Become a Certified Nurse Midwife (CNM) – Education, Licensure & Salary

“For me, midwifery is a form of activism. It involves striving to safeguard people’s reproductive rights and freedoms. However, many individuals may not fully understand the implications and intricacies involved when opting for midwifery.”

Nikia Grayson, DNP, Chief Clinical Officer, Choices Center for Reproductive Health in Memphis, Tennessee

Certified nurse midwives (CNMs) are advanced practice nurses who provide primary care services to women of all ages, from adolescence through menopause. In addition to well-woman care, CNMs offer family planning counseling, preconception care, labor and delivery support, and postpartum care. From fertility through post-menopause, CNMs are highly trained professionals who offer evidence-based, patient-centered care. 

Consistently, CNMs help provide quality outcomes for their patients. Research published in the journal Policy, Politics, & Nursing Practice found that women who had low-risk births “had lower odds of a cesarean birth, induction/augmentation of labor, complications of birth, postpartum hemorrhage, endometritis, and preterm birth and higher odds of a vaginal birth, vaginal birth after cesarean, and breastfeeding than women whose births were attended by physicians.” 

In addition to being expert caregivers, CNMs are also strong advocates for women’s health and well-being. They work tirelessly to promote health equity and access to quality care, and they are a powerful force in the fight against maternal mortality. CNMs are trained in both nursing and midwifery, are certified by the American College of Nurse-Midwives, and must be licensed to practice in their state. In most states, CNMs are advanced practice registered nurses (APRNs), although a few states only require national certification and a registered nurse (RN) license to practice. 

Currently, the demand for CNMs is steady compared to all other jobs. The Bureau of Labor Statistics (BLS 2023) estimates that between 2022 and 2032, there will be a 6 percent increase in jobs in this field, which is double the national average of 3 percent for all jobs.

A career caring for mothers and babies as a CNM can be very rewarding. Keep reading to learn more about how to enter this field with our step-by-step guide and comprehensive list of state licensure requirements. 

Meet the Expert: Nikia Grayson, DNP, MPH, MSN, MA, CNM, FNP-C, FACNM

Dr. Nikia Grayson is the esteemed chief clinical officer at the Choices Center for Reproductive Health in Memphis, Tennessee. Recognized for her role in the revival of Black midwifery in the southern region, her efforts are centered on education and training. She is dedicated to broadening the range of birthing choices for Black mothers and birthing individuals. 

Dr. Grayson is a devoted advocate for inclusive reproductive and social justice, tackling health inequities and systemic racism that pervade the healthcare system by delivering culturally sensitive care. Her impactful work has drawn recognition from various community platforms, organizations, educational establishments, and fellowship programs. Among these are the University of Tennessee Health Science Center, Frontier Nursing University, and the Healthy Communities Fellowship. What is something many people don’t know about the certified nurse midwife profession?

Dr. Grayson: Certified nurse midwives offer an extensive range of healthcare services that go beyond merely pregnancy and childbirth. While our expertise lies in prenatal care and labor and delivery, CNMs also provide comprehensive women’s health services throughout their life stages. This includes family planning, gynecological care, and management of menopause.

It’s a common misconception that our role is limited to maternity care. We adopt a holistic approach emphasizing counseling, education, and support to empower our patients. Our goal is to help them make informed decisions about their healthcare. What is one piece of advice you would give to a certified nurse midwife who is starting out?

Dr. Grayson: Always remember why you chose to be a midwife and prioritize fostering relationships with your patients. It’s integral to our role as midwives to be attentive and truly listen, giving importance to our patients’ concerns, validating their experiences, and actively involving them in their care and decision-making process.

As midwives, one of our fundamental roles is to uphold people’s autonomy, which is crucial. Establishing relationships based on trust and rapport with our patients significantly shapes their healthcare experiences and potentially other areas of their lives. This can lead to improved communication and overall patient satisfaction.

Additionally, I encourage newer CNMs to seek guidance from seasoned midwives. Mentorship can provide invaluable insights, especially when navigating the complex healthcare system. In a field like midwifery, which is still expanding and needs an abundance of practitioners, such mentorship can prove extremely beneficial.

For me, midwifery is a form of activism. It involves striving to safeguard people’s reproductive rights and freedoms. However, many individuals may not fully understand the implications and intricacies involved when opting for midwifery. 

Despite the challenges, I wholeheartedly believe in the importance and fulfillment of this profession and would choose it again without hesitation. Yet, it’s crucial to acknowledge that it’s a demanding field. We must be proactive in influencing healthcare policies and regulations surrounding midwifery. Without such efforts, practicing this profession in our country could become increasingly difficult, so understanding this aspect is equally vital.

How to Become a Certified Nurse Midwife (CNM)

Step 1: Complete High School Or Equivalent (Four Years)

Being a CNM is a highly skilled and demanding profession. To be successful, CNMs must have a strong foundation in both the sciences and the liberal arts. They must understand and use complex medical terminology, maintain accurate records, and effectively communicate with patients and their families. In addition, midwives must be able to work long hours, sometimes under stressful circumstances. As a result, completing high school or earning a GED is essential for anyone who wants to pursue a career in this field.

Step 2: Attend A Nursing Program At An Accredited School (Two to Four Years)

To be a CNM, one must first complete an associate of science in nursing (ASN) or a bachelor of science in nursing (BSN). These programs educate students with the knowledge and skills necessary to become successful registered nurses and prepare them to sit for the national certification exam. 

In addition to providing students with the theoretical knowledge necessary to become an RN, nursing programs also include clinical components that allow students to gain hands-on experience. These clinical rotations can take place in various settings, such as hospitals, clinics, and long-term care facilities

Step 3: Pass the National Council Licensure Examination Practical Nurse Exam: The NCLEX-RN (Timeline Varies) 

All states require that applicants for an RN license pass the National Council Licensure Examination Practical Nurse Exam (NCLEX-RN). This comprehensive exam evaluates a candidate’s knowledge and skills in providing quality nursing care. 

Step 4: Obtain Entry-Level Work Experience (Timeline Varies) 

Before pursuing additional education as a CNM, obtaining entry-level work as an RN is important. Working as an RN allows them to gain a valuable foundation of knowledge and skills they can draw upon throughout their careers. During this time, they learn how to assess patients, develop treatment plans, and administer medication. In addition, RNs gain experience in working with other medical professionals, which is essential for CNMs who often collaborate with doctors and nurses. 

Step 5: Complete a Graduate Nursing Degree in Midwifery (18 months to Four Years)

With an undergraduate degree in nursing and a few years of entry-level work experience, aspiring CNMs can apply for and attend a graduate midwifery nursing program. Students should ensure the Accreditation Commission for Midwifery Education (ACME) accredits their program, as this can be required for licensure and is required for American Midwifery Certification Board (AMCB) certification. The degree completed can be either a master of science in nursing (MSN)  or a doctor of nursing practice (DNP). If a nurse holds a master’s degree in another field, they can complete a post-master’s certificate. 

Step 6: Obtain American Midwifery Certification Board (AMCB) Certification (Timeline Varies) 

American Midwifery Certification Board (AMCB) certification is required in most states to be licensed as a CNM and provide care to patients. This certification ensures that CNMs have the knowledge and skills necessary to provide high-quality patient care and perform all the duties required for this role. 

Step 7: Meet The Requirements For State Licensing (Timeline Varies) 

A license to practice as a CNM or an advanced practice nurse (APRN) is required to practice in every state. The requirements will vary by state. Use the detailed guide below to learn about the requirements to practice as a CNM in every state.

What Does a Certified Nurse Midwife Do?

There are a variety of settings where CNMs can work. Typically, they work in hospitals, clinics, or private practices, although some may work in birth centers or have home birth practices. In recent years, the demand for CNMs has grown as more women seek out alternatives to traditional obstetric care. As a result, CNMs are now working in various settings, allowing them to best meet their patients’ needs. 

Day-to-day duties for CNMs can include:

  • Obtaining health histories from patients
  • Ordering, performing, and interpreting diagnostic tests
  • Monitoring patients during labor and delivery
  • Providing postpartum care
  • Caring for newborn babies during the first few weeks of life
  • Educating patients about pregnancy and childbirth
  • Counseling to patients who are considering abortion or adoption
  • Assisting in the management of gynecologic conditions
  • Performing minor surgical procedures
  • Completing well woman exams
  • Administering STI screenings 
  • Prescribing medications as needed

How Much Do Certified Nurse Midwives (CNMs) Make?

The Bureau of Labor Statistics (BLS May 2022) estimates that the 7,950 CNMs practicing in the US earn $122,450 per year on average. The percentiles for wages are:

  • 10th percentile: $77,510
  • 25th percentile: $102,510
  • 50th percentile (median): $120,880
  • 75th percentile: $137,010
  • 90th percentile: $171,230

Certified Nurse Midwife Certifications

In most states CMNs must be board-certified to practice. The American Midwifery Certification Board (ACMB) is the certification agency for CNMs. Eligibility requirements to sit for the exam include completing an Accreditation Commission for Midwifery Education (ACME) accredited certified nurse midwife program with either an MSN or DNP and a current RN license in the US. Candidates must apply for the exam, submit their documentation, and pay the $500 examination fee. 

Certified Nurse Midwife (CNM) Licensure Requirements By State

State Licensing Authority Eligibility & Details Renewal Requirements

Virginia Board of Nursing

In Virginia, CNM license requirements include:

  • Evidence of a current Virginia RN license or RN license with multi-state privilege
  • Complete online application and fee of $125 through online license portal
  • Certification of professional certification for the specialty area of educational preparation issued by the American Midwifery Certification Board
  • Submit an official transcript from a graduate degree program in nursing, sent directly from the education institution

License renewals for CNMs in Virginia are required biennially.

The renewal fee is $80, and CNMs must either have a current national certification or complete 40 hours of continuing education.

Kimmy Gustafson

Kimmy Gustafson


Thanks to her experience writing in healthcare, Kimmy Gustafson has delivered in-depth articles on timely topics for since 2022. Her aim is to assist both students and professionals in navigating the intricate process of selecting a nursing program and understanding the ever-evolving realm of nursing education.

Kimmy has been a freelance writer for more than a decade, writing hundreds of articles on a wide variety of topics such as startups, nonprofits, healthcare, kiteboarding, the outdoors, and higher education. She is passionate about seeing the world and has traveled to over 27 countries. She holds a bachelor’s degree in journalism from the University of Oregon. When not working, she can be found outdoors, parenting, kiteboarding, or cooking.

Rachel Drummond, MEd

Rachel Drummond, MEd


At, Rachel Drummond has applied her extensive experience in education and mindfulness to elucidate the importance of self-care for nursing students since 2022. Through her writings, she underscores the role of mental and physical well-being in fostering resilient and compassionate healthcare professionals.

Rachel is a writer, educator, and coach from Oregon. She has a master’s degree in education (MEd) and has over 15 years of experience teaching English, public speaking, and mindfulness to international audiences in the United States, Japan, and Spain. She writes about the mind-body benefits of contemplative movement practices like yoga on her blog, inviting people to prioritize their unique version of well-being and empowering everyone to live healthier and more balanced lives.