How to Become a Nurse Midwife in North Carolina - Midwife Schooling Requirements for 2025

by Imed Bouchrika, Phd

Co-Founder and Chief Data Scientist

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Many aspiring healthcare professionals wonder exactly how to become a nurse midwife in North Carolina. With the state seeing a 15% rise in demand for maternal healthcare in recent years, the need for qualified nurse midwives has never been more urgent. Pursuing this career not only ensures job security but also offers the chance to improve maternal and infant health outcomes, especially in underserved communities. 

I have studied this topic in depth and will explain each aspect clearly. In the following sections, I will walk you through the key requirements, certification processes, and more, so you can make informed decisions about your future in nurse midwifery.

Key Points About Becoming a Nurse Midwife in North Carolina

• A 15% surge in maternal healthcare demand over recent years has led to a notable rise in the need for experienced nurse midwives in the state.
• An accredited nurse midwifery graduate program typically takes 2-3 years and prepares you for advanced practice.
• Aspiring nurse midwives must pass the national certification exam by the American Midwifery Certification Board (AMCB) and apply for state certification to practice legally in North Carolina.

Table of Contents

1. What is the minimum degree requirement to become a nurse midwife in North Carolina?
2. What are the admission requirements for nurse midwife programs in North Carolina?
3. What courses are included in nurse midwife programs in North Carolina?
4. What are the clinical training requirements for nurse midwife programs in North Carolina?
5. How long does it take to become a certified nurse midwife in North Carolina?
6. How much does it cost to attend nurse midwife school in North Carolina?
7. What financial aid options are available for nurse midwife students in North Carolina?
8. Are there pathways for nurse midwives to transition into nurse practitioner roles in North Carolina?
9. What are the top accredited nurse midwife schools in North Carolina?
10. Which advanced degrees support career advancement for CNMs in North Carolina?
11. What organizations accredit nurse midwife programs in North Carolina?
12. Other Things to Know About Becoming a Nurse Midwife in North Carolina

What is the minimum degree requirement to become a nurse midwife in North Carolina?

To become a nurse midwife in North Carolina, the minimum degree requirement is a Master of Science in Nursing (MSN) with a specialization in nurse-midwifery. This advanced degree lays a strong foundation by combining rigorous nursing education with focused training in midwifery, enabling graduates to handle complex maternal and newborn care confidently.

The curriculum emphasizes evidence-based care throughout a woman’s lifespan, preparing nurse midwives to support pregnancy, childbirth, and postpartum needs with skill and compassion. Aspiring professionals benefit from clinical experiences in diverse healthcare settings, which are essential to understand the unique challenges and opportunities within North Carolina’s varied communities, especially in rural and underserved areas. 

Choosing the right nurse midwifery graduate programs in North Carolina means engaging with a curriculum that meets core competencies established by leading professional organizations. The MSN program integrates training in primary care, gynecologic care, and family planning, reflecting the broad scope of midwifery practice and the multifaceted role nurse midwives play in patient care.

This comprehensive education also aligns with growing opportunities in the field, as the demand for nurse midwives continues to rise. For those exploring nursing career options, this degree is not simply a credential but a pathway to developing the clinical expertise and thoughtful judgment necessary for advanced practice in midwifery. Such preparation is vital for making a meaningful impact on women’s health across the state.

What are the admission requirements for nurse midwife programs in North Carolina?

Admission to nurse midwife programs in North Carolina demands both academic readiness and professional experience, reflecting the complexity of the best specialty career choice for nurses. Meeting these criteria ensures candidates are well-prepared to succeed and contribute meaningfully.

• Minimum Degree Requirement: A Bachelor of Science in Nursing (BSN) from an accredited ACEN or CCNE program is mandatory for all applicants.
• Minimum GPA: Most programs expect an undergraduate GPA between 2.7 and 2.75 overall, with a preference for a 3.0 or higher in the nursing major.
• RN License: A current, unrestricted RN license in North Carolina or a compact state is required; some programs only admit out-of-state applicants from South Carolina.
• Clinical Experience: At least one year of paid clinical experience as an RN is necessary, preferably including labor and delivery, completed within three years before applying.
• Letters of Recommendation: Three professional references are required, ideally from MDs, certified nurse midwives, nurse practitioners, or nursing supervisors familiar with the applicant’s clinical work.
• Personal Statement: A statement outlining career goals and motivations for pursuing midwifery must be submitted.
• Interview: Selected applicants participate in a personal interview with midwifery faculty after application review.
• Additional Prerequisites: Completion of an introductory statistics course (grade C or better) and sometimes a basic health assessment course is required.
• International Applicants: Must provide CGFNS-validated credentials, demonstrate English proficiency, and meet licensure rules, often including a telephone interview.
• Immunizations and Background Check: Documentation of required immunizations, current AHA BLS certification, and a criminal background check are mandatory before enrollment.
• Unique North Carolina Requirements: Some programs emphasize commitment to serving underserved populations and restrict out-of-state applicants to South Carolina residents only.

Certified nurse midwifery is a field primarily made up of experienced professionals, with most practitioners entering after years of nursing education and clinical practice. In the chart below, the age distribution suggests that midwifery often attracts individuals later in their careers, following substantial preparation and hands-on experience. This trend highlights the advanced qualifications and maturity commonly found among certified nurse midwives.

What courses are included in nurse midwife programs in North Carolina?

In North Carolina, nurse midwife programs are structured to provide a comprehensive education that blends rigorous coursework with extensive clinical practice. The nurse midwife program curriculum North Carolina emphasizes advanced knowledge and practical skills essential for serving diverse communities effectively.

Core courses in North Carolina nurse midwifery schools typically include:

• Advanced Health Assessment: Develops the ability to perform thorough physical, psychological, and social evaluations of women and newborns, laying the groundwork for accurate diagnosis and individualized care planning.
• Reproductive and Sexual Health: Focuses on managing reproductive health issues from adolescence to menopause, including family planning, fertility, and common gynecological concerns, preparing students for a broad spectrum of women’s health needs.
• Pharmacology for Advanced Practice Nurses: Provides in-depth understanding of medication use specific to maternity and women’s health, covering drug interactions, pharmacokinetics, and safe prescribing tailored for midwifery practice.
• Pathophysiology: Examines disease processes related to pregnancy and women’s health, equipping students to identify and respond appropriately to complications and coexisting conditions.
• Perinatal Care: Offers detailed knowledge of prenatal, labor, delivery, and postpartum care to support mothers and infants throughout childbirth.
• Newborn Care: Teaches assessment and management of healthy and at-risk newborns, emphasizing early detection of complications and promotion of infant well-being.
• Evidence-Based Practice and Research: Builds skills in critically evaluating research and applying findings to improve maternal and newborn healthcare quality.
• Leadership and Professional Issues: Prepares students for leadership roles by addressing healthcare policy, ethics, collaboration, and advocacy within the clinical setting.
• Primary Care for Women: Covers preventive care and management of common acute and chronic conditions tailored to women’s health needs across their lifespan in North Carolina.
• Clinical Practicum: Requires 500–1,000 supervised clinical hours, allowing students to apply classroom knowledge in real-world settings under expert guidance.

This curriculum reflects the core courses in North Carolina nurse midwifery schools designed to prepare graduates not only for certification but also for impactful practice. For those exploring further, understanding what requirements are needed to become a charge nurse can also provide valuable context for leadership pathways in nursing.

What are the clinical training requirements for nurse midwife programs in North Carolina?

In North Carolina, nurse midwife programs demand a minimum of 4,000 clinical hours completed over at least 24 months. This extended hands-on experience spans diverse healthcare environments, such as hospitals—including labor, delivery, and postpartum units—birthing centers, OB/GYN clinics, and community health centers. These varied settings prepare students to handle a broad spectrum of patient needs, from routine births to more complex situations requiring advanced clinical judgment.

Throughout clinical training, students focus on several essential competencies. These include prenatal care, where they learn comprehensive pregnancy assessment and education; labor and delivery management, emphasizing support for physiologic birth and complication handling; postpartum care involving physical recovery and emotional support; newborn assessment, including resuscitation and feeding guidance; as well as well-woman and primary care, which cover gynecologic exams, contraception counseling, and chronic disease management.

Preceptors, typically seasoned nurse midwives or physicians, play a vital role by mentoring students, overseeing their clinical work, and ensuring mastery of required skills. Their guidance not only shapes clinical competence but also evaluates readiness for independent practice.

North Carolina’s regulatory landscape requires graduates of accredited programs to pass the American Midwifery Certification Board exam and mandates at least 24 months of clinical experience before full independent licensure, underscoring the state's commitment to patient safety and professional excellence. This depth of training becomes even more critical in light of the many rural communities across the U.S. that still lack access to maternity care providers, as shown below.

How long does it take to become a certified nurse midwife in North Carolina?

The path to becoming a CNM in North Carolina starts with earning a BSN, which typically takes four years of full-time study. After completing the degree, graduates must pass the NCLEX-RN exam to gain RN licensure. While not always mandatory, many graduate programs prefer applicants with at least one year of clinical RN experience to ensure they bring practical insight to advanced training.

Next, aspiring CNMs must complete graduate-level education—either an MSN or a DNP with a focus on midwifery. An MSN typically takes two to three years, while a DNP can require an additional one to two years. These programs combine rigorous coursework with hands-on clinical experience in maternal health, aligning with national standards set by the Accreditation Commission for Midwifery Education.

Once graduate education is complete, candidates must pass the national certification exam through AMCB and apply for state licensure in North Carolina. The full journey—from BSN through certification—usually spans seven to eight years, depending on study pace, clinical hour requirements, and licensure processing time. Those who complete this path enter a rewarding career with strong financial potential, especially in industries that offer the highest salaries for nurse midwives, as shown in the chart below.

How much does it cost to attend nurse midwife school in North Carolina?

The cost of attending nurse midwife school in North Carolina can vary significantly depending on the type of institution and your residency status. At public universities like East Carolina University (ECU), in-state students can expect to pay around $3,963 per credit hour, while out-of-state students may pay nearly double that, at approximately $7,322 per credit hour. Since most nurse midwifery programs require 40 to 55 credit hours, tuition alone could range from roughly $158,000 to over $400,000, depending on these variables.

Private and online programs may offer more predictable pricing. For instance, Frontier Nursing University offers a flat tuition of $38,775 for its Master of Science in Nursing with a nurse-midwifery focus, regardless of state residency. However, students must still account for additional mandatory fees—including application, clinical lab, and graduation fees—which can add several hundred dollars per term. Other required expenses like textbooks, clinical supplies, and certification-related costs typically total $1,500 to $2,500.

Students should also prepare for indirect costs that can arise during their training. Travel and lodging may be necessary for clinical placements, especially in rural areas. Liability insurance is another requirement for clinical participation, adding to the overall financial planning needed to successfully complete a nurse midwifery program in North Carolina.

If you want to understand how long does it take to become a womens health nurse practitioner and the financial commitment involved, carefully reviewing each program’s official tuition and fee schedule is crucial. 

What financial aid options are available for nurse midwife students in North Carolina?

Financing advanced nursing education in North Carolina requires careful navigation of diverse aid options tailored to nurse midwife students. Combining federal, state, institutional, and program-specific support can significantly lessen financial burdens, making this vital profession more accessible.

• Federal Loans and Grants: Direct Unsubsidized and Graduate PLUS Loans offer substantial funding, while some federal grants and work-study funds may be available depending on eligibility.
• State Grants and Scholarships: Programs like the North Carolina Nurse Scholars Program reward commitment to teaching or serving in state healthcare with scholarships.
• Institutional Scholarships: Universities provide merit- and need-based awards specifically for advanced nursing students, often requiring separate applications.
• National Scholarships: Organizations such as the AANP offer scholarships based on academic and professional merit within nursing specialties.
• Loan Repayment Programs: HRSA initiatives support graduates working in underserved areas, easing debt through loan forgiveness or repayment.
• Work-Study and Assistantships: Part-time employment opportunities help students earn income while gaining relevant experience.

When I spoke with a nurse midwife from North Carolina who graduated locally, she described the financial aid process as “a puzzle that required patience and persistence.” She recalled juggling multiple applications for scholarships and loan programs, then strategically combining a state scholarship with federal loans to cover tuition.

The work-study position she secured not only eased her expenses but also enriched her clinical understanding. Reflecting on the journey, she said, “Each piece of aid felt like a stepping stone, not just money, but encouragement that I was supported in this demanding path.” Her experience underscores the importance of exploring every available option thoughtfully and proactively.

Are there pathways for nurse midwives to transition into nurse practitioner roles in North Carolina?

In North Carolina, integrating nurse practitioner training with midwifery practice can broaden clinical opportunities and diversify professional roles. Combining advanced coursework with hands-on clinical experience allows nurse midwives to expand their scope of practice while meeting separate licensure requirements. Exploring options such as the top nurse practitioner programs in North Carolina can provide targeted pathways for dual certification and enhanced expertise.

What are the top accredited nurse midwife schools in North Carolina?

Choosing the right accredited nurse midwifery programs in North Carolina is essential for those aiming to become Certified Nurse-Midwives (CNMs). Graduation from an ACME-accredited program not only ensures eligibility for state licensure but also prepares students with rigorous clinical experience and strong professional networks. These programs balance academic excellence with real-world practice, a vital combination for success in this rewarding field.

• East Carolina University – MSN in Nurse Midwifery/Certificate: ECU offers the state’s only ACME-accredited nurse-midwifery program, featuring a hybrid format that blends online coursework with hands-on clinical experiences throughout North Carolina. This program is ideal for working nurses seeking flexibility without sacrificing quality clinical training.
• Frontier Nursing University (Distance/Online Option): Though based in Kentucky, Frontier’s ACME-accredited program is popular among North Carolina students due to its online delivery and flexible clinical placements statewide. It is nationally recognized for emphasizing care in rural and underserved communities, producing a significant portion of the nation’s nurse-midwives.
• Georgetown University – MSN in Nurse Midwifery/Women’s Health Nurse Practitioner: Georgetown provides an online program accessible to North Carolina students, combining nurse-midwifery with women’s health for career versatility. Its strong faculty expertise supports students through local clinical placements, enhancing practical skills and professional growth.
• Vanderbilt University School of Nursing – MSN in Nurse Midwifery: Vanderbilt’s hybrid program welcomes North Carolina residents and includes brief on-campus intensives alongside distance learning and local clinical rotations. Known for national rankings and faculty mentorship, it ensures comprehensive preparation for CNMs.
• Baylor University – DNP in Nurse Midwifery: Baylor’s ACME-accredited DNP program offers online coursework with clinical site options in North Carolina. It uniquely integrates advanced practice and leadership training, appealing to nurses pursuing a terminal degree and aspiring to roles beyond clinical care.

For those exploring the best nurse midwife schools in North Carolina has to offer, understanding these programs’ strengths helps align educational goals with career aspirations. The path to becoming a CNM often includes navigating online and hybrid options, clinical placements, and program accreditation—all critical to licensure and professional success. Additionally, learning about the obstetrics nurse career can provide valuable context for what lies ahead after completing an accredited program.

Which advanced degrees support career advancement for CNMs in North Carolina?

Advanced degrees are essential for CNMs in North Carolina who aim to elevate their careers beyond initial certification. These programs equip professionals with the skills and credentials to take on leadership, education, and specialized clinical roles within the healthcare system.

• MSN Nurse Midwifery Track: This foundational degree prepares nurses for primary healthcare roles focused on women and is required for APRN licensure. Graduates can pursue senior clinical positions and mentorship opportunities.
• Doctor of Nursing Practice: As the highest practice-focused degree, the DNP enables advancement into executive leadership, clinical education, and health policy roles. It emphasizes evidence-based practice and quality improvement.
• Post-Master’s Certificate in Nurse Midwifery: Designed for MSN-prepared nurses in other specialties, this certificate provides targeted midwifery training, allowing APRNs to broaden their clinical scope.
• Dual Focus Master’s Degrees (Nurse-Midwifery/WHNP): These programs prepare CNMs to also become Women’s Health Nurse Practitioners, increasing versatility and enhancing care options in underserved areas.

What organizations accredit nurse midwife programs in North Carolina?

Accreditation ensures the quality and legitimacy of nurse midwife programs in North Carolina, with the ACME serving as the primary accrediting body. ACME is the only organization recognized by the U.S. Department of Education to accredit midwifery programs nationwide. Its standards are specifically designed to assess the educational quality and clinical rigor necessary for safe and effective midwifery practice.

In North Carolina, programs like the one at East Carolina University are ACME-accredited, meaning graduates are eligible to sit for the AMCB exam and pursue licensure. Choosing an accredited program is essential for students seeking professional recognition, career mobility, and access to national certification. When evaluating nurse midwife program tuition in North Carolina, it’s equally important to weigh accreditation status to ensure your investment supports long-term professional goals.

For those exploring educational pathways, options such as hybrid and online formats at accredited institutions like ECU provide flexibility without compromising standards. For students interested in advancing their nursing education efficiently, resources outlining the easiest RN to MSN online programs to get into can be invaluable in making informed decisions that balance cost and academic rigor.

What do nurse midwives in North Carolina say about their careers?

• Completing my nurse midwifery program at the University of North Carolina Chapel Hill was an enriching experience that deeply connected me to the local community. Starting my teaching career in a local school has allowed me to nurture future nurse midwives, sharing both clinical knowledge and my passion for maternal health. North Carolina’s diverse population and rich cultural heritage present unique challenges and opportunities that keep me motivated every day. I feel privileged to contribute to the health and well-being of families across the state while continuing to grow professionally in a supportive environment. - Andrea
• Finishing my studies at Duke University’s nurse midwifery program gave me a strong foundation grounded in evidence-based practice and patient-centered care. Transitioning into teaching at a local school has been incredibly rewarding, especially as I witness students develop their skills and confidence. North Carolina’s blend of urban and rural communities offers the chance to impact women’s health in varied settings, which has broadened my clinical perspective. The state’s commitment to healthcare innovation and education makes it an ideal place for career advancement and lifelong learning. - Latisha
• After graduating from East Carolina University’s nurse midwifery program, I found my passion for community impact amplified by working closely with underserved populations in North Carolina. The personal growth I’ve experienced through this career is profound, especially as I see the tangible difference made in maternal and infant outcomes. Teaching in a local school also allows me to give back by preparing dedicated professionals who will continue this vital work. North Carolina’s environment and resources support a fulfilling career that blends professional development with heartfelt service. - Jamie

Other Things to Know About Becoming a Nurse Midwife in North Carolina

Can I be a midwife without a nursing degree in North Carolina?

No, you cannot become a CNM in North Carolina without a nursing degree. You must first become a registered nurse, complete a graduate midwifery program, and pass a national certification exam. Only CNMs are licensed to practice midwifery in the state. Other non-nursing midwife paths exist but are not recognized as CNMs.

What is the difference between a nurse midwife and a midwife in North Carolina?

ACNM is a registered nurse with graduate-level midwifery training and national certification. CNMs can prescribe medications and work in hospitals or clinics. Other midwives, like direct-entry or traditional midwives, may lack nursing credentials and have limited recognition in North Carolina. Only CNMs are licensed to provide full maternal care in the state.

Is a midwife in North Carolina higher than an RN?

A CNM has more education and a broader scope of practice than a general RN, especially in maternal care. CNMs must earn an RN license, complete graduate studies, and pass a certification exam. They often work independently and earn higher salaries than RNs. However, both roles are essential and collaborative, not hierarchical.

Is becoming a nurse midwife in North Carolina hard?

Yes, it’s challenging but possible with dedication. You must earn a BSN, become an RN, complete a graduate midwifery program, and pass a national exam. The process involves rigorous academics and clinical training. While demanding, it leads to a rewarding and impactful career in maternal health.

References:

• Chapel Hill OBGYN. (n.d.). What training is required to be a midwife? Chapel Hill OBGYN. https://chapelhillobgyn.com/blog/how-to-become-a-midwife-in-nc/

• East Carolina University College of Nursing. (n.d.). Nurse midwifery admission process. ECU College of Nursing. https://nursing.ecu.edu/msn/midwifery/nurse-midwifery-admission-process/

• Frontier Nursing University. (n.d.). Admissions criteria: Master of Science in Nursing. Frontier Nursing University. https://frontier.edu/admissions/admissions-criteria-msn/

• Midwife Schooling. (n.d.). How to become a nurse midwife in North Carolina | CNM programs. Midwife Schooling. https://www.midwifeschooling.com/north-carolina/

• North Carolina Board of Nursing. (n.d.). Certified nurse midwife. North Carolina Board of Nursing. https://www.ncbon.com/certified-nurse-midwife-0

• North Carolina Affiliate of the American College of Nurse Midwives (NCACNM). (n.d.). Become a midwife. NCACNM. https://www.ncmidwives.org/become-a-midwife