Certified Nurse Midwife
What is a Certified Nurse Midwife?
A Certified Nurse Midwife (CNM) is one of the roles of a broader group of nurses called Advanced Practice Registered Nurses (APRNs). Other APRN roles include: Nurse Anesthetist, Clinical Nurse Specialist, and Nurse Practitioner. A CNM specializes in providing care to women of child-bearing age from prenatal care, through labor and birth, and postpartum care. A Certified Nurse Midwife may also care for the neonate in the immediate postpartum period.
The CNM often works in an independent practice and, in addition to normal RN practice, may prescribe medications, order lab and x-rays, make medical diagnoses, and prescribe treatments.In addition to working with pregnant women, the Certified Nurse Midwife often works with the woman’s partner to educate about reproduction and sexual issues.
Quick Facts about Certified Nurse Midwife:
- 2015 Median Pay
- Number of Jobs in 2014
- Job Prospects from 2014-2024
- Better than average
- Projected Employment in 2024
- Projected Employment Change from 2014-2024
- Areas of Growth
- Rural, inner cities, medically underserved areas
Figure 1: Accessed online from Bureau of Labor Statistics July 2016
What does a Certified Nurse Midwife do?
The Certified Nurse Midwife role is a blend of the traditional nursing role with the role of an obstetrician or gynecologist. The CNM has the diagnostic and treatment capabilities of the physician while maintaining a nursing focus on patient and family centered care. Depending on state-specific scope of practice, a Certified Nurse Midwife will do some or all of the following:
- Take medical and nursing histories from patients and families;
- Perform in-depth physical exams including gynecological exams;
- Order tests based on the physical exam;
- Analyze results of tests;
- Assist with family planning;
- Create plans of care for labor and delivery;
- Prescribe medications and treatments based on the plan of care;
- Repair lacerations suffered during delivery;
- Teach and collaborate with patients and families about sexual and reproductive health and problems;
- Consult with other members of the healthcare team as needed during problem pregnancies and deliveries;
- May work with obstetricians during unplanned Caesarian deliveries;
- Conduct or participate in research studies.
Where do Certified Nurse Midwives work?
The Certified Nurse Midwife can work in a wide variety of environments including acute care hospitals, physician offices, and outpatient clinics. Many CNMs elect to go into private practice where they can create their own environment and maintain their own client lists. Again, it is important that you understand that CNM practice is governed by each state’s Board of Nursing so it is critical to understand the rules and regulations in your state.
What qualities should a Nurse Midwife have to be successful?
The most important quality for a successful Nurse Practitioner is to be an excellent Registered Nurse. The CNM must have those basic skills as a foundation for advanced practice. In addition to great nursing skills, the successful CNM will also have exceptional listening and communication skills. Patience and a willingness to allow the woman to direct care as much as possible is a huge plus. Since much of the work of the CNM is independent, the ability to accurately assess and develop an appropriate plan of care is essential. A certified nurse midwife must be attentive to details since they are responsible for two lives – the mother and the unborn child. In a metadata review done in the Journal of Advanced Nursing (J Adv Nurs. 2006 Nov;56(4):414-29), Nicholls and Webb found that the most critical contributions to being a good nurse midwife are:
- Possessing good communication skills;
- Being compassionate and supportive;
- Being knowledgeable;
- Possessing good physical skills;
- Keeping up with the most current research;
- Treating women and their partners as individuals.
How much can I expect to earn as a Nurse Midwife?
The great news is that, in addition to providing an essential service, the Certified Nurse Midwife can expect to earn a very good living. As of May 2015, the median annual wage was $92,510 with a range from $70,260 to $137,040. Of course, wages vary widely by state, cost of living, and need. In May 2015, the US Bureau of Labor Statistics showed the following as average wages by state:
Figure 2: Accessed online from Bureau of Labor Statistics July 2016
What are the job prospects for a Nurse Midwife?
The need for Certified Nurse Midwives will grow faster than other professions through 2024. Job prospects for the CNM are excellent over the next 10 years as baby boomers age and begin to leave the work force. This attrition in the already undersupplied physician and nursing populations will make the need for the Nurse Midwife. As health insurance becomes more universal, CNMs will offer a more affordable alternative to traditional physician directed healthcare.
In May 2015, the US Bureau of Labor Statistics (BLS) showed the following as employment of CNMs by state:
Figure 3: Accessed online from Bureau of Labor Statistics July 2016
How can I become a Nurse Midwife?
Certification to become a Certified Nurse Midwife is regulated by the American Midwifery Certification Board. The certification by this board is recognized in all 50 states. The CMN continues to practice under the regulations set in each state and each hiring institution may also have requirements that a nurse must meet in order to practice. A CNM must be a Registered Nurse before being eligible for this advanced degree. In order to earn the CNM, you must earn a master’s degree (or higher) from an accredited program. Typically, this means that you must have a Bachelor’s degree in nursing first; however, if you have a bachelor’s degree in another health science, there are NP programs that will allow you to prepare for RN licensure at the same time you are studying for a Master’s degree in nursing. If you are a full time student in a Master’s program, you can expect to spend two to three years earning the Master’s degree that will prepare you to take the American Midwifery Certification Board exam.
Certified Nurse Midwives work with women throughout their reproductive years. Recertification is required to maintain the high standards required for this specialization.