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How to Become a Midwife

image for Daniel Besic / Getty Images
Daniel Besic / Getty Images

Midwives are primary care providers responsible for caring for women during pregnancy, labor and childbirth. Certified nurse-midwives (CNMs) and certified midwives (CMs) work in hospitals, clinics and private practices providing comprehensive gynecological and maternity care.

If you’re considering a career as a midwife, there are many aspects of the job you’ll want to consider beforehand. There are two educational routes you can take for obtaining a degree in midwifery, and many different options for those who complete these degree programs. Keep reading to find out more about the responsibilities of a midwife, where they practice, and how to become one.

Many midwives in the United States are certified nurses who, in addition to a degree in nursing, have also obtained a graduate degree from an accredited midwifery program and passed a national certification exam. Such midwives are called certified-nurse midwives and, and in many states, have the authority to write prescriptions, order tests, and provide primary and specialty care. CNMs can legally practice in all 50 states and the District of Columbia.

Certified nurse-midwives provide care to women throughout their lifespan, including gynecological and other physical exams, family planning advice, prenatal care, assistance in labor and delivery, care of newborns, and post-menopausal care. According to the American College of Nurse-Midwives (ACNM), nurse-midwives are trained in all of the latest safe scientific procedures available to assist in the normal birth process.

Certified midwives, unlike certified nurse-midwives, are not advanced practice registered nurses. They often hold other professional designations as healthcare providers, such as physical therapist or physician's assistant. Certified midwives must pass the same certification exam as nurse-midwives but are only licensed to practice in Delaware, Missouri, New Jersey, New York and Rhode Island. In states where they are licensed to practice, CMs provide the same care and services as CNMs.

CNMs and CMs work in a variety of settings, including private practices, hospitals, birth centers, health clinics and home birth services. Though midwives are very involved in the labor and delivery process, much of their time is spent caring for women in their role as primary care providers. They perform routine exams and checkups, and in the case of those who work in private practices, may spend a portion of their time handling the administrative tasks of the business.

Some CNMs and CMs choose to enter educational roles by teaching at the university level in schools of nursing, public health, medicine, or allied health.

Midwives’ schedule and pay vary greatly depending on their practice setting and geographic location. According to the ACNM, the median annual salary for certified nurse-midwives and certified midwives is approximately $70,000.

There are several routes to becoming a midwife. Those who wish to be able to practice midwifery in all 50 states should consider obtaining a bachelor’s degree in nursing, followed by a graduate degree from an accredited midwifery program. Most midwifery programs are run within nursing schools, and many of these programs require a degree in nursing as a prerequisite for admission. Upon completion of a program in midwifery, graduates must pass the national certification exam given by the American Midwifery Certification Board.

If you have already obtained a bachelor’s degree in a field other than nursing, or if you would like to bypass a nursing degree altogether, there are currently two accredited programs in the United States for certified midwives. Upon completing an accredited program and passing the midwifery certification exam, CMs are eligible to practice in Delaware, Missouri, New Jersey, New York and Rhode Island.

Laws and regulations governing the practice of midwifery are rapidly changing in the United States. CNMs and CMs are regulated on the state level. For more information on state statutes and regulations, contact your state’s board of nursing, board of medicine, board of midwifery, or the state department of health.

For more information on alternative ways to practice midwifery in the United States, such as a career in certified professional midwifery, visit the ACNM’s website and midwifery credentials chart.