A certified nurse-midwife, or CNM, is an advanced practice registered nurse (APRN) specializing in family planning, labor, delivery, and care of the newborn. CNMs provide reproductive care to women and their partners and also treat sexually transmitted infections. A CNM has a master’s degree or higher in addition to being an RN (registered nurse). CNMs practice in clinics, birth centers, hospitals, public health offices, and patients’ homes.
Responsibilities of a Certified Nurse-Midwife
A certified nurse-midwife (CNM) provides care focused on improving the health of women and their newborns. This branch of medicine is referred to as obstetrics (childbirth and care of women giving birth) and gynecology (female reproductive health). CNM’s scope of practice varies by state, from complete independence to some supervision or ongoing collaboration with a physician. A CNM provides nursing-based care with additional expertise in these skills:
- Gathering patients’ medical and personal histories
- Performing annual physical exams, including gynecological exams
- Ordering and interpreting tests from patient samples like urine or blood
- Creating plans of care for labor and delivery with patients
- Providing prenatal care to expectant mothers
- Monitoring women and fetuses during labor
- Delivering babies and responding to complications
- Collaborating with other providers in emergency situations
- Caring for healthy newborns in the first 28 days of life
- Assessing and caring for mothers after birth
- Providing family planning services
- Treating sexually transmitted infections with prescription medications
- Working with physicians and other professionals to care for patients
Certified nurse-midwives are passionate about caring for women and families. Successful CNMs are great at connecting with patients, communicating with coworkers, and handling critical situations. CNMs are also knowledgeable about the cultural traditions surrounding childbirth and are able to respectfully incorporate patients’ wishes into patient-centered plans of care.
Education and Certification
CNMs are also required to complete ongoing education and recertification throughout their careers. Shadowing other providers, skills demonstrations, in-person classes, online lectures, and computer-based testing are all possible examples of continuing education. Each state has its own requirements for the number of hours of education required per year. Failure to complete certain classes or failure to obtain enough hours would make a CNM ineligible to practice. CNMs may be responsible for registering for and reporting their own continuing education hours to their state’s board.
Salary and Job Outlook
The annual mean wage of certified nurse-midwives in the U.S. ranges from $71,580 to $153,310. CNMs in California reported the highest annual mean wage of $169,530, which is an hourly mean wage of $81.50. The CNM profession is expected to grow by 38% between 2022 and 2032, which is slightly higher than the average for all jobs.
Work Environment
CNMs may be most commonly employed by offices of physicians, but many CNMs will also care for their patients at a hospital, birth center, or at a patient’s home during delivery. CNMs work within a group of providers and, at times, will be expected to care for patients usually seen by other providers. Patients have emergencies and may go into labor at any time. CNMs’ schedules and teamwork reflect those possibilities.
Work schedules can be a combination of hours in different locations. For example, a CNM may have clinic hours, birth center shifts to care for laboring patients, and possibly on-call hours. Due to the often unplanned nature of labor and delivery, CNMs can expect to work evenings, nights, weekends, and holidays on a rotating basis.
Path to Becoming a CNM
A certified nurse-midwife is first a certified registered nurse (RN) with a Bachelor of Science in Nursing (BSN). Then, hopeful CNMs complete either a master’s or doctorate degree in nurse-midwifery. Completion of either the MSN or DNP option enables students to take the national certification exam. Certification is required in all 50 states.
Benefits of Being a Certified Nurse-Midwife
A career as a CNM provides opportunities to educate and support patients in some of their most vulnerable moments. Patients look to their CNMs for guidance and education during critical times. CNMs are able to develop connections with families and watch them grow.
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