How to Become a Certified Nurse Midwife

Certified nurse midwives (CNMs) are advanced practice registered nurses (APRNs) that provide primary care for women across the lifespan, focusing particularly on women’s reproductive health and caring for pregnant women before, during, and directly after pregnancy. Their typical responsibilities include conducting physical assessments and gynecological exams, providing family planning services and preconception advising, and assisting low-risk pregnant women during labor. In some settings, CNMs also provide care to newborns during their first month after birth.

Overview: How to Become a Certified Nurse Midwife

To become a certified nurse midwife, individuals must fulfill the following requirements:

• Earn and maintain an active license as a registered nurse (RN) in their state of residence
• Complete a nurse midwifery program that has been accredited by the Accreditation Commission for Midwifery Education (ACME), the accrediting body of the American College of Nurse Midwives (ACNM)
• Pass the national CNM certification exam administered by the American Midwifery Certification Board (AMCB)
• Apply for licensure/certification as a CNM in their state of residence

Become a Registered Nurse

As CNMs are a type of APRN, they must be licensed RNs before pursuing education and certification in nurse midwifery. To become an RN, individuals must complete a Bachelor of Science in Nursing (BSN), an Associate Degree in Nursing (ADN), or a diploma in nursing from a program that has been accredited by either the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN).

After completing their nursing education at an accredited institution, students must take and pass the NCLEX-RN, the licensure exam administered by the National Council of State Boards of Nursing (NCSBN). Once they have passed the NCLEX-RN, candidates need to apply for an RN license from their state’s board of nursing. Maintaining this license often requires the completion of continuing education credits.

Complete an Accredited Nurse Midwifery Program

To become a CNM, registered nurses must complete a nurse midwifery program that has been accredited by the ACME, which is the accrediting body of the ACNM. On-campus, hybrid, and online accredited nurse midwifery programs are available, and can culminate in a graduate degree (ex. MSN or DNP) or certificate, depending on the program.

(Note: On OnlineFNPPrograms.com, we classify any program that requires three or fewer visits to campus per year as an online CNM program. We consider programs that require more than three visits to the campus per year to be hybrid or on-campus programs, and do not currently include these types of programs on the site.)

Regardless of their class format, all accredited nurse midwifery programs involve rigorous coursework and extensive clinical hours requirements. Nurse midwifery programs’ curricula typically include a combination of foundational courses in advanced practice nursing, such as Advanced Health Assessment and Advanced Human Physiology and Pathophysiology, as well as courses that are specific to nurse midwifery, such as Primary Care of Women and Labor, Birth, and Infant Care. Clinical hours requirements for nurse midwifery programs generally range from 600 to 1000 hours, and give students the chance to work with women in a real clinical setting, fulfilling actual nurse midwifery responsibilities under the supervision of a preceptor.

Types of Nurse Midwifery Degree Programs

Depending on a student’s academic and professional background, several educational pathways exist for RNs who wish to become certified nurse midwives. Below are the main types of nurse midwifery programs that are available to RNs:

• BSN to MSN Programs in Nurse Midwifery are suitable for RNs who have earned their BSN from a CCNE or ACEN-accredited nursing program. These programs are comprised solely of graduate-level courses.

• ADN/RN to MSN Programs in Nurse Midwifery are for registered nurses who have earned their ADN or diploma in nursing from an accredited program, and who would like to earn their BSN and MSN together through one concerted program. These types of programs include both undergraduate and graduate coursework, and often waive certain classes (such as humanities courses or select general education requirements) so that students can take fewer overall units to earn their two degrees, relative to earning their BSN and MSN separately.

• Post-MSN Certificate Programs in Nurse Midwifery are for individuals who have already completed an MSN or higher graduate degree in nursing in a specialty other than nurse midwifery, and who would like to gain training and certification as a nurse midwife. Post-MSN certificates consist of graduate-level coursework, and focus specifically on essential topics in nurse midwifery.

• Doctor of Nursing Practice (DNP) Programs in Nurse Midwifery are typically for individuals who have earned either their BSN or MSN (some DNP programs only accept nurses with an MSN, while other nursing programs have BSN to DNP tracks). DNP programs in nurse midwifery involve a combination of masters-level and doctorate-level coursework. In addition to training students on the clinical responsibilities of nurse midwives, DNP programs may focus on APRN’s role in health policy, and educate students about how to influence health care systems and organizations through research, education, and advocacy.

For more information on nurse midwifery programs, including their admission requirements, typical length of study, and curricula, please refer to our online nurse midwifery programs page.

Coursework for Nurse Midwifery Programs

As mentioned previously, nurse midwifery programs typically contain a combination of general courses in advanced practice registered nursing and courses that focus specifically on the nurse midwifery role. Below is a list of typical courses that students might find in nurse midwifery programs.

Core APRN Courses

• Advanced Health Assessment: How to conduct thorough physical exams, and take accurate medical histories. How to analyze and integrate patients’ physical, psychological, social, cultural, and genetic information into an effective health care plan.
• Advanced Human Physiology and Pathophysiology: The structure and function of the human body and how a healthy human body works. Students study the human body at the organ systems, organ, tissue, and molecular level in order to understand how different systems and mechanisms in the human body work together. How common diseases originate, develop, and affect human health across the lifespan, and how APRNs can use their knowledge of diseases and human physiology to develop sound treatment plans for patient conditions.

Courses Specific to Nurse Midwifery

• Primary Care of Women: How to address the health care needs of women from adolescence on through old age. The unique health issues that women face, such as reproductive health challenges and breast cancer. How to treat common ailments that afflict women, and advise patients in effective self-care.
• Antepartum Management: How a healthy pregnancy should progress, and the common health issues that pregnant women may face prior to birth. How to conduct physical examinations to evaluate the health of mother and fetus, address reproductive health issues/complications that may arise, and advise patients about proper self-care during pregnancy.
• Newborn Care: How to evaluate the health of and care for newborn infants during their first few months of life. The common conditions and syndromes that newborns are at risk of developing, and how to address them.

Obtain Certification Through the American Midwifery Certification Board

Students who have completed an ACME-accredited nurse midwifery program can qualify to take the CNM certification examination administered by the AMCB. The American Midwifery Certification Board’s CNM credential is accepted in all 50 states within the United States, as well as the District of Columbia and Puerto Rico, as proof of an individual’s qualification to practice as a nurse midwife. (Note: all CNMs must also obtain state licensure in order to legally practice within their state of residence.)

To qualify to take the AMCB’s CNM exam, registered nurses must submit a CNM Exam application along with proof of their registered nursing license and verification that they have completed an accredited program in nurse midwifery. The CNM Exam is a four-hour exam that tests students on women’s primary and gynecological care, as well as the antepartum, intrapartum, and post-partum stages of pregnancy. This exam also tests students on newborn care and the professional issues that nurse midwives face in the modern workplace. For a specific breakdown of test content, as well as other details about the examination, students should refer to the AMCB website.

Apply to State Board of Nursing for Certification as a CNM

Once students have passed the AMCB’s CNM examination, they must submit an application to their state’s board of nursing to obtain certification as a nurse midwife in their state of residence. Students can typically find these applications on their state board of nursing’s website.

Most state boards of nursing require nurse midwives seeking state licensure/certification to submit proof that they have completed an accredited nurse midwifery program, evidence of certification through the AMCB, documentation that they have had recent clinical experience (either through an nurse midwifery program or professional work), and transcripts of any relevant nursing education. As state licensure requirements for certified nurse midwives are subject to change, students should contact their state board of nursing to learn about the most up-to-date requirements for state certification/licensure.