How to Become a Nurse Midwife (CNM) in Texas

How to Become a Nurse Midwife (CNM) in Texas

Are you a registered nurse who has an interest in midwifery? 

Do you have a passion for women’s health, particularly before, during, and after pregnancy? 

That’s great! 

Nurse midwives are in high demand in Texas.

More and more people are turning to midwives because of the high quality of care they can offer to women prepartum, intrapartum, and postpartum. 

Not to mention that the care midwives offer is not just limited to childbearing, but to all aspects of women’s health in various stages of life! 

They can offer gynecological, obstetrical, and family planning services to women in adolescence and even those who are past their menopause.

Being a nurse midwife can be very rewarding for you! 

But the question is… How do you become one? 

The process is long and requires a lot of determination, but the steps to get there are not that complicated. 

We’ll give the whole process to you in just 5 steps! 

We’ll also answer some frequently asked questions, such as:

  • Are nurse midwives in demand in Texas?
  • How much does a nurse midwife earn in Texas?
  • How long does it take to become a nurse midwife in Texas?

So, if you’re ready to learn how to become a nurse midwife (CNM) in Texas, let’s begin!

How to Become a Nurse Midwife (CNM) in Texas – 5 Simple Steps 

Here are the 5 steps to becoming a nurse midwife:

  1. Become an RN in Texas and Gain Experience
  2. Enroll in a Nurse Midwifery Program 
  3. Become Nationally Certified
  4. Apply for your CNM License in Texas
  5. Maintain Your RN and CNM Licenses

Let’s discuss each step.

Step #1: Become an RN in Texas and Gain Experience 

A Certified Nurse Midwife (CNM) is different from a Licensed Midwife. 

A nurse midwife must first become a Registered Nurse (RN) before specializing in Nurse Midwifery.

So, before we can talk about how to become a CNM, you need to know how to become an RN in Texas. 

You can read a full article on how to become an RN in Texas here, but let’s give an overview of some steps.  

Enroll in an Approved RN Program 

The first step to becoming an RN is to enroll in an approved RN program. This can be an Associate Degree in Nursing (ADN) or a Bachelor’s Degree in Nursing (BSN). 

An ADN takes two years to complete, while a BSN takes four years to complete. 

Both will qualify you to take the NCLEX-RN.

However, since the BSN is a longer and more in-depth training program, it will usually open up more opportunities for advancement in the future. 

Many schools also require a BSN for you to be able to enroll in their CNM programs. 

However, if you are an ADN-RN, you still have a chance to pursue a CNM degree without completing a BSN by taking an RN-to-MSN degree. 

Just make sure the program is accredited by the Texas Board of Nursing.

Get Your RN License in Texas

After graduating from your ADN or BSN, the next step is to apply for a license through the Texas Board of Nursing. 

Licensure by Examination 

All aspiring RNs need to take the NCLEX-RN. 

To qualify for the exam you need to submit a few requirements, such as a transcript of records, a criminal background check, and an application fee and exam fee.

You also need to take the Nursing Jurisprudence exam. This is a unique requirement in Texas. 

A few weeks after you pass the NCLEX, you can expect to receive your RN license. 

Licensure by Endorsement

If you are already an RN in another state that is not part of the nursing licensure compact, then you need to apply for an RN license in Texas by endorsement. 

To do this you also need to submit several requirements, including a copy of your RN license from the state you are coming from. 

Multistate License

Texas is part of the Nursing Licensure Compact.

This is an agreement among some states that an RN licensed in one compact state can practice as an RN in another compact state without having to go through the endorsement process. 

Since Texas is a compact state, RNs from another compact state do not need to have a Texas license to become a CNM in Texas, as long as they pass all the other requirements. 

Gain Experience 

After becoming an RN, the next step is to gain relevant experience in the nursing field. 

Most CNM schools will look at your professional nursing experience before accepting you into their program. 

This is also an important step for you as it helps you determine whether this is the path you want to take. 

Step #2: Enroll in a Nurse Midwifery Program 

Once you are an RN in Texas or an RN with a multistate license, then you can enroll in a nurse-midwifery program in Texas. 

You can go for a master’s or doctoral degree in nurse-midwifery. 

Some also choose to take a dual specialization by including a master’s in women’s health. 

Accredited Programs

When choosing a CNM program, make sure that it is accredited by the Texas Board of Nursing and the Accreditation Commission for Midwifery Education (ACME). 

There are 2 accredited nurse-midwifery programs in Texas – the Texas Tech University Health Sciences Center School of Nursing in Lubbock and the Baylor University College of Nursing in Dallas. 

Coursework and Clinical Experience

CNM programs are usually divided into two phases – the didactic courses and the clinical experience. 

Some of the subjects you may expect to take include:

  • Theoretical foundations of advanced nursing practice
  • Nursing in research
  • Pathophysiology
  • Pharmacological principles
  • Advanced health assessment
  • Women’s Health
  • Antepartum/postpartum care
  • Intrapartum/newborn care
  • Evidence-based care in nurse-midwifery

The clinical component usually includes 500-1000 hours of experience in different settings, such as hospitals, birth centers, women’s health clinics, and community health settings.

Step #3: Become Nationally Certified 

After completing your CNM program, it’s time to prepare yourself for national certification. 

To become a Certified Nurse Midwife, you need to take the national examination offered by the American Midwifery Certification Board (AMCE).

The American Midwifery Certification Board offers the exam through Computer Based Testing in many different test centers. 

The exam consists of 175 multiple-choice questions that can be answered in 4 hours. 

You may read more information about the exam here

If you opted for a dual specialization to include women’s health, you can also take the Women’s Health Care Nurse Practitioner exam through the National Certification Corporation.

Step #4: Apply for Your CNM License in Texas

Now that you are nationally certified, you can apply for your CNM license in Texas through the Texas Board of Nursing. 

You can find the online application forms here


The requirements for all Advanced Registered Nurses in Texas are similar. 

These include:

  • a $100 application fee ($150 if you are applying with prescriptive authority)
  • your Texas RN license or your RN license from another nursing compact state 
  • certification of completion of your CNA educational program approved by the Board 
  • your national certification from the AMCE with the expiration date
  • completion of a minimum of 400 hours of practice within the last 24 calendar months or completion of your advanced practice nursing educational program within the last 24 calendar months
  • completion of a minimum of 20 contact hours of continuing nursing education within the last 24 calendar months or completion of your advanced practice nursing educational program within the last 24 calendar months.

After reviewing and accepting your application, the Texas Board of Nursing will send you your CNM license. 

Step #5: Maintain Your RN and CNM Licenses

Becoming a Certified Nurse Midwife is rewarding. You will find a lot of job opportunities open for you with good compensation. 

But while you are enjoying your career, don’t forget to renew your RN and CNM licenses! 

You will not be able to continue practicing as a CNM with expired or deactivated licenses. 

You need to renew both your licenses every 2 years by completing 20 contact hours of continuing education related to nurse-midwifery. 

The 20 contact hours will be enough for both your RN license and your CNM license. 

CNMs with prescriptive authority also need to complete at least five additional contact hours in pharmacotherapeutics.

Another way to renew your licenses is by maintaining your national certificate and meeting the applicable targeted continuing education requirements.

You will be expected to pay $129 for your RN and CNM licenses. You can check the fees here.

Frequently Asked Questions About Becoming a Nurse Midwife (CNM) in Texas

We already covered the 5 steps to becoming a nurse midwife in Texas. But you may still have some questions about becoming a nurse midwife. 

Here, we will discuss some common and important questions. 

Are nurse midwives in demand in Texas?

Yes! According to the BLS, the demand for nurse midwives is expected to rise by 40% from 2021 to 2031. 

Texas is also the third state with the highest employment of nurse midwives. 

Over the last few years, more and more women have been looking to midwives for care during delivery. 

This may be because deliveries led by midwives are seen to be less invasive and more natural. 

How much does a nurse midwife earn in Texas?

According to the US Bureau of Labor Statistics, the average annual salary of CNMs in Texas is $ 85,030.

How long does it take to become a nurse midwife in Texas?

This depends on where you are in your nursing journey and the pace you would like to go. 

But for a general idea, you can expect the following time frame:

  • RN education program – 4 years
  • Licensure and experience – 1-2 years
  • Master’s degree in nurse-midwifery – 2-3 years

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