How To Become a Certified Nurse-Midwife (CNM): Salary & Career Paths for 2025

by Imed Bouchrika, Phd

Co-Founder and Chief Data Scientist

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Certified Nurse-Midwives (CNMs) play a vital role in providing holistic care, from prenatal checkups to postpartum support, and even general gynecological services. However, the path to certification can seem complex, with multiple educational requirements, licensing exams, and varying state regulations. Many aspiring nurse-midwives struggle to find clear, up-to-date information on how to navigate this process effectively.

This guide breaks down everything you need to know about becoming a Certified Nurse-Midwife—from education and certification to salary insights and career paths. Whether you are a registered nurse (RN) looking to specialize, a student researching midwifery programs, or a career-changer exploring opportunities in women’s health, this article provides expert-backed advice to help you make informed decisions.

Key things you should know about becoming a Certified Nurse-Midwife (CNM)

• To become a Certified Nurse-Midwife (CNM), you must first earn a Bachelor of Science in Nursing (BSN), become a licensed RN, and complete an accredited midwifery graduate program.
• Professionals must pass the national certification exam from the American Midwifery Certification Board (AMCB) to practice as a CNM.
• The median annual wage for nurse midwives in the U.S. is around $129,480.

Table of Contents:

1. What does a certified nurse-midwife (CNM) do?
2. How much does a certified nurse-midwife make per year for 2025?
3. How is a CNM different from a traditional midwife or an obstetrician?
4. What is the step-by-step process of becoming a CNM?
5. How long does it take to become a certified nurse-midwife?
6. What is the AMCB CNM certification exam?
7. What is the job outlook for certified nurse-midwives?
8. How can additional certifications expand career opportunities for CNMs?
9. What are the different career paths for certified nurse-midwives?
10. Can fast-track programs accelerate my journey to becoming a CNM?
11. How Can Prospective CNM Students Evaluate Program Quality?
12. Should Nurse-Midwives Pursue Dual Certification in Mental Health?
13. What challenges do CNM candidates commonly face?
14. Are there scholarships for nurse-midwifery students?
15. What are the highest-paying industries for CNMs?
16. How Do Nurse-Midwives Stay Updated with Evolving Clinical Practices?
17. Other things you should know about becoming a certified nurse midwife

What does a certified nurse-midwife (CNM) do?

A Certified Nurse-Midwife (CNM) is a highly trained healthcare professional specializing in women’s reproductive health, pregnancy, childbirth, and postpartum care. CNMs provide comprehensive, patient-centered care that extends beyond maternity services to include gynecological and primary care for women throughout their lives. For aspiring nurses interested in pursuing this path, a 1 year nursing program online degree can serve as a fast-track foundation toward advanced practice roles like midwifery.

Key Responsibilities of a CNM:

• Provide Prenatal and Postpartum Care – CNMs monitor fetal development, conduct ultrasounds, and offer guidance on nutrition, exercise, and overall maternal health during pregnancy.
• Assist with Labor and Delivery – They support natural childbirth, manage pain relief options, and intervene when necessary to ensure a safe delivery for both mother and baby.
• Offer Gynecological and Reproductive Healthcare – CNMs perform routine exams, Pap smears, breast exams, and screenings for sexually transmitted infections (STIs).
• Educate and Counsel Patients – They provide contraceptive counseling, fertility assistance, and menopause management, ensuring women have informed choices about their health.
• Support Family Planning and Contraceptive Care – CNMs prescribe and recommend birth control methods, intrauterine devices (IUDs), and natural family planning techniques.
• Work in Various Healthcare Settings – They practice in hospitals, birth centers, private clinics, and academic institutions, collaborating with obstetricians and healthcare teams.
• Advocate for Maternal Health and Midwifery Care – CNMs promote holistic, low-intervention birth options, advocate for policies supporting midwifery, and educate the public on maternal wellness.

How much does a certified nurse-midwife make per year for 2025?

According to the U.S. Bureau of Labor Statistics (BLS), the median annual salary for Certified Nurse-Midwives (CNMs) was $129,480, along with nurse anesthetists and nurse practitioners. Compared to other nursing roles, such as certified nursing assistants (CNAs), a CNM's wage is significantly higher than a CNA salary. However, salaries can vary significantly based on factors such as geographic location, level of experience, work setting, and employer type. CNMs working in hospitals and outpatient care centers tend to earn higher wages than those in physicians' offices or birth centers.

Beyond base salaries, CNMs may receive bonuses, overtime pay, and benefits such as retirement contributions, malpractice insurance, and tuition reimbursement for continuing education. Experienced CNMs or those who take on leadership roles, such as clinical directors or educators, can earn even more. While the salary for nurse-midwives is already competitive, job outlook projections remain strong, with demand expected to grow as more healthcare providers emphasize holistic and patient-centered maternity care.

How is a CNM different from a traditional midwife or an obstetrician?

A CNM differs from a traditional midwife and an obstetrician (OB-GYN) in terms of education, scope of practice, and approach to care. CNMs are registered nurses with a master's or doctoral degree in midwifery, allowing them to provide comprehensive maternity care, including prenatal, labor and delivery, postpartum, and general women’s health services. While CNMs require advanced degrees, many people exploring the highest paying medical jobs with 2 year degree options may look into related healthcare roles that offer quicker entry into the field.

They practice in hospitals, birth centers, and clinics, often collaborating with OB-GYNs for high-risk cases. In contrast, traditional midwives, such as Certified Professional Midwives (CPMs) or lay midwives, typically train through apprenticeships or certification programs and focus on low-risk home births with minimal medical intervention. Unlike CNMs, they are not required to have a nursing degree and generally do not work in hospitals.

On the other hand, OB-GYNs are medical doctors (MDs or DOs) who complete medical school and a four-year residency specializing in pregnancy, childbirth, and reproductive health. They are trained to handle high-risk pregnancies, perform C-sections, and provide surgical interventions when necessary. OB-GYNs work primarily in hospitals and private clinics and may take a more medicalized approach to childbirth compared to CNMs, who emphasize holistic, patient-centered care with a focus on natural birth when possible.

What is the step-by-step process of becoming a CNM?

Becoming a CNM requires completing a nursing degree, gaining clinical experience, and obtaining certification. Below is a step-by-step guide to the process:

• Earn a High School Diploma or GED: A strong foundation in science and healthcare-related subjects, such as biology, chemistry, and anatomy, helps prepare students for nursing school.
• Obtain a Bachelor of Science in Nursing (BSN) Degree: Aspiring CNMs must complete a BSN program from an accredited nursing school, which includes coursework in nursing principles, maternal health, and patient care. Some candidates with an Associate Degree in Nursing (ADN) can enroll in RN-to-BSN bridge programs, such as a 6-month RN to BSN program, to meet this requirement more quickly and efficiently.
• Become a Licensed Registered Nurse (RN): Graduates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to obtain their RN license, which allows them to practice nursing legally in their state.
• Gain Experience in Women’s Health or Labor & Delivery: While not always required, working in areas like obstetrics, labor and delivery, or maternal health provides valuable hands-on experience and strengthens midwifery skills.
• Complete a Graduate-Level Midwifery Program: Candidates must earn a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) with a midwifery focus, accredited by the Accreditation Commission for Midwifery Education (ACME). These programs cover advanced midwifery care, neonatal health, pharmacology, and high-risk pregnancy management.
• Gain Clinical Midwifery Experience: During graduate training, students complete supervised clinical rotations where they practice prenatal care, labor and delivery assistance, postpartum care, and newborn assessments under the guidance of experienced CNMs or obstetricians.
• Pass the Certified Nurse-Midwife (CNM) Exam: Graduates must pass the American Midwifery Certification Board (AMCB) exam, which tests their knowledge in midwifery practice, maternal-fetal health, and clinical decision-making.
• Obtain State Licensure to Practice as a CNM: CNMs must apply for state licensure, as requirements vary by state. Some states also require prescriptive authority or additional certifications to practice independently.
• Pursue Continuing Education and Specializations: To stay current in the field, CNMs often take continuing education courses and may pursue additional certifications in lactation consulting, family planning, or high-risk pregnancy management.

How long does it take to become a certified nurse-midwife?

Becoming a CNM typically takes six to eight years, depending on your educational background and whether you pursue full-time or part-time study. This timeline includes completing an undergraduate nursing degree, gaining any required clinical experience, and earning a graduate degree in nurse-midwifery. Those who already hold a bachelor's degree in nursing (BSN) may be able to complete the process more quickly, while individuals with a non-nursing background or an associate degree in nursing (ADN) may need additional coursework. Given the strong career outlook for BSN graduates, starting with a BSN can provide a solid foundation and open doors to advanced roles like nurse-midwifery.

Factors such as program format (online vs. in-person), part-time vs. full-time enrollment, and state licensing requirements can also influence how long it takes to become a CNM. Accelerated programs and bridge options may shorten the timeline, while part-time study or additional licensing steps can extend it. Despite the years of training required, becoming a CNM offers strong career stability, high earning potential, and the opportunity to make a meaningful impact in women’s healthcare.

What is the AMCB CNM certification exam?

The AMCB Certified Nurse-Midwife (CNM) certification exam is a nationally recognized test administered by the American Midwifery Certification Board (AMCB) to assess the competency of aspiring nurse-midwives. This computer-based exam consists of 175 multiple-choice questions, covering key areas such as pregnancy, labor and delivery, postpartum care, newborn health, gynecology, and primary care.

Candidates must have completed an Accreditation Commission for Midwifery Education (ACME)-accredited midwifery program to be eligible for the exam. The test is designed to ensure that CNMs possess the clinical knowledge and decision-making skills required to provide safe, evidence-based maternity and reproductive healthcare. The exam is administered at approved testing centers and must be completed within four hours. A passing score grants the CNM credential, which is valid for five years before recertification is required through continuing education and the AMCB Certificate Maintenance Program.

What is the job outlook for certified nurse-midwives?

The job outlook for Certified Nurse-Midwives (CNMs) shows moderate growth, with employment projected to increase from 7,200 in 2023 to 7,700 by 2033. This represents a 7% growth rate, which is slower compared to nurse anesthetists (10%), who are expected to grow from 49,900 in 2023 to 55,100 in 2033, and nurse practitioners (46%), whose employment is projected to rise significantly from 292,500 in 2023 to 427,900 in 2033. As the demand for advanced practice nurses increases, many aspiring CNMs are turning to RN to MSN online programs to accelerate their education and enter the workforce more efficiently.

Although CNM job growth is not as rapid as other advanced nursing roles, midwives continue to play a vital role in maternal healthcare. Demand for CNMs is expected to be influenced by increasing recognition of midwifery-led care, efforts to improve maternal health outcomes, and expanded access to reproductive healthcare services. While the overall number of CNMs remains small, their role in providing holistic, patient-centered maternity and gynecological care ensures continued demand in hospitals, birthing centers, and private practices. The chart below shows the employment projections number for nurse midwives, nurse anesthetists, and nurse practitioners in the U.S.:

How can additional certifications expand career opportunities for CNMs?

Certified Nurse-Midwives seeking to broaden their clinical and leadership roles may benefit from pursuing additional certifications and advanced practice courses. These programs can lead to specialized skills in fields such as family practice, where CNMs can diversify their service offerings. For example, enrolling in RN to FNP programs can provide a structured pathway to transition into family nurse practitioner roles, thereby opening access to more comprehensive care settings. Enhanced qualifications not only increase clinical versatility but may also result in higher compensation and more strategic responsibilities within multidisciplinary teams.

What are the different career paths for certified nurse-midwives?

CNMs have various career paths, ranging from direct patient care to leadership, education, and policy-making roles. Below are some of the most common career options for CNMs:

• Hospital-Based CNM: CNMs working in hospitals provide comprehensive maternity and reproductive care, including prenatal checkups, labor and delivery support, and postpartum care. They often collaborate with obstetricians, neonatologists, and nurses to manage both low- and moderate-risk pregnancies while having access to advanced medical interventions when needed.
• Birth Center Midwife: CNMs in freestanding birth centers offer a holistic, patient-centered approach to pregnancy and childbirth. They focus on low-intervention births while ensuring access to medical care if complications arise. These settings provide a home-like environment and emphasize natural childbirth techniques such as water births and movement-based labor support.
• Private Practice CNM: CNMs in private practice work independently or as part of a physician-led team, providing personalized maternity and gynecological care. They often build long-term relationships with patients and may have more control over treatment plans, scheduling, and the continuity of care.
• Academic and Research CNM: CNMs with a passion for education and evidence-based practice may work in universities, teaching hospitals, or research institutions. They train future midwives, contribute to midwifery research, and help shape best practices and policies in maternal healthcare. Many CNMs looking to advance their careers in academia or leadership roles choose to enroll in online DNP programs, which provide flexible options while continuing clinical practice.
• Military or Government CNM: Some CNMs serve in the military, Veterans Affairs (VA) hospitals, or other federal healthcare settings, providing care to service members, veterans, and their families. These roles often include leadership responsibilities, policy development, and healthcare program management.
• Public Health and Community Midwife: CNMs in public health programs focus on maternal and infant health initiatives in underserved areas. They may work for government agencies, nonprofit organizations, or international health programs, helping to improve access to midwifery care for marginalized populations. Some CNMs choose to further their expertise in public health by enrolling in accelerated MPH programs online, which provide specialized training in health policy, epidemiology, and community health leadership.

Can fast-track programs accelerate my journey to becoming a CNM?

For experienced RNs aiming to transition into midwifery, fast-track programs offer an efficient route to solidify foundational nursing competencies while meeting prerequisites for advanced midwifery education. By leveraging innovative course structures that blend flexible online learning with essential clinical practice, these programs can minimize downtime and expedite career progression. Utilizing options like RN to BSN online fast track allows candidates to meet academic requirements promptly, thereby positioning them to take full advantage of accelerated nurse-midwifery pathways without compromising educational quality.

How Can Prospective CNM Students Evaluate Program Quality?

To ensure a program meets professional standards, prospective CNM students should review key quality indicators such as accreditation by recognized bodies, comprehensive clinical partnerships, and experienced faculty credentials. Analyzing curriculum structure, especially the integration of hands-on clinical practice with theoretical instruction, can provide insight into a program’s ability to prepare graduates for real-world challenges. Additionally, evaluating alumni success and career support services may help determine if the program effectively supports transition into practice. Candidates transitioning from non-nursing fields might consider reviewing online direct entry MSN programs as an alternative pathway to achieving qualifications and ensuring academic rigor.

Should Nurse-Midwives Pursue Dual Certification in Mental Health?

Integrating mental health expertise into nurse-midwifery practice can enhance comprehensive patient care, especially in recognizing and managing postpartum mood disorders and anxiety. Pursuing dual certification or targeted training in behavioral health equips nurse-midwives with the skills needed to assess early psychiatric symptoms and collaborate more effectively with mental health professionals. Such interdisciplinary training can lead to improved patient outcomes and a more holistic approach to care. For added flexibility and affordability in further education, consider exploring cheap PMHNP programs.

What challenges do CNM candidates commonly face?

CNM candidates often encounter hurdles that extend beyond academic requirements. Navigating diverse state licensing regulations, securing competitive clinical placements, and balancing rigorous coursework with professional and personal commitments are frequent challenges. Candidates may also face variability in program costs and the need to evaluate quality education pathways, making financial planning and reliable information on program affordability essential. For example, selecting an affordable BSN to DNP online program can help mitigate financial burdens while ensuring quality education that meets clinical standards.

Are there scholarships for nurse-midwifery students?

Yes, there are numerous scholarships and financial aid options available for students pursuing a career in nurse-midwifery. These scholarships are offered by professional organizations, universities, healthcare institutions, and government programs to support students in accredited midwifery programs.

• American College of Nurse-Midwives (ACNM) Foundation Scholarships: The ACNM Foundation offers multiple scholarships, such as the Midwives of Color-Watson Midwifery Student Scholarship and the Varney Participant Award, to support students from diverse backgrounds pursuing midwifery education.
• HRSA Nurse Corps Scholarship Program: This federal program covers tuition, fees, and other educational costs for nursing and midwifery students who commit to working in underserved communities after graduation.
• March of Dimes Graduate Nursing Scholarships: Designed for nursing students specializing in maternal-child health, this scholarship helps fund graduate education for those committed to improving pregnancy and infant health outcomes.
• State and University-Based Scholarships: Many nursing and midwifery schools offer institution-specific scholarships, often based on academic performance, financial need, or commitment to serving rural or underserved populations. Some students also seek out the easiest RN to BSN program to accelerate their education while minimizing costs, making it more affordable to pursue a career in nurse-midwifery.
• Diversity and Inclusion Scholarships: Organizations such as the National Black Nurses Association (NBNA) and the Hispanic Scholarship Fund offer financial aid to underrepresented students in healthcare, including those pursuing nurse-midwifery degrees.

What are the highest-paying industries for CNMs?

Here are the highest-paying industries for Certified Nurse-Midwives (CNMs) along with their average salaries and descriptions:

• Outpatient Care Centers ($136,920): CNMs working in outpatient care centers earn the highest salaries, as they often provide prenatal, postpartum, and reproductive healthcare in specialized clinical settings. These facilities typically offer flexible schedules, lower patient loads, and a focus on preventative care, leading to a high demand for experienced midwives.
• Hospitals ($136,050): In hospital settings, CNMs assist with labor and delivery, emergency obstetric care, and high-risk pregnancies. They work alongside obstetricians, nurses, and anesthesiologists in labor and delivery units, maternity wards, and surgical teams, contributing to their higher earning potential due to the complexity of the cases they handle.
• Offices of Physicians ($126,270): CNMs in physician-owned practices provide routine gynecological care, family planning services, and low-risk prenatal care. While salaries in this setting are slightly lower than in hospitals and outpatient centers, these roles often offer more predictable work hours and greater autonomy in patient care.
• Educational Services ($123,880): CNMs who work in universities, nursing schools, or midwifery training programs educate future nurse-midwives and conduct research on maternal and infant health. While they may earn less than clinical practitioners, they benefit from academic schedules, research opportunities, and career stability.
• Offices of Other Health Practitioners ($118,300): CNMs in independent midwifery practices, birth centers, and holistic health clinics focus on personalized maternity care, water births, and alternative birthing methods. Those looking to manage or open their own practice may benefit from earning a healthcare administration degree, which provides essential business and leadership skills for running a successful midwifery clinic.

The top-paying industries for Certified Nurse-Midwives (CNMs) are those that provide specialized maternal care, including outpatient care centers, hospitals, and physicians' offices. The chart below highlights how these settings offer higher salaries compared to others, demonstrating the financial benefits of working in more advanced or high-demand healthcare environments:

Here’s what graduates have to say about their nurse-midwifery degrees:

"Becoming a Certified Nurse-Midwife was one of the most rewarding journeys of my life. The hands-on clinical training and evidence-based coursework gave me the confidence to support women through pregnancy, birth, and beyond. Now, I get to empower and care for families every day—it's truly a dream come true!" – Shiela

"Midwifery school was both challenging and inspiring, but the mentorship from experienced midwives made all the difference. Learning how to provide holistic, patient-centered care strengthened my passion for women's health. Today, I work in a birth center where I help families experience safe and natural childbirth." – James

"Earning my Nurse-Midwife degree opened doors to an incredibly fulfilling career. The mix of clinical rotations, research, and real-world practice prepared me to handle both routine and high-risk pregnancies. I now work in a hospital setting, and every birth I attend reminds me why I chose this path." – Martha

How Do Nurse-Midwives Stay Updated with Evolving Clinical Practices?

Continuing education is essential for nurse-midwives to maintain clinical proficiency amid evolving healthcare practices. CNMs regularly engage in advanced certifications, specialized workshops, peer-reviewed research, and professional conferences that enhance their ability to provide evidence-based care. Additionally, interdisciplinary courses and targeted training sessions offer opportunities to expand expertise in areas such as patient safety, updated clinical protocols, and innovative care models. Participation in professional associations also supports the exchange of best practices and fosters leadership development. Exploring programs like accelerated nurse practitioner programs can further broaden clinical perspectives and support career advancement without overlapping established educational pathways.

Key Findings

• Certified Nurse-Midwives (CNMs) earn a competitive median annual salary of $129,480, with top-paying industries offering over $211,820 per year.
• CNMs can work in hospitals, birth centers, private practices, academia, public health, and telehealth, allowing for flexibility and specialization.
• The number of CNM positions is expected to grow from 7,200 in 2023 to 7,700 by 2033, reflecting the ongoing need for maternal and reproductive healthcare providers.
• Becoming a CNM requires 6–8 years of education, including a BSN, RN experience, and a graduate-level midwifery degree.
• Numerous scholarships, grants, and loan forgiveness programs help aspiring CNMs manage the cost of education.

Other things you should know about becoming a certified nurse midwife

Can a midwife be called a nurse?

A Certified Nurse-Midwife (CNM) is both a midwife and a nurse, as they are required to have a registered nursing (RN) license before completing advanced midwifery training. However, certified midwives (CMs), who follow a similar educational path but do not hold a nursing degree, cannot be called nurses. The title “nurse-midwife” is specific to those who have completed both nursing and midwifery education.

Do hospitals hire newly certified nurse-midwives?

Yes, hospitals do hire newly certified nurse-midwives, though some prefer candidates with prior labor and delivery or women’s health nursing experience. Many hospitals offer mentorship programs or residency-like training to help CNMs transition into clinical practice. New CNMs can find hospital positions in labor and delivery units, maternity wards, and women’s health clinics, where they work alongside obstetricians and healthcare teams.

What clinical experience do you need to become a CNM?

To become a CNM, students must complete a minimum of 500–1,000 clinical hours in prenatal care, labor and delivery, postpartum care, gynecology, and primary care during their graduate midwifery program. Many programs also require or strongly recommend prior work experience as a registered nurse (RN), particularly in labor and delivery, maternal health, or neonatal care, to strengthen hands-on skills and clinical decision-making.

Can you become a CNM without taking on student debt?

It is possible to become a CNM without significant student debt by utilizing scholarships, grants, employer tuition reimbursement, and loan forgiveness programs. Federal programs like the HRSA Nurse Corps Scholarship and Public Service Loan Forgiveness (PSLF) offer financial relief for CNMs who commit to working in underserved or public healthcare settings. Additionally, some hospitals and healthcare organizations provide tuition assistance in exchange for a work commitment after graduation.

References:

• Baker College. (2021). What Is a Certified Nurse-Midwife and How to Become One? https://www.baker.edu
• U.S. Bureau of Labor Statistics. (2024). OOH: Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners. https://www.bls.gov
• Puts, C. (2023). Midwifery care and maternal health outcomes: A systematic review. Journal of Research in Nursing and Midwifery, 12(4). InteresJournals