What Is A Certified Nurse Midwife (CNM) in The USA?
A certified nurse midwife (CNM) helps new mothers throughout their fertility journeys. From pregnancy to postpartum care, they are with their patients every step. But that’s not all — these nurse practitioners treat female patients throughout their lives, from puberty through menopause.
A certified nurse midwife is a registered nurse who specializes in women’s health.
Working as a certified nurse midwife helps you provide prenatal and postnatal care to expectant mothers and play a key role during labor and delivery.
You may not know that certified nurse midwives train to treat various sexually transmitted diseases in male and female patients. While they mostly focus on obstetrics, they are also passionate about reproductive health.
What is the difference between a certified nurse midwife and a nurse midwife?
Certified nurse midwives and nurse midwives are the same things. However, there are different types of midwives with various titles in healthcare.
A certified nurse midwife holds a valid RN license, and they have successfully completed a graduate-level education in midwifery. In addition, CNMs are all certified through the American Midwifery Certification Board.
A certified midwife (CM) does not have to be a nurse. They are non-nurse professionals who completed graduate-level midwife training and are now certified.
There are also certified professional midwives (CPMs) from various backgrounds. Some are RNs; some are not. They can submit a professional portfolio for review through the North American Registry of Midwives, or apply for certification after completing an educational program accredited by the Midwifery Education Accreditation Council.
CNMs who have certification through the American Midwifery Certification Board can directly apply to become a CPM through the North American Registry of Midwives.
In some states, CPMs also have prescriptive authority and can write medical prescriptions for their patients.
Another type of midwife is the direct-entry midwife or DEM. DEMs are midwives who have become a midwife without becoming a nurse. They still undergo education and training, but they are not registered nurses. Each state has its own regulations and requirements for DEM, but they tend to have the least formal amount of education and training.
What is the difference between a certified nurse midwife (CNM) and a labor and delivery nurse (L&D nurse)?
Labor and delivery nurses are RNs with specialized training in caring for laboring mothers. They can also assess newborns and provide immediate postnatal care. CNMs are nurse practitioners with advanced degrees. They also see their patients on a long-term basis, and they act as primary prenatal and postnatal care providers.
While labor and delivery nurses do not deliver babies, a CNM is fully trained and qualified to assist in childbirth. They can deliver your baby vaginally or with assistance, but they do not perform C-sections.
What qualifications does a certified nurse midwife need?
All certified nurse midwives must hold valid RN licenses in their state, then complete a master’s or doctoral midwifery program. They also must complete extensive clinical rounds training before passing a certifying exam.
According to the American Midwifery Certification Board, to become a CNM, you must:
Hold a graduate degree from an accredited program
Have verification from the director of their midwifery program that they have successfully met all the requirements of graduation and completed their degree, as well as the date it was finished
An attestation from the program director that the nurse is performing safe practice as a beginner practitioner
Proof of current RN license
You can learn more about the eligibility requirements for CNM certification in the ACMB’s 2022 Candidate Handbook.
What work does a certified nurse midwife do day to day?
As a nurse practitioner, CNMs can see their own patients and perform various duties. They provide gynecological services, such as pap smears, offer reproductive health and fertility counseling, test for, diagnose, and treat sexually transmitted diseases, and see patients before and after delivery.
Prenatal care planning is a large part of a CNMs job responsibilities. They meet with expectant parents to discuss their birthing options and develop personalized birth plans.
After delivery, CNMs perform follow-up postnatal care. They help new moms adjust to life with a baby, counsel them on common postnatal issues, and treat various conditions they may develop.
In every state but Maryland, CNMs can legally admit patients to hospitals. They can stay to assist their patients throughout labor and delivery; CNMs are also qualified to oversee natural home births and deliveries in birthing centers.
Where do certified nurse midwives work?
Certified nurse midwives can work in hospitals, birthing centers, women’s health clinics, and outpatient physician’s offices. They also tend to commute between the office and hospital or patients’ homes to assist with labor and delivery.
What is it like to be a certified nurse midwife?
Working as a certified nurse midwife is a dynamic career. You usually offer services in multiple settings, and your client care also varies. You perform various gynecological services and consult with patients for some hours of the week.
Then, you attend to mothers in labor during on-call hours. You may visit them in the hospital, attend to them in their homes, or assist with their labor in a birthing center.
Being a certified nurse midwife helps you support women’s health throughout their lives. You can help an adolescent learn about the importance of routine exams, then counsel an experienced mom about her current issues with breastfeeding. Another patient may be in her 50s, experiencing signs of menopause.
This career is multifaceted, fast-paced, and great for a nurse who already loves working in women’s health but wants even more clinical responsibility.
How much do certified nurse midwives make?
Salaries vary for certified nurse midwives based on their education and experience. Generally, as nurse practitioners, a CNM can earn at least $90,000 a year, though they usually earn higher than that.
According to ShiftMed’s research, the average nurse practitioner earns $116,438.80 annually.
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Advantages of choosing a career as a certified nurse midwife
Do you love women’s health, labor, and delivery nursing? Then you could thrive as a certified nurse midwife! For nurses exploring nurse practitioner specialties, pros and cons lists are helpful.
These benefits and disadvantages of being a CNM can help you narrow your focus and decide if this is the right career path for you.
Advantages of choosing a career as a certified nurse midwife
1) Support women throughout their lives
Caring for women’s reproductive health is the cornerstone of being a nurse midwife. You will be present for them during every part of their healthcare, and you can build long-term relationships with your patients.
It is rewarding to watch a woman go through pregnancy, childbirth, and motherhood and support her as she and her body change throughout the journey.
Non-expecting patients are equally special, allowing you to explore other aspects of women’s health nursing through gynecological practice.
2) Experience the miracle of childbirth
You will routinely witness new babies enter the world as a CNM. It is always a magical experience watching a baby be born and celebrating a new life with the family.
3) Independence as a practitioner
CMNs are given far greater career autonomy than nurse midwives or RNs. In some states, nurse practitioners are given full practice authority. This means they can work without a supervising physician. You have just as much responsibility for your patients with full practice authority as a medical doctor.
In states that do not allow full practice authority, you are still granted a lot of freedom in approaching patient care. You work in partnership with a physician, but your patients are still your responsibility, and the care you provide them is self-directed.
4) Dynamic work environments
CMNs can work in various locations, including hospitals, women’s health clinics, birthing centers, and group practices. There are many opportunities to provide care to women and find locations that suit your preferences.
5) In-demand career with a high salary
Across the United States, nurse practitioners in all specialties earn an average of $116,438 annually. According to the Bureau of Labor Statistics, career growth for certified nurse midwives and nurse practitioners is expected to grow by 40% through 2031.
In many parts of the country, nurse practitioners are highly sought-after because of their advanced skills and ability to deliver direct patient care.
Disadvantages of choosing a career as a certified nurse practitioner
1) Irregular work schedule
Many CNMs work rotating shifts, nights, weekends, and holidays. They also have on-call hours to provide support whenever their patients go into labor. For some NPs, balancing their professional lives with their family and relationships can be a challenge.
2) Birth losses
Sometimes, not every birth goes according to plan. Medical emergencies during labor can result in a baby or mother dying. Some pregnancies are already complicated, and the stress of labor and delivery can lead to birthing trauma for patients. Some babies also have severe cognitive deformities or developmental disabilities that are unknown until birth. This devastates the family, and it can be difficult to be a part of.
While most labors and deliveries are not tragic, there is always the possibility of something going severely wrong, so you must be prepared.
3) Your care is somewhat restricted
As a CNM, you are still a nurse, not a doctor. You are not qualified to take on high-risk pregnancies or perform C-sections. This can be frustrating when you’ve worked with a patient for a long time and realize you won’t be able to help them during their pregnancy journey.
4) High-stress Levels
With so many responsibilities, it’s no surprise that many certified nurse practitioners experience chronic stress. Stress can negatively affect your work performance and personal life, so you need the right resources to maintain a healthy balance.
How to become a certified nurse midwife
Becoming a certified nurse midwife starts by earning your RN license. To do this, you will need to complete a bachelor’s of nursing (BSN) program. BSNs are required to complete the next step of your CNM career path — obtaining a graduate degree.
With a midwifery master’s or doctoral program, you can gain clinical experience and sit for a certifying exam as a CNM.
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Frequently asked questions about certified nurse midwives
How long does it take to become a certified nurse midwife?
It takes 6 to 8 years to become a fully certified nurse midwife. You will have to earn a bachelor’s and graduate degrees, then pass a certifying exam. Employers also look for candidates with several years of RN experience.
What’s the difference between a certified nurse midwife and a certified midwife?
A certified nurse midwife is an advanced practice registered nurse who operates as a nurse practitioner. They have a graduate degree and extensive experience working in women’s health. Certified midwives have similar education and training requirements but do not have to be registered nurses.
Are CNMs in demand?
Yes, nurse practitioners as a whole are especially in demand right now. The Bureau of Labor Statistics estimates nurse midwives and nurse practitioner jobs will grow by 40% through 2031. To put that into perspective, the growth rate for all occupations from 2021 to 2031 is 5%.