A midwife is a person who assists a woman during childbirth. The traditional term for this function is “midwifery,” and the art has been active for hundreds of years. In today’s world, the midwife is a trained healthcare provider fully versed in women’s health issues, including all stages of pregnancy, delivery and postpartum care of both the newborn infant and its mother. The role of the midwife is part health care practitioner, part educator and part counselor, supporting the emotional as well as the physical needs of the mother. Nurse-midwives are advanced practice nurses (APNs) who choose to specialize in the field of obstetrics and gynecology.
There are essentially two types of midwife, each with a different title and different requirements for practice.
Direct-Entry Midwives (CPM) Direct-entry midwives, as their name implies, enter directly into a midwifery program without the prerequisite of a college or nursing degree or the necessity of holding any other professional credential. Although there are no formal education or certification requirements, midwives can be licensed and credentialed in various ways. Direct entry midwives are often credentialed as Certified Professional Midwives (CPM) by the North American Registry of Midwives (NARM). The CPM credential indicates that the midwife has graduated from an accredited midwifery education program, or has met the equivalent of all NARM certification requirements, and has passed the NARM national certification examination. This NARM certification must be renewed every three years. An alternative certification with similar requirements, Certified Midwife (CM), is offered by the American College of Nurse Midwives (ACNM). This certification is voluntary, and some states allow the direct-entry midwife to practice with just a state license.
Most direct-entry midwifery education programs take about three years, although education and licensing requirements vary from state to state.
Certified Nurse-Midwife (CNM) Certified nurse-midwife (CNM) is one of the four specialties of the advanced practice nurse (APN). One must first be an RN (Registered Nurse) before becoming an APN or entering midwife training. The CNM certification is issued to registered nurses who have graduated from a midwifery education program accredited by the American College of Nurse Midwives (ACNM), and who have passed a national exam. Many CNMs include education in midwifery as part of an overall master’s degree program. There are currently about 45 advanced degree programs for nurse-midwives.
As many direct-entry midwives have private practices, their income depends on their own rates and on the number of clients and births they perform. According to the Midwifery Education Accreditation Council, midwives charge between $2,000-4,000 per birth, and define a “busy” practice as attending two to four births per month. These figures vary widely depending on the location, experience, and length of care provided.
Most certified nurse-midwives are hospital or clinic employees, with salaries approximately the same as those of another advanced practice nurse specialty, nurse practitioner. According to the U.S. Bureau of Labor Statistics, in 2004, the median annual salary of registered nurses was about $52,330, with a range running from less than $37,300 to a high of more than $74,760. Wages and salaries for nurse-midwives can potentially be significantly higher, as the practice requires more schooling and training.