Certified Nurse Midwife – Requirements, Procedure, Salary, and Job Outlook
Nursing is a widely growing profession due to the reforms in the health care industry. It is a great career option as it allows growth, job stability, and specialization in many fields. If you are one such aspirant who wants to make a career in nursing, then certified nurse midwife provides you one such opportunity. Certified nurse midwives are advanced practice registered nurses who provide care to the women before, during, and after pregnancy. They also assist women with general illness and health issues in all stages of life. In some cases, they work with a gynecologist and other physicians and assist them in treating women suffering from chronic or severe diseases.
Becoming a CNM is not an easy task, and you need to follow a complete step by step procedure to get certified. As these midwives are APRN, so a candidate must have a minimum of ADN or BSN degree with a valid RN certificate and they must complete the certification course and get licensed by the regulatory authority of the state.
There are different bodies that accredit the midwife education programs and process of certification. Some are listed below:
- The graduate level programs for midwifery education are certified by the Accreditation Commission for Midwifery Education (ACME).
- Certificate to the candidates is given by American Midwifery Certification Board (AMCB).
- The CNM programs are accredited by the National Commission For Certifying Agencies (NCCA).
- The whole process and standards of midwifery education and practices are maintained by the American College of Nurse-Midwives (ACNM).
What are the personality traits required for an Ideal CNM?
- Physically and mentally fit
- Helpful and caring
- Flexible and Observant
- A good listener
- A good communicator
- Fully able to work on her own and with the team
- Calm, responsible, intuitive, and patient
- Respectful, objective, and non-judgmental
- Reproductive Health
- Women’s Health
- Neonatal care
- Women’s acute care
- Women Primary care
- Consultation and education
- Intrapartum, Postpartum, and Antepartum issues
- Non-surgical gynecological care
- Puberty and Menopause
- Childbirth and delivery related issues.
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Other than providing general care to women, certified nurse midwife performs many tasks and has a wide area of responsibilities. It includes:
- providing prenatal care; family planning services,
- performing the gynecological exams,
- delivering babies,
- providing surgical assistance to physicians during cesarean birth,
- managing emergency situations during labor like hemorrhaging,
- assisting the physicians during cesarean birth,
- wellness care, educate the family of the newborn on how to lead a healthy life, etc.
Stepwise Procedure to Become a Certified Nurse Midwife
Step 1: Entrance Requirements
To pursue a career as a certified nurse midwife, you must have completed graduation in the field of nursing from an accredited college or university.
After completing the graduation, you need to become a registered nurse by completing the whole procedure including obtaining a license by taking National council licensure exam for registered nurse (NCLX-RN). Now, If you are an RN but do not have a graduate degree, you can obtain it through bridge programs, before nurse-midwifery education.
Step 2: Completing the program
A candidate must complete the training/ course for nurse midwife from an AMCB approved school that has curriculum approved by NCCA.
The whole course of nurse midwives is a long term program and the curriculum includes:
- Advanced health assessment.
- Management of psychiatric symptoms and their assessment.
- Care and management of the antepartum, intrapartum, and postpartum woman.
- Cultural and linguistic competency
- Management of complications faced by the mother, if any.
- Preventing the diseases and promoting health.
- Assessing the common primary care sign, symptoms, and managing them.
- Issues in nurse-midwifery professional practice.
- Clinical pharmacology
- Health care of the newborn and the mother
The aspirants can complete the course online or offline depending on their requirements but, only a specific portion of the course is available online.
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Step 3: Clinical Experience
Completing only the theoretical session is not enough to get the certificate. You have to complete the clinical practice also. This part must be completed under the supervision of either a CNM/CM or APRN, who has the clinical expertise and knowledge of the content of this section.
A candidate must know:
- Management of primary care for women- reproductive health, pregnancy, etc.
- Care for the newborn.
- How to manage sexually transmitted disease in the males (1).
After completing step 2 and 3, a master’s or doctoral degree will be granted which is the minimum requirement for the certification exam.
Certification is provided by a national accreditation body, i.e., AMCB, and all states have to abide by the guidelines. Only those candidates are eligible to take the certification exam who have completed their nurse-midwifery program from the institute accredited by ACNM-ACME.
General Requirements / Eligibility for Examination
Apart from following the above-mentioned procedure, there are certain other criteria that are required to be fulfilled to be eligible for the examination.
- S/he must not be convicted under the jurisdiction, and must not have any case or evidence of abuse against midwifery practices.
- Must not have his/her previous or current nursing license suspended or revoked.
- Must not fill false details in the application form.
- Must submit the document of the practitioner, duly attested by the director of the nurse-midwifery program.
- The candidate must meet the institutional requirement for a graduate degree which is verified by the director (2).
Once a candidate fulfills the above criteria, s/he has to fill and submit the examination form to get approved as a candidate for certification.
In addition to the form, an aspirant has to submit examination fee which is to be paid either online or by check along with a copy of RN license.
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Format of Examination
The AMCB offers a computer-based testing for nurse-midwifery examination. The exam will consist of 175 multiple choice questions which are to be answered within 4 hours. After the completion of the exam, the results will be provided immediately on the site of the exam itself. The exam will cover the following areas (3):
- Newborn =7%–16%
- Intrapartum =17%–26%
- Postpartum =15%–18%
- Women’s Health/Primary care = 8%–16%
- Well Woman/Gynaecology = 15%–18%
- Antepartum =19%–26%
You have to pass the exam in no more than 4 attempts within 24 months of completion of your CNM programs. To retake the test, one must wait for 30 days after the first attempt and for 90 days, for the remaining attempts.
Scheduling the Exam
The candidates have to schedule the exam directly with the Applied Measurement Professionals, Inc. (AMP) , which administers the exam. If a candidate wants to change or reschedule the exam, then:
- If he reschedules the exam within 2 days, no extra fees will be charged (applicable only once).
- In any other case, s/he has to submit the rescheduling fee.
- The fee for the certification exam is $500.
- Reexamination fee is same as the examination fee.
- For rescheduling the exam, you have to pay $121.
- For every retest, you have to submit the whole fee again.
General documents that are to be submitted:
- Copy of current, active license must be submitted with a written letter from U.S jurisdiction that confirms the validity of the certificate.
- A copy of web verification of the license.
The certificate is valid for 5 years and upon completion of this duration, the candidates have to renew the certificate in order to continue as a CNM. To maintain the current certificate or for recertification, AMCB proposed a method called certificate maintenance program whose purpose is to keep the CNM certificate valid, and to provide the status of the certificate to licensing authorities.
Certificate Maintenance Program
There are two methods under this program through which an individual can maintain his/her certification.
Method 1: Certificate Maintenance Method
If you prefer this method then, you have to complete 3 AMCB modules within the 5-year certification cycle. The modules consist of the below-mentioned areas, and a candidate has to complete one out of each of the three modules.
- Antepartum and Primary Care of the Pregnant Woman
- Intrapartum, Postpartum, and Newborn
- Gynecology and Primary Care for the Well-Woman.
Along with this, you must obtain 20 hours of educational units, submit the fee (if any), and apply for the recertification by filling the recertification application form online (4).
Note: There are several methods to complete the educational hours like: attending a conference, publishing an article, etc. These educational units must be approved by any one of the following: ACNM, ACCME, AMA, AAFP, ACPE, AANP and NPWH.
CMP Fee Structure
The annual fee for maintaining certificate is $55. If you wish to pay the complete 5-year fee, then you have to pay $247.50.
If you lose the certificate anyhow or want a replacement certificate, then you have to pay $50.
Note: If you failed to complete the CMP requirements then your certificate lapses and no new certificate will be issued.
Method 2: Re-examination Method
Under this method, an individual has to appear for the examination during or after the 4th year of his certification cycle. If you have opted for this method and have given the test, then you can not move to option 1, and you must pass the exam before the expiration of your current certificate i.e. by the end of 5th year. Along with this, pay the examination fee ($500) and submit the recertification application form.
Although it is a specialization, there are many environments and health care settings where a nurse midwife can work. This may include:
- Birthing Centers
- Private Practices
- Public Health Departments,
- Health Maintenance Organizations (HMOs), etc.
According to BLS, the environments that generated most of the jobs are
- Physicians office – 48%
- Hospitals (state, private and local)- 28%
- Others (outpatient care center, educational services, health practitioners) – 13%
According to the Bureau of Labor statistics, the employment opportunities for nurse midwives and similar profession are expected to grow by 31% from 2014 to 2024, which is greater than the average of all occupation taken together.
This growth is due to the fact of health-care legislation, growing number of illness among women, and increased focus on preventive care.
The Bureau of Labor Statistics states that the annual mean salary of a nurse midwife and similar professions is $104,740 for the year 2015.
The hourly salary for the same profession is $50.36 per hour.
According to indeed.com, the average salary of a certified nurse midwife is $82,000, as of May 2016, which is 42% higher than the average salary of all occupations.