How to Become a Nurse Midwife

A nurse midwife consulting with a pregnant patient

For centuries, expectant mothers have relied on the services of midwives to deliver babies. In today’s world, the profession has broadened in scope and embraced standardized practices. Mothers who choose to work with certified nurse midwives (CNMs) can rest assured that their healthcare providers are highly qualified and experienced professionals who adhere to a strict standard of care and professional ethics.

If you feel drawn to the healthcare profession or you’re already a registered nurse (RN) who would like to take your career further, you may be interested in the process of becoming a CNM. It’s a rather lengthy process, as nurse midwives must be highly trained. You will need to earn graduate-level degrees and obtain an advanced, specialty certification and license.

This career guide will walk you through the process of how to become a certified nurse midwife from start to finish. If you already work as an RN with an associate’s degree or you already have a bachelor’s degree, you can skip to the sections that are most relevant to you.

What Does a Certified Nurse Midwife Do?

As the name suggests, a CNM is specially educated, trained and licensed to assist expectant mothers with the labor and delivery process. CNMs typically focus on safe and natural birth techniques while taking steps to reduce the need for medical interventions such as C-sections.

However, assisting at births is only part of what CNMs do. These highly trained professionals offer a broad range of care from pre-conception through postpartum recovery. Some of the services a CNM can provide include the following: 

  • Pre-conception health evaluations 
  • STD testing for male and female partners 
  • Family planning services 
  • Gynecological examinations and well-woman care 
  • Prenatal care 
  • Postnatal care of mother and baby 
  • Newborn care

CNMs not only coach and guide expectant mothers through the birthing process, but also educate them about their birthing options and help them to create birthing plans. New moms often rely on CNMs to teach them how to breastfeed and take care of their newborns.

Earning Your Bachelor of Science in Nursing Degree

After high school, the first step in the process to become a CNM is to earn your Bachelor of Science in Nursing (BSN) degree. Choose an accredited school and a program that leads to licensure. Nursing degrees involve a blend of classroom instruction, laboratory work and hands-on clinical courses, and some schools may also offer simulated learning experiences.

BSN degree programs are an intensive learning journey. Be sure to utilize your professors’ office hours and tutoring services on campus to stay on track towards graduation. Nursing students can generally expect to study topics, including: 

  • Organic chemistry and biochemistry 
  • Human anatomy and physiology 
  • Microbiology 
  • Applied pathophysiology 
  • Pharmacology 
  • Evidence-based nursing research and practices

In short, you will learn the essentials of conducting health assessments and diagnostics, as well as administering treatments and assisting with procedures. If you enroll at a school that offers simulated learning experiences, you can also expect to be immersed within a clinical setting that features common scenarios you may encounter as a nurse. You will be expected to apply your nursing knowledge and critical thinking skills as you work through the various scenarios.

Become a Registered Nurse

After you graduate with your BSN degree, the next step in the process of how to become a CNM is to obtain licensure as a registered nurse (RN). You’ll need to take the National Council Licensure Examination (NCLEX-RN) in order to be legally allowed to practice as a nurse. This is administered by the National Council of State Boards of Nursing (NCSBN).

There is typically a brief waiting period after graduation before you are authorized to take the NCLEX. In most states, the waiting period is 45 days, although this is subject to change. Some nursing students prefer to take the NCLEX as soon as possible so that their classwork is fresh in their minds. Others prefer to wait a longer to fit in some extra time for studying.

Before you can take the NCLEX, you’ll need to apply to your state’s nursing regulatory body (NRB) for licensure. You will then be allowed to register with the test administrator (Pearson VUE) and pay your registration fees. You’ll also need your Authorization to Test (ATT) from your NRB before you can schedule your exam date.

The NCLEX-RN is a computerized, adaptive test that consists of four main areas: 

  • Safe and effective patient care 
  • Health promotion and maintenance 
  • Psychosocial integrity 
  • Physiological integrity

It’s a good idea to invest in one or more NCLEX study guides and take several practice tests as you prepare for your exam date.

Acquire Practical Experience as an RN

After acquiring your licensure, you’ll officially be an RN and able to enter the nursing workforce. However, you won’t be quite ready to become a CMN yet. The next step is to acquire at least one to two years of clinical experience in a healthcare setting.

This is an opportunity to further refine your knowledge and skills. Don’t hesitate to ask questions or request feedback from the more experienced nurses with whom you work. Interactions with patients also provide opportunities to grow as a professional.

Earn Your RN to BSN Degree If Applicable

If you already hold an associate’s degree or diploma certificate in nursing and have an active, unencumbered nursing license you can complete an RN to BSN degree program instead of a conventional four-year bachelor’s degree program. An RN to BSN program is an accelerated program of study designed specifically for practicing RNs who hold an associate’s degree or diploma certificate in nursing and want to earn a BSN degree. You can earn your degree in as few as 12 months.1

Completing your BSN is attainable even for busy professionals, as a majority of the program is offered online with practicum hours in your local community. Additionally, many RN to BSN students find that their employers offer tuition reimbursement as well as flexible scheduling options, to support your educational journey. Talk to your HR department about your plans to see what assistance might be available for you.

Earn a Master of Science in Nursing Degree

The next step in the process of becoming a CNM is to earn your Master of Science in Nursing degree (MSN). An MSN degree often offers opportunities to specialize. For example, you might choose a concentration in health informatics, patient safety, or nursing leadership

If possible, choose a concentration that reflects your ambitions to become a CNM, such as a concentration in midwifery or obstetrics. A degree that is focused on patient safety would also be a good choice.

When choosing a degree program, you should also consider the accreditation status of the school. In order to become certified through the American Midwifery Certification Board (AMCB), your graduate program must be accredited or hold pre-accreditation status from the Accreditation Commission for Midwifery Education (ACME).

In addition, like the RN to BSN program, the MSN degree offers considerable value to healthcare employers. Because of this, your employer may offer reimbursement of tuition fees and flexible scheduling while you complete your degree.

Earn a DNP Degree

You can apply for your nurse midwife certification with just a master’s degree. However, it’s a good idea to consider earning a Doctor of Nursing Practice or DNP degree. A DNP degree is a terminal degree program, and by earning it, you will have proven to have reached the pinnacle of academic achievement in your field. 

Nurses with a DNP degree may be better prepared to tackle the challenging midwifery certification exam. They may also qualify for a more lucrative pay rate and have more desirable job opportunities available to them. Furthermore, nurses with a DNP are well-recognized as experts in their fields.

A DNP degree is a practice-focused degree, which is ideal for nurses who wish to continue to provide direct patient care; although, a DNP degree typically culminates in a major research project, such as a dissertation or another type of evidence-based research project. For this, you should choose a topic that focuses on improving health outcomes in obstetric settings.

Acquire Your National Midwifery Certification

After completing the academic requirements for becoming a nurse midwife, the next step is to acquire your national certification from the American Midwifery Certification Board. The AMCB recommends taking the certification exam as soon as possible after graduation, as you will be granted four tries to pass the exam within 24 months of your graduation.

Note that the AMCB might not necessarily define the date of completion as your actual graduation date. Rather, the date of completion is the date upon which you completed the nurse-midwifery or midwifery portion of your academic program.

In other words, it’s in your best interests to take the exam as soon as possible, even if you’re not completely confident that you can pass the exam just yet. You can consider your first attempt to be a practice test that will help you better prepare for successfully passing the exam on a subsequent attempt.

Begin preparing for your exam before your graduation date. You’ll find exam preparation materials available from the American College of Nurse-Midwives (ACNM). The exam itself is four hours long and covers the following topic areas: 

  • Antepartum 
  • Intrapartum 
  • Postpartum 
  • Newborn 
  • Well Woman/GYN 
  • Women’s Health/Primary Care

Apply for an Advanced Practice Registered Nursing License

Once you earn your certification, you will officially be a CNM. However, you cannot practice as a CNM until you acquire your advanced practice registered nursing (APRN) license. You can apply for the APRN license through your state’s board of nursing.

Each board will have its own requirements, but in general, you can expect to submit proof of your qualifications. You will likely be required to send proof of your RN license, academic achievements and CNM certification.

Note that many states have entered into a compact state agreement that allows RNs to legally practice in any member state without having to acquire a new license. Currently, this is only applicable for RN licenses, and only in participating states. There has been an effort made toward creating a compact state agreement for APRN licenses, CNMs and other APRNs, but this has not yet come to fruition, so, while this is pending, apply for your APRN license in the state in which you plan to practice.

Grand Canyon University’s College of Nursing and Health Care Professionals is pleased to offer a variety of nursing degrees, both on campus and online, to help students reach their goals within the nursing field. These degrees include the Bachelor of Science in Nursing (Pre-Licensure) degree program, many Master of Science in Nursing programs, and a Doctor of Nursing Practice degree. Click on “Request Info” at the top of your page to learn more about applying to one of GCU’s accredited nursing programs.

1Transfer of 90 credits that apply to your degree and continuous enrollment required

The views and opinions expressed in this article are those of the author’s and do not necessarily reflect the official policy or position of Grand Canyon University. Any sources cited were accurate as of the publish date.

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