According to the U.S. Bureau of Labor Statistics (BLS), the demand for CNMs as well as other APRNs is expected to increase by 45% through 2029.
How to Become a Midwife in 10 Steps
Becoming a midwife has never been a more natural choice for compassionate, committed individuals interested in working with expectant mothers and newborns.
In addition to supporting the childbirth experience, a midwife can provide care across a woman’s life, including obstetrical and primary care, depending on their credentials and location.
What Is a Midwife?
Midwifery combines evidence-based practice with woman-centered care. “Midwives offer holistic care that includes not just the woman but her partner and family. Midwives look at the entire picture of the person’s life when helping care for them,” says Amber Wilson, CNM, DNP, host of the “Journey to Midwifery“ podcast.
Many midwives are advanced practice registered nurses (APRNs) who have a master’s degree and are credentialed as certified nurse-midwives (CNMs).
A certified nurse-midwife (CNM) is qualified to provide both primary and obstetrical care to women throughout their lives. CNMs provide many of the same services as physicians, but with a holistic, woman-centered perspective that offers an alternative to the traditional approach to pregnancy and childbirth.
Demand for Midwives
Both the healthcare and the alternative medicine industries are thriving, making a midwife career not only a rewarding choice but also a very promising one.
Steps to Becoming a Midwife
There are several educational paths that lead to different midwifery credentials, which can make becoming a midwife seem confusing. For example, do you want to become a certified nurse midwife or just a certified midwife? Following these ten tips can help you find answers and get started on the right track.
1. Visualize Yourself as a Midwife
Can you imagine yourself guiding a first-time mother through her labor and delivery experience? Do you get excited at the thought of listening to a fetal heart rate monitor, measuring prenatal growth signs, and talking with moms and dads about the transition into parenthood? Are you the kind of person who can handle being on call evenings, weekends, and holidays?
Take the time to imagine yourself becoming a midwife to see if it syncs with who you are.
“Midwives ensure that the person being cared for is at the center and is active in decisions regarding the care they need,” Wilson says. “It should be a collaborative, cohesive relationship, and the midwife is there to serve the woman and her family’s needs.”
Consider whether you have these qualities, which experienced midwives say can help you succeed:
How long does it take to become a midwife: On average it takes between 6 to 8 years to become a nurse-midwife. If you already hold a bachelor’s degree, earning an MSN degree can take between 18 to 24 months as a full-time student.
2. Get Educated About Natural Childbirth
The American College of Nurse-Midwives (ACNM)’s mission is to “promote the health and well-being of women and infants” through “the development and support of the profession of midwifery as practiced by certified nurse midwives and certified midwives.”
Certified nurse midwives assist in natural and medicated births, and often the decision on how to proceed is based on more than philosophical preferences.
Along these lines, midwifery practices can have different views on aspects of natural childbirth such as unmedicated labor and delivery, birthing locations, and physician involvement. Knowing where you stand on these issues will help you choose a path that will be most satisfying to you in the long run.
CNMs assist in natural and medicated births, and often the decision on how to proceed is based on more than philosophical preferences. Considerations such as the needs of the mother and baby, the birth location, and state laws also can be factors.
“CNMs do care for and handle many types of birth,” Wilson says. “If a CNM is caring for someone in a homebirth or birth center setting, then an epidural and anything high risk are not done there. Some out-of-hospital settings do have alternative medication such as nitrous oxide or even IV pain medication. In a hospital, a CNM can participate in most births, but might co-manage with a physician, depending on the acuity of the pregnant person.”
3. Take a Holistic Approach to Midwifery
CNMs specialize in reproductive health, but they’re trained to provide care for women from puberty through menopause. So, keep in mind that, while you’ll spend a good portion of your time on prenatal, delivery, and postpartum care, you’ll also provide primary health care, routine gynecological care, and contraception advice to women of all ages.
Here are some of the most common types of services that CNMs provide in addition to caring for women and their newborns:
While a CNM may or may not be formally certified as a holistic practitioner, the philosophy of holistic care, which brings together physical, psychological, emotional, and spiritual well-being, is consistent with midwifery.
“We’re taking care of the whole person and her whole family, with her whole life,” says Sarita Bennett, DO, CPM, president of the Midwives Alliance of North America (MANA).
4. Learn the Difference Between CNMs and CMs
CNMs and certified midwives (CMs) both must pass a certification exam administered by the American Midwifery Certification Board (AMCB). But their education is different, and this can affect their roles. Here’s how they compare.
|Certified Nurse Midwife||Certified Midwife|
|Active RN license required||RN license not required|
1. Associate Degree in Nursing or a Bachelor of Science
2. Master of Science in Nursing or a Doctor of Nursing Practice in midwifery or MSN or DNP plus post-graduate certificate in midwifery
1. Bachelor of Arts or a Bachelor of Science in a non-nursing field
2. Master of Science in Nursing in midwifery
|Most attend births in hospitals, though they may be authorized to attend births in homes, birthing centers, and office settings, depending on state laws.||Most attend births in hospitals, though they may be authorized to attend births in homes, birthing centers, and office settings, depending on state laws.|
|Licensed in 50 states, Washington, D.C., and U.S. territories||Licensed in Delaware, Hawaii, Maine, New Jersey, New York, and Rhode Island only|
|Authorized to prescribe medication in all U.S. jurisdictions||Authorized to prescriptive medication in New York, Rhode Island, and Maine only|
While CNMs comprise the majority of midwives in the U.S., there are other ways to practice midwifery. Such as licensed midwives (LMs), certified professional midwives (CPMs), and lay midwives.
However, midwives who don’t qualify as CNMs aren’t RNs and have less authority and autonomy in providing services. Becoming one of these midwives means you will likely practice outside of hospital settings, depending on the laws in the state in which you practice.
5. Decide What Kind of Work Environment You Prefer
“If you’re going into this field, you have to consider, ‘What kind of midwifery do I want to practice and where?’ and ‘How autonomous do I want to be?'” Bennett says.
One of the benefits of becoming a midwife is that you have the flexibility to work in a variety of locations. Almost 95% of babies delivered by CNMs in the U.S. are born in hospitals, according to the ACNM, but CNMs can work in many types of environments.
Depending on laws in your state, you could work at:
When exploring educational programs, it’s important to decide where you’d prefer to work so you can find a program that matches your career preferences and goals.
6. Determine Which Type of Program Is Best for You
There are several educational pathways to becoming a midwife. Choosing the right program depends on the type of practice you want to pursue and where you want to work.
In addition to completing the required education, most midwives must pass a certification exam to earn their credentials. Licensing requirements in terms of education and experience may also vary by state, depending on the type of midwife certification you choose.
|Type of Midwife||Required Education Options|
|Certified Nurse Midwife||Bachelor of Science in Nursing (BSN) and Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) in Nurse Midwifery.|
Bridge program for Associate Degree in Nursing (ADN) to MSN in Nurse Midwifery.
MSN with a post-graduate certificate in nurse midwifery.
|Certified Midwife||Bachelor’s degree in any discipline, completion of required science prerequisites, and Master of Science in Nursing (MSN) in Nurse Midwifery.|
|Certified Professional Midwife||Completion of an approved apprenticeship or educational program that may grant a certificate or degree in midwifery.|
|Registered Midwife/Licensed Midwife||Completion of a state-approved educational program based on the apprenticeship model.|
|Lay or Traditional Midwife||Education through self-study and apprenticeship.|
If you were wondering how to become a midwife without a nursing degree, note the CPM, LM, and traditional midwife paths in the table above. And if you’re like many students, you’ll weigh program costs when you choose a school.
The federal Health Resources and Services Administration (HRSA) reported that in 2020 over $107 million in active grants were given to health care professions, including maternal and child healthcare, to train more workers. Some of this money went to students to help pay for their education.
Federal loans, grants, and loan repayment programs are also available to midwifery students in accredited colleges or career schools that meet program criteria. You may also qualify for private student loans or school-based or private scholarships to fund your education. Talk to the financial aid director at your school to learn about all the options you have.
7. Find an Accredited Nurse Midwifery Program
Accreditation is a review process that determines whether a school or program meets established criteria for educational standards. As part of your research, make sure the schools and midwifery programs you’re exploring are accredited.
If your program isn’t accredited, you won’t be eligible for federal financial aid and student loans. Plus, if you need to change programs or schools, you won’t be able to transfer credits from a program that isn’t accredited to a school or program that is accredited.
These organizations award accreditation for MSN programs:
- The Commission on Collegiate Nursing Education (CCNE)
- The Accreditation Commission for Education in Nursing (ACEN)
Depending on your education and practice, it’s also important to look for these accreditations to qualify for specific post-graduate certifications.
8. Look for Like-Minded Faculty
Nurse midwives share a foundation of excellent advanced training, but not all practice the same way. If you’re passionate about drug-free delivery, look for faculty members who share your convictions. If more personalized care is a priority for you, ask questions to be sure you’ll learn from professors who focus on providing that for women and their newborns.
Certified holistic nurse midwives receive expanded training in a range of holistic modalities such as aromatherapy, massage, and reiki, among others.
Some nurse midwives train during or after their master’s program to earn certification as a holistic nurse by the American Holistic Nurses Credentialing Corporation. Certified holistic nurse midwives receive expanded training in a range of holistic modalities such as aromatherapy, massage, and reiki, among others.
“One important aspect of holistic nursing is spiritual assessment and care—often not incorporated into standard CNM curricula,” says Kathleen Bell, RN, MSN, CNM, AHN-BC, MS1-BC, special adviser to the board of directors of the Oregon Holistic Nurses Association. “Another is holistic nursing’s strong emphasis on self-care.”
9. Choose a School with a Good Certification Exam Pass Rate
The AMCB administers the exam that all CNMs and CMs must pass to become certified. Attending a nurse midwife program with a high exam pass rate is one indicator of a quality education.
When you research midwife programs, Bell suggests also looking at:
After earning your certification as a CNM, there are many ways to expand your options and advance your career, whether or not you remain at the bedside.
The path you take will depend on your goals, Wilson says: “You can get a doctorate degree or a PhD; you can teach undergraduate or graduate students. You can get involved with politics. Some CNMs run social media pages to educate on health issues, or even just ethical and policy issues. Some midwives have (and are writing) books, some publish journal articles, some have started businesses to help midwives with their career or be mentors. The possibilities are whatever you want them to be.”
10. Think About What Kind of Salary You Want to Earn
With the most formal education and preparation, CNMs usually earn the highest salaries among all types of midwives. CNMs typically work in hospitals and physicians’ offices, where they may also have opportunities for advancement in management roles.
According to the BLS, the median salary for certified nurse midwives is $111,130. Based on BLS data, O*Net reports a median annual salary of $51,840 for midwives who aren’t registered nurses, a broad classification that includes CPMs, licensed midwives, registered midwives, and lay midwives.
Earning a Doctor of Philosophy (PhD) or Doctor of Nursing Practice (DNP) can help you move your prospects and salary to the next level. A PhD can prepare you to conduct research, develop healthcare policies, and teach at a university. While a DNP can qualify you to direct clinics or programs and teach at many post-secondary institutions.
You’re now properly equipped to start the journey. But there is one more thing you must know. Do not confuse becoming a midwife with becoming a doula. They’re not the same thing! But some women do hire both a doula and a CNM when giving birth.
Midwives and doulas both support women through pregnancy and birth, but their roles and required education are starkly different. Certified Nurse Midwives require more education, mandatory training, and state licensure. They may also be authorized to prescribe medication and treatment.