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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.

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.

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