When people think of “midwife” they might visualize a natural setting birth, bringing a baby into the world in a birthing pool with classical music playing in the background. This could not be further from the truth. While rural-setting midwives may face unique challenges, nurse midwives actually belong to a group of advanced practice nurses (including nurse practitioners and nurse anesthetists). These are highly skilled nurses who hold a Master’s Degree in Nursing (MSN), and help women and families through all stages of pregnancy and pre-planning for pregnancy. They are compassionate, consummate professionals who are versatile in their caregiving.
As a nurse midwife, you’ll provide care to women—both during the stages of pregnancy and planning, and in a general wellness capacity. As such, you’ll perform women’s health exams, educate patients on healthy lifestyles and assist with reproductive health issues for both patients and their partners.
Your primary responsibility will be to your patients and their newborn babies but every day will present a new challenge for nurse midwives. Here’s a sampling of what you might do on a day-to-day basis:
- Perform physical exams
- Work with women and their partners on pregnancy planning
- Be a health care provider for women
- Record pertinent information regarding patients’ health
- Deliver prenatal, newborn and postpartum care to mother and baby
- Be present to assist or manage the actual childbirth
- Help with postpartum issues, such as depression
- Refer patients to specialists for a variety of pregnancy and/or women’s health issues
Nurse midwives are most often employed in the following settings, according to the U.S. Bureau of Labor Statistics (BLS):
Offices of other health practitioners
Outpatient care centers
Some nurse midwives may make house calls, but it’s important not to confuse a nurse midwife with a doula, who frequently provides in-home care to assist with birth and postpartum issues such as lactation.
Who is the best fit to become a nurse midwife? What traits and skills will help you succeed in your career? Granted, skills can be learned but traits are often inherent, so you may have them or you don’t, but they can be cultivated and improved upon. That said, here are some proven traits and skills that make for a great nurse midwife:
- Dependability: Baby could make a surprise entrance at any time so you’ll need to be there when he or she does.
- Compassionate: You’re a caregiver at the core, so you’ll need empathy and compassion to deal with people’s situations.
- Supportive: You may be delivering a woman’s first baby or fifth, and you’ll need to support your patients through some painful, perhaps nervous times.
- Flexibility: All nurses need to be flexible to deal with a crisis that could happen at any given moment.
- Organized: If you have six patients whose due dates are around the same time, you’ll need to be highly organized to accommodate everything that must be done.
- Good-natured: Some of your patients will be nervous and anxious. You’ll need to be able to maintain a good disposition while you dispel their fears and reassure them.
- Good ethical standards: All nurses must have good boundaries and be ethical in their dealings.
- Resourcefulness: Babies don’t know anything about timetables and schedules and all their needs are immediate. You may need to dig deep in order to help new moms deal with pre- and post-birth health issues and solutions.
Because nurse midwives are highly specialized, there aren’t a huge number in the United States, according to the BLS. They cite a national employment figure of 6,500 nurse midwives. But the good news is there is huge opportunity for growth in this field, with the BLS anticipating a 21 percent job growth rate over the coming decade. If you consider the national average for all careers is seven percent, you’ll realize how much potential there is for future nurse midwives. In fact, that equates to adding some 64,000 jobs through 2026.
Where is the largest employment level for nurse midwives? The BLS says the top five states that employ nurse midwives are as follows:
The metro areas and cities that employ the most nurse midwives are as follows:
Nurse midwives earn a healthy salary, with the BLS reporting a median annual wage of $99,770, with the top 10 percent in the field earning over $142,510 annually.
Lowest 10 percentile
Highest 10 percentile
Of course, how much you’re paid often depends upon the healthcare facility in which you work. Here’s how salaries stack up by industry:
Outpatient care centers
Other health practitioner office
General and surgical hospitals
Location also is a major factor in your salary. The BLS reports these states as highest paid employers of nurse midwives:
|State||Annual Mean Salary|
To get more granular, here are the top paying metro areas/cities for nurse midwives:
|Metro||Annual Mean Salary|
|San Jose, CA||$146,200|
|San Francisco, CA||$137,260|
If you’ve earned your two-year associate’s degree in nursing (ADN) and have aspirations to move beyond registered nursing and into an advanced practice nursing field, you’ll need to earn your bachelor’s degree in nursing (BSN) or take an RN-to-BSN program, which will cut down your time in the classroom. If you’re just starting out and feel sure this is the path for you, you’ll want to enroll in, and complete, an accredited four-year BSN program immediately.
You’ll then be ready to pursue the required Master of Science in Nursing (MSN) degree, which will prepare you for your certified nurse midwife career.
In your BSN program you’ll study subjects such as these:
- Anatomy and physiology
- General chemistry
- Issues in nursing
- Holistic nursing and complementary alternative therapies
- Communities and family
Your MSN program will concentrate more on core and specialized nurse midwifery topics such as these:
- Labor and delivery
- Women’s health issues
- Physiology and pathophysiology
- Applied pharmacology
- Intrapartum and postpartum care
- Midwifery issues
- Research methods
- Public policy
- Care of newborns
- Advanced practice nursing roles and issues
You may be able to choose between an education and management focus at this level as well. This means if you want to teach nurse midwifery or do research, you’ll have that option. If you choose management, you may find yourself in an administrative role in a birthing center or women’s health facility.
Like all advanced practice nursing roles (and nursing in general), you’ll want to earn your certification. The American Midwifery Certification Board (AMCB) issues the exam that results in you being able work as a certified nurse midwife.
The purpose of certification is to uphold and set the national standard for the field, and to protect the public by ensuring certified nurse midwives meet the recognized safe practice criteria.
To become a certified nurse midwife, you must successfully pass the computer-based test called the Certification Examination in Nurse Midwifery. There are requirements to be eligible to sit for the exam, such as:
Proof of licensure
from an accredited institution approved by the Accreditation Commission for Midwifery Education (ACME)
$500 exam fee
This exam consists of 175 multiple choice questions that test your knowledge in the following areas:
- Well Woman/Gyn
- Women’s Health/Primary Care
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No matter what level you’re at in your nursing career, we can help you find the right accredited school to either take the first steps toward your ADN or BSN, or put you on the path to a master’s in nursing program so you can reach your goal of becoming a nurse midwife.