What Are CNMs (Certified Nurse Midwives)?

What Are CNMs (Certified Nurse Midwives)

Are you currently pregnant or considering having a child? 

Then perhaps you’ve heard of nurse midwives and want to learn more about these healthcare providers.

Or perhaps you are a nursing student who wants to learn more about the different nursing specialties.

Well, whatever your current situation, we’ll be answering a lot of questions about nurse midwives.

We’ll answer the following questions:

  • What Are CNMs (Certified Nurse Midwives)?

  • What Do CNMs Do?

  • Where Do CNMs Work?

  • What Qualities Should CNMs Have?

  • What is the Difference Between a Certified Midwife and a Nurse Midwife? 

  • Do CNMs Have Good and Viable Careers?

  • How Do I Become a CNM?

  • How Long Does It Take to Become a CNM? 

  • How Much Do CNMs Earn?

At the end of this, you’ll have a much wider and deeper understanding of this noble profession.

So, if you’re ready, let’s dive right into it! 

What Are CNMs (Certified Nurse Midwives)?

Certified Nurse Midwives (CNMs) are advanced practice registered nurses (APRNs) who focus on the reproductive health of women in different life stages, especially during pregnancy and childbirth. 

They offer preconception, pregnancy, childbirth, postpartum and newborn care, as well as other gynecologic and family planning services. 

What Do CNMs Do?

The American College of Nurse Midwives (ACNM) lists the core competencies and responsibilities of nurse midwives.  

These include:

  • Primary care

    • assessing physical, mental, and social health

    • recommending screening and immunization

    • promoting healthy behaviors

    • treating common health problems such as infections and mild chronic conditions

    • utilizing consultation, collaboration, and/or referral to appropriate healthcare services

  • Preconception care and family planning

    • preparing individuals and families for pregnancy, physically, emotionally, psychosocially, and sexually 

    • counseling on nutrition, medications, and maternal lifestyle

    • prescribing health and laboratory screening

    • ensuring fertility awareness, cycle charting, signs and symptoms of pregnancy, and pregnancy spacing 

  • Gynecological care

    • diagnosing common gynecologic problems

    • educating on available contraceptive methods 

    • managing sexually transmitted infections including partner evaluation, treatment, or referral

    • counseling for sexual behaviors that promote health and prevent disease 

    • Counseling, intervening or referring for unplanned or undesired pregnancies, sexual and gender concerns, and infertility

    • managing complications and emergencies

  •  Perimenopausal and postmenopausal periods 

    • educating on the effects of menopause on physical, mental, and sexual health

    • identification of health problems 

    • counseling and education for health maintenance and promotion

    • initiating or referring for age/risk-appropriate periodic health screening 

    • managing and alleviating common discomforts 

  • Antepartum period 

    • confirming and dating pregnancy

    • promoting normal pregnancy using management strategies and therapeutics

    • managing common discomforts of pregnancy 

    • assessing the influence of environmental, cultural and occupational factors, health habits, and maternal behaviors on pregnancy outcomes

    • assessing health risks, including but not limited to domestic violence, infections, and substance use/abuse

    • assessing emotional, psychosocial, and sexual changes during pregnancy

    • providing anticipatory guidance related to birth, breastfeeding, parenthood, and change in the family constellation

    • managing health problems, complications, and emergencies

    • monitoring placental physiology, embryology, fetal development, and indicators of fetal wellbeing

  • Intrapartum period or childbirth 

    • confirming and assessing labor and its progress

    • monitoring maternal and fetal status 

    • managing complications, abnormal intrapartum events, and emergencies

    • facilitating physiologic labor progress

    • supporting psychosocial needs during labor and birth

    • managing labor pain through pharmacologic and non-pharmacologic strategies 

    • administering local anesthesia, spontaneous vaginal birth, third-stage management, episiotomy repair 

  • Postpartum care 

    • offering management strategies and therapeutics to facilitate a healthy puerperium 

    • alleviating discomforts of the puerperium 

    • educating on self-care, psychosocial coping, healing, and readjustment of significant relationships and roles following pregnancy

    • facilitating the initiation, establishment, and continuation of lactation 

    • counseling on the resumption of sexual activity, contraception, and pregnancy spacing 

    • managing complications and emergencies

  • Newborn care 

    • assessing the effect of the maternal and fetal history and risk factors on the newborn

    • preparing and planning for birth based on ongoing assessment of maternal and fetal status

    • facilitating the physiologic transition to extrauterine life through the establishment of respiration, cord clamping and cutting, thermoregulation, establishment of feeding and maintenance of normoglycemia, bonding, and attachment

    • managing emergencies through resuscitation, stabilization, consultation, and referral as needed

    • evaluating the newborn

    • developing a plan in conjunction with the woman and family for the care of the newborn for the first 28 days of life including normal behaviors and development to promote attachment, feeding and weight gain, normal daily care, interaction, and activity, etc. 

Where Do CNMs Work?

Nurse midwives work in various settings, such as major hospitals, private practices, outpatient clinics, health and birthing centers, community or government offices, and individual homes (to assist with home births). 

The BLS lists the industries with the highest levels of employment for nurse midwives. You can see the table below. 

Industries with the highest levels of employment in Nurse Midwives:



Percent of industry employment

Hourly mean wage

Annual mean wage

Office of Physicians





General Medical and Surgical Hospitals





Outpatient Care Centers





Offices of Other Health Practitioners





Local Government excluding schools and hospitals (OEWs Designation)





What Qualities Should CNMs Have?

Nurse midwives work with women of all ages, particularly those in their childbearing years. They assist mothers throughout pregnancy, delivery, and immediately after birth. 

Certain qualities and skills are needed for this kind of work. 

These include:

  • good listening skills 

  • good communication skills

  • caring and compassionate approach 

  • empathy and patience 

  • ability to intervene judiciously 

  • being an advocate for women

  • ability to work with diverse populations 

  • ability to function in high-stress situations 

  • strong leadership skills 

What is the Difference Between a Certified Midwife and a Nurse Midwife? 

So, there are nurse midwives and there are midwives. What’s the difference? 

The first main difference has to do mainly with their educational backgrounds. 

Nurse midwives have to graduate from an RN education program, take the licensure exam, and become registered nurses. 

Midwives graduate with an undergraduate degree other than nursing. The undergraduate degree may be healthcare-related or not. However, they will need to complete some health and science courses as part of their midwifery program. 

Both programs for nurse midwives and midwifery have to be approved by the Accreditation Commission for Midwifery Education (ACME).

There is also a difference in the licensure and scope of practice of both professions. 

Not all states allow Certified Midwives (CMs) to prescribe medications and obtain licensure. But all states recognize Certified Nurse Midwives (CNMs) and allow them to obtain licensure. 

What is the Difference Between a Nurse Midwife and a Doula? 

Nurse midwives (and even midwives) provide comprehensive healthcare services for women throughout their lifespans. This is especially true during pregnancy, childbirth, and the postpartum period. They can also provide newborn care. 

Doulas, on the other hand, are trained to provide physical, emotional, and informational support to mothers before, during, and after childbirth, but they do not provide medical care. Their main role is only supportive.

They do not have the same educational and certification requirements that nurse midwives and midwives do. 

Do CNMs Have Good and Viable Careers?


Employment of nurse midwives is expected to increase in the next decade by 7% from 2021-2031, according to the BLS

It is also listed as #24 in Best Health Care Jobs. 

Nurse midwives are contributing significantly to better care for women and their families. More and more organizations are adding nurse midwives to their healthcare teams. 

Working as a nurse midwife is both meaningful and rewarding, personally and professionally.

How Do I Become a CNM?

Becoming a CNM is not a walk in the park. It involves many years of study and training. 

However, as we have seen, it is very rewarding and meaningful. 

So, what exactly does it take to become a CNM? 

Here are the five steps to becoming a CNM: 

Step 1: Become a Registered Nurse (RN) and Gain Experience

Since a nurse midwife is an advanced practice registered nurse (APRN), this means that you first have to become a registered nurse. 

You need to enroll in an RN program and take the NCLEX-RN exam. 

You can then apply for an RN license in your state and start practicing as an RN.

You should gain at least 1-2 years of experience working with women and mothers. 

You can read more about how to become an RN in this article

Step 2: Complete an MSN or DNP in Nurse Midwifery

After gaining experience as an RN, you can enroll in an MSN or DNP program in nurse-midwifery. This will include both classroom instruction and clinical experience.

The program has to be accredited by the  Accreditation Commission for Midwifery Education (ACME).

Step 3: Take the National Certification Exam (CNE) 

After graduation, aspiring nurse midwives must take the national Certified Nurse-Midwife Examination through the American Midwifery Certification Board

This is optional in some states, however, such as California. 

Step 4: Apply for Your CNM License

You can apply for your CNM license once you meet all your state’s requirements for licensure. 

You can apply through your state’s regulatory board of nursing. 

Step 5: Keep Your RN and CNM Licenses Active 

After becoming licensed, you will be expected to keep updated and maintain your license by fulfilling various requirements. 

Most states require you to renew your license every two years and prescribe a certain number of continuing education units. 

You can read more about how to become a CNM in this article

How Long Does It Take to Become a CNM? 

This depends on whether you take an ADN or a BSN, how many years of experience you gain as an RN before proceeding to advanced studies, whether you take an MSN or DNP, and the pace at which you pursue your studies. 

However, as a rough estimate, you can expect around 7-10 years to become a CNM. 

This can be broken down as:

  • become an RN - about 4 years

  • take the NCLEX-RN - soon after graduation

  • gain experience - 1-2 years

  • finish an MSN or DNP - 2-4 years 

  • take the national exam - soon after graduation

How Much Do CNMs Earn?

Nurse midwives earn a mean annual wage of $114, 210 and an hourly mean wage of $54.91. 

You can see this table on the BLS website

Employment estimate and mean wage estimate for Nurse Midwives:



Mean hourly wage

Mean annual wage

Wage RSE






Percentile wage estimates for Nurse Midwives:




50% (Median)



Hourly Wage






Annual wage






Top-Paying States

The top-paying states for CNMs are West Virginia, Utah, California, Massachusetts, and New York respectively. 

Top paying states for Nurse Midwives:



Employment per thousnad jobs

Location quotient

Hourly mean wage

Annual mean wage

West Virginia





















New York




Top-Paying Industries

The top-paying industries for CNMs are outpatient care centers, general medical and surgical hospitals, offices of physicians, the academe, and local government units. 

Top pying industires for Nurse Midwives:



Percent of industry employment

Hourly mean wage

Annual mean wage

Outpatient Care Centers





General Medican and Surgical Hospitals





Office of Physicians





Colleges, Universities and Professional Schools





Local Government, excluding schools and hospitals (OEWs Designation)





In Summary

If you’re a woman or mother seeking care from a nurse midwife or if you’re an aspiring nurse midwife, we’ve given you all you need to know about this profession.

The work of nurse midwives is very crucial and meaningful. They can make a great impact on women and their families. 

Although getting to this point takes a lot of time and effort, it is very rewarding professionally and personally. 

We hope you found this article helpful! 

If you have any more questions about CNMs, leave us a comment! 

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