Certified Nurse-Midwife Question and Answer

Although qualified to administer drugs and perform medical procedures, those interventions are not routine for the nurse-midwife, and they are used only when the mother requests them.

Most nurse-midwives deliver babies in hospitals and in homes. They also provide both prenatal and postpartum care for both mothers and newborns. In addition, the nurse midwife provides family planning and birth control counseling, and normal gynecological services such as: physical and breast exams, pap smears, and preventive health screening. In most states, a nurse-midwife can prescribe medications.

The American College of Nurse-Midwives (ACNM) estimates that soon, one in ten babies in the U.S. will be delivered by certified nurse-midwives. Ten years ago, only three percent of births in the U.S. were attended by nurse-midwives.

Worldwide, the nurse-midwife delivers more than two-thirds of births.

A women's health nurse practitioner (NP) is focused on all aspects of women's health, from birth control and gynecological services to menopause and osteoporosis. Whereas the nurse-midwife is more highly focused on issues before, during and after pregnancy and childbirth.

Certified nurse-midwives (CNMs) are registered nurses who are also certified. To become a certified nurse-midwife, RNs must graduate from a nurse-midwifery program accredited by the American College of Nurse-Midwives, and pass a national certification exam. CNMs are educated in both nursing and midwifery and can practice anywhere in the U.S.

In contrast, Direct-Entry Midwives (also called Lay, Licensed, or Professional Midwives) practice midwifery, but they are not registered nurses, and are not certified.

You can find a list of Direct-Entry Midwife schools on the Natural Healers web site.

The American College of Nurse-Midwives does offer a Certified Midwife (CM) designation for Lay Midwives who graduate from a midwifery school accredited by the ACNM, and pass a certification exam. The CM designation is for lay midwives who want to show that they practice midwifery at an accredited standard.

National certification is required in some states for licensed CNMs to practice. ACNM rules state that only graduates of ACNM accredited programs are eligible to take the certification exams for CNMs. All CNMs must pass the national board exams, which are given four times each year around the country.

There are currently nearly 50 ACNM-approved nurse-midwife degree programs. You can find a list of these nurse-midwife schools in our directory. Some states require additional requirements for licensing of nurse-midwives. Check with your state board of nursing for details.

According to the ACNM, current memberships are more than 6,700 of which approximately 5,700 are in clinical practice.

Nurse-midwife program requirements vary by school, but for most programs you'll need:

• Bachelor's degree, (although it is not always required that it be in nursing)
• A current license to practice as a registered nurse in one of the 50 states
• One to two years nursing experience
• A minimum GPA of 3.0.

You can find the specific requirements for each school on their Web sites or in their application forms.

You will need a bachelor's in nursing degree (BSN) to become a Certified Nurse-Midwife. Depending on the program, you may not need a bachelor's degree to take courses, but you'll need one to apply for CNM certification.

Some states require a master's in nursing degree (MSN) to become a licensed CNM, while some require only a bachelor's degree. The number of states (and employers) requiring master's degrees is increasing. According to the American College of Nurse-Midwives, 70 percent of nurse-midwives have masters' degrees and 4 percent have doctoral degrees. Most schools list their requirements in the application materials. Some schools have master's completion programs which allow practicing nurse-midwives without a master's degree to earn their master's in an accelerated program.

Certified nurse-midwives (CNMs) work in hospitals, clinics, birthing centers, health departments, private practices, institutions, and with physicians. Some nurse-midwives may even practice on their own.

According to a recent Journal of Nurse-Midwifery survey, more than half of CNMs practice in an office or clinic setting. And most CNMs listed hospitals or physicians as their employers.

In addition to bachelor and master degrees studies when required, length of nurse-midwife certificate study depends on the program, but most run one- to two-years depending on semester schedules.

Specific nurse-midwife courses vary by program, but you can expect to see courses in the following:

• Anatomy
• Antepartum, Intrapartum/Postpartum
• Biochemistry
• Breastfeeding
• Epidemiology
• Family Planning
• Genetics and Embryology
• Health research
• Integration
• Laboratory Medicine
• Neonatology
• OB complications
• Pathophysiology of Gynecology and Obstetrics
• Pharmacology principles
• Primary Care of Women
• Professional Issues

Distance learning programs are available, usually to students who live more than one hundred miles from the school. Course attendance is through videoconferencing, the World Wide Web, telephone and fax. A few on campus visits are also required. Reading materials assigned are textbooks, online information and publications available through libraries and direct mailings.

Clinical work is conducted near the student's location with certified nurse-midwives who are pre-approved by the college.

Midwives can be men or women, and the population of male nurse-midwives is growing. According to the ACNM, 2 percent of CNMs are male.

Check with the individual nursing schools for details. Some nursing schools require a particular type of labor and delivery (L&D) experience or length of experience in order to qualify for admission.

The ACNM recommends that high school students who want become CNMs "enroll in a 4-year university program that awards a bachelor's of science in nursing (BSN) degree, and then apply to a nurse-midwifery education program."

If you already have a bachelor's degree in a non-nursing field, then some schools have accelerated programs which can allow you to directly enter a BSN or MSN program, with a focus on nurse-midwifery.

According to the 2009 Payscale.com survey, nurse-midwifes earned between $35,000 to $60,000 in the first four years of practice, with more experienced nurse midwives making more than $70,000 per year.

Incomes vary greatly depending on years and type of experience, the area of the country you work in, benefit packages, and employment of each CNM, such as whether a nurse-midwife works within an institution or practices on his or her own.