Becoming a Nurse Midwife

Midwifery, a common practice in many countries worldwide, is increasing in popularity in the United States. The movement to view birth as a natural occurrence in the lifecycle of a woman, instead of one that needs medical attention, has led many Americans to start embracing the practice of midwifing. In fact, more than 90 percent of deliveries are normal and do not require the invasive medical procedures that are sometimes performed "just-in-case", like episiotomies, use of forceps and labor induction.

Being a Midwife

There are two main types of midwives: a lay-midwife and a nurse midwife. Becoming a lay-midwife, also known as a direct-entry midwife, does not require a nursing degree. Individuals gain experience through an apprenticeship in which they attend births and learn the specifics of prenatal and postnatal care from a trained midwife. Lay-midwives offer their services primarily to patients who want to have a homebirth.
 
Becoming a nurse midwife, on the other hand, requires a nursing degree. Unlike lay-midwives, nurse midwives can also legally prescribe necessary tests and medications to patients. They are highly trained in all aspects of gynecological care, including annual pap smears, breast exams and general women's health issues. This is advantageous to clients seeking a non-traditional or a more personal form of primary provider care (PPC) beyond childbirth.

Becoming a Nurse Midwife

General requirements for those interested in enrolling in a nurse midwife school program include:
  • bachelor's degree
  • current registered nurse license in one of the 50 states
  • GPA of 3.0 or higher
  • one to two years nursing experience.

Getting Certified

The American College of Nurse Midwives (ACNM), formed in 1955, offers accreditation to become a certified nurse midwife (CNM). In 1994, ACNM introduced guidelines and a certification program for lay-midwives to become certified midwives (CM). Certification ensures that CMs are educated with the same skills and knowledge as a CNM even though they are not registered nurses.
 
Currently only three states, New York, New Jersey and Rhode Island, recognize CMs officially and grant licenses to practice. The list is short, but supporters of midwifery see this as a positive move towards more empowerment and control for women over their own healthcare choices.

Finding Work as a Midwife

Individual state laws regulate how and where a midwife can practice. Opportunities are more readily available for a certified nurse midwife since CNM status ensures licensure from the state. Doctors are also more likely to offer nurse midwives formal physician back up in case of an emergency. Affiliation with a doctor or practice provides peace of mind for patients. Keep in mind, however, that physicians may require the midwife to follow certain practices and procedures.
 
Places in which nurse midwives work include:
  • birthing centers
  • clinics
  • hospitals
  • private physician practices
  • private practices of their own.

Salary Expectations for Midwifes

Annual salaries for entry-level certified nurse midwives as of 1999, according to a survey conducted by the University of Minnesota, were between $35,000 and $40,000. More experienced certified nurse midwife salaries range upwards of $80,000, with the average being around $55,000 annually.
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