and further education may be required to become a midwife, including either a masters in nursing or another comparable graduate degree, along with midwifery certification. Make sure you check with the licensure requirements in your state to determine the appropriate level of education needed to become a nurse midwife.

If you already have an RN through an associates degree, many colleges and universities offer an RN to BSN or RN to MSN program. In these nursing degree programs, you must have your RN to be admitted, but it will lead to a bachelors of science in nursing or a masters of science in nursing. Most of these programs are very flexible, with classes online and self-paced so you can work as a nurse as you attend class.

Work experience will be important too. So working while you attain your MSN is a great idea, since by the time you have completed your MSN, you may also have the work experience requirements necessary to become a nurse midwife.

Experience Requirements

Most jobs require experience as a midwife. This is usually easy to obtain along your path to an advanced degree. Most nurse midwives start out by getting their RN. Once you have your RN, you may work in labor and delivery, which will provide you with a lot of experience with the types of duties you'll have as a nurse midwife.

After you receive your graduate degree, you'll have an apprenticeship that usually lasts a minimum of one year. This too will provide you with experience as a nurse midwife in all aspects of the birthing process including well-woman care, prenatal care, birth, and post-natal care.


The American Midwifery Certification Board (AMCB) offers a Certified Nurse-Midwife (CNM) and Certified Midwife (CM) designation. In order to qualify for the CNM designation, you must take the certification examination in nurse-midwifery. The cost of the test is $500 and you must hold a masters degree in nursing and have an active RN license in order to sit for the exam. The contents of the exam are as follows:

  • Antepartum 15%–25%
  • Intrapartum 25%–35%
  • Postpartum 5%–10%
  • Newborn 10%–15%
  • Well Woman/Gyn 15%–20%
  • Primary care 12%–16%
  • Professional issues Up to 5%

In the exam, and particularly the clinical portion, you will be tested on your knowledge and judgment of both normal and deviations from normal. Approximately two-thirds of the clinical exam is devoted to normal phenomena and one-third to deviations from normal. In addition at least two-thirds of the content for each clinical area is devoted to items testing clinical judgment.

This is why education and experience are so critical to your success as a nurse midwife, because without these, you won't have the critical thinking skills and judgment necessary for the clinical setting. View the full Nurse Midwifery Certification Examination requirements.

Midwife Salary

You're probably wondering, "how much does a midwife make?" Of course, the answer always depends on a variety of factors, like the level of your education, your years of experience as a midwife, the city you live in, and the location where you're working. However, you can get a general idea of how much money you'll make as a midwife.

According to the Bureau of Labor Statistics, median pay for RNs was $64,690 per year in 2010. As a nurse-midwife, you are considered a specialize nurse, and a graduate level nurse, so you can expect to make more than the median salary. The top 10 percent of RNs earned more than $95,130 per year, and many of these are nurses with 20+ years of experience. In fact, you can generally expect your pay to increase along with your years of experience.

Some geographical comparisons can be helpful in understanding how much you'll make as a nurse midwife. According to, in 2011, a nurse midwife in New York makes up to $121,000 compared to a nurse midwife working in Louisiana, who will make an average of $78,000.

Another thing to consider with salary is the benefits you'll receive. A benefits package may include things like health insurance, life insurance, paid time off, sick leave, maternity leave, and retirement. These things are not usually calculated into annual salary, however, they have a definite dollar value to them, and if you work as a midwife in a private practice, you're likely not to receive these same benefits.

Additional Resources

Here are some additional resources for nurse midwifery to give you an idea of what is involved with the practice and what will be required of you to gain certification and successfully become a nurse midwife.