How to Become a Midwife

October 10, 2023


Reviewed by:

Luke Hartstein

Former Admissions Committee Member, NYU Grossman School of Medicine

Reviewed: 10/10/23

Do you have a passion for women’s healthcare and considering a career as a midwife? Read on to find out how to become a midwife!

Midwives are becoming more popular within healthcare because they focus on wellness and patient empowerment, taking a more inclusive and holistic approach towards maternal care. 

Oftentimes, seeking out a midwife allows patients to decide the outcomes of their care, making it particularly appealing for many. 

The growing demand for midwives may encourage those interested in medicine to explore alternative avenues of practice. Here, we will be answering questions about the profession, from what a midwife is, to different types of midwives, how to become a midwife, and more.

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What Is a Midwife?

While many might have a broad understanding of a midwife’s role in maternal care, what they actually do can be a mystery to most. A midwife is a clinical professional with extensive training and education in healthcare with a focus on women’s health. 

Midwives take a holistic approach in their practice by developing a trusting relationship with their patients, allowing them to take part in the decision-making process throughout their pregnancy. Patients have the opportunity to make more choices when it comes to how they receive care. 

If you’re thinking about becoming a midwife, expect to perform gynecological exams and provide overall maternal care, including educating mothers-to-be on breastfeeding, health, nutrition, and exercise during pregnancy, and infant care. 

Additionally, as a midwife, you will be helping primary care professionals with support during labor and delivery, educating patients on their options regarding childbirth and possible outcomes, counseling, and postpartum care for infants. 

Depending on the type of midwife, and whether or not they are certified, some midwives can also provide a variety of healthcare services for sexual and reproductive health, gynecologic health, family planning, and primary care, in addition to maternal care. 

Midwives can also assess, diagnose, and treat patients in partnership with various healthcare establishments such as public healthcare, private clinics, ambulatory care clinics, homes, hospitals, and birth centers.

Types of Midwives and Education Requirements

It is challenging to discuss the roles midwives take within healthcare without understanding the different types of midwives that are out there. Most practicing midwives hold certification through the American College of Nurse-Midwives (ACNM) or the North American Registry of Midwives (NARM), while some don’t. 

With this said, each type of midwife has a varying range of responsibilities and capabilities for patient care. In the US, midwives are categorized either as nurse midwives, who are trained and certified in nursing and midwifery, or direct entry midwives, who only receive midwife training. We will be going over each type below. 

Certified Nurse-Midwife (CNM)

Certified nurse-midwives, or CNMs, are trained under nationally accredited programs for nursing and midwifery. They hold access to all healthcare settings, such as private clinics, public healthcare, and hospitals. CNMs are also able to assess, diagnose, and treat patients in collaboration with a primary healthcare professional. 

To become a CNM, you’ll need to hold a bachelor’s degree in nursing as well as a graduate degree in nursing, followed by an accredited nurse-midwife program. Due to their extensive education, CNMs are legally able to practice in all states in the US.

Among all the different types of midwives, CNMs have access to the most healthcare settings and hold the most hands-on roles when it comes to patient care. CNMs often spend more time with patients during labor than their primary provider, giving you assistance and encouragement throughout the process. 

Direct-Entry Midwife (DEM) 

Direct-Entry Midwives, or DEMs, are those who do not get formal nursing training. The main differences between CNMs and DEMs and their subtypes are that they typically pursue a bachelor’s education in fields unrelated to nursing and enter into a graduate midwifery program.  

Certified Midwife (CM)

The capacity of a CNM and a Certified Midwife (CM) are virtually similar. CMs are able to provide patients with the same care and have access to the same healthcare settings that a CNM does with the exception of prescribing medication. 

The main difference between CM and CNM educational paths is that CMs are not required to complete a BSN, though they are still required to hold a bachelor’s degree in a health-related field and a graduate-level degree in midwifery. 

Since CMs are not trained nurses, there are limitations to the geographic locations in which they are able to practice. 

While CNMs are legally recognized practitioners in all states in the US, CMs are not. As per the American College of Nurse-Midwives, CMs are currently only able to legally practice in the following states:  

  • Delaware
  • Hawaii
  • Maine
  • Maryland
  • New Jersey
  • New York
  • Oklahoma
  • Rhode Island
  • Virginia 
  • District of Columbia

With this said, depending on where you would like to practice may determine the best route to take. 

Certified Professional Midwife (CPM)

Certified Professional Midwives, or CPMs, are able to perform similar services as CNMs and CMs, however, they only work in out-of-hospital settings. Just like CMs, CPMs are not authorized to prescribe medications. 

To become a CPM, you must be able to demonstrate your knowledge and practical understanding of working outside hospitals or public healthcare settings. Since CPMs typically work with private clinics and provide care in their patients’ homes, this is what sets them apart from CMs. 

CPMs attain their certifications through NARM and must either successfully complete NARM’s Portfolio Evaluation Process or graduate from a program accredited by the Midwifery Education Accreditation Council (MEAC). To date, 28 states authorize CPM practice. 

Whether you would like to pursue a CNM or a DEM, you’ll have to take the certified nurse-midwifery exam, which is administered by the American Midwifery Certification Board (AMCB), to earn your certificate. 

Finally, you’ll have to apply for licensure in the state you would like to practice. Depending on which path you choose, this may be easier. For instance, CNMs will have many more options in terms of where they can practice, whereas DEMs generally have fewer options and may find licensure a bit more challenging depending on the state.

Midwife Salaries

Now that you have an idea of the type of training and education it takes to become a midwife, you might be asking how much a midwife makes. 

According to the US Bureau of Labor Statistics, midwives make an average of between $77,510 to $171,239 annually in common workplace settings such as physician’s offices, hospitals, schools, and local government establishments. Midwives within outpatient care centers are reported to earn the most at $153,310 per year. 

Another aspect that can impact midwife salary is geographical location. The states with the highest employment levels for midwives and their respective annual mean wages are as follows: 

  • California: $169,530
  • New York: $126,610
  • Florida: $97,690
  • Texas: $93,280
  • Minnesota: $116,780

These rates can reflect the overall demand for midwives within these regions, costs of living, and overall quality of life.

Should You Become a Midwife? Factors to Consider

While job security may be appealing, there are many more considerations you should make before taking on a position within healthcare–or any field, at that. 

In the case of becoming a midwife, it’s essential to think about whether it aligns with your values and your goals. Identify your passions and ask yourself whether you think being a midwife would be a fulfilling path for you. 

If you answered yes to the above, then you can continue your thought process by asking yourself whether or not you would be willing to go through the years of training and education required to be a certified midwife. 

With a bachelor’s degree and the base master’s degree that is required to complete your training, the process will take approximately seven years. 

Another thing to consider is what type of midwife you’d like to become. Ideally, taking the path toward a CNM will reap more benefits, especially in terms of where you’d like to practice geographically. As mentioned previously, many more options are available for CNMs. However, the training you receive will be much more intensive.

FAQs: How to Become a Midwife

Now that we have gone over how to become a midwife, we will cover some frequently asked questions that might help you decide whether or not this is the right path for you!

1. What Do I Need to Be a Midwife?

To be a midwife, you’ll need a bachelor’s degree and a Master’s in Midwifery from an accredited program. If you’d like to become a CNM, you’ll be required to have a BS in Nursing, while DEMs don’t need a specific degree to pursue a career as a midwife. 

To be a CPM, you’ll need to formally demonstrate your knowledge and experience in non-hospital settings. This is done through NARM’s Portfolio Evaluation Process. Alternatively, you’ll have to graduate from a program accredited by the Midwifery Education Accreditation Council (MEAC) to meet this requirement.

Regardless of what type of midwife you become, it is mandatory to attain licensure in the state you wish to practice. 

2. How Long Does It Take to Become a Midwife?

Generally speaking, it will take about seven years to complete your education as a midwife. You’ll have to commit four years to your undergraduate degree and three years for a graduate degree in midwifery.

3. Is It Difficult to Be a Midwife?

As with any career path, becoming a midwife will certainly come with challenges. Your education and training will prove to be intensive as you’ll be required to develop a deep understanding of clinical practices, obstetrics, infant care, family planning, ethics, and many more. 

Additionally, if you take the path of CNM, you’ll have to undergo nursing training as well, which is rigorous by nature. 

4. How Do I Become a Midwife Without Being a Nurse?

To become a midwife without nursing training, you can pursue a path as a direct-entry midwife or a DEM. This usually requires the completion of a Bachelor’s degree in any field–preferably something healthcare-related for CMs, followed by the completion of an accredited midwife graduate program.

5. Is Midwifery Easier Than Nursing?

While both have similarities and stark differences in practice, it’s always challenging to label one as easier or more challenging than the other. The answer to this question ultimately depends on your passion and capacity to handle the stresses of either profession. 

6. Is It Worth Being a Midwife?

It certainly is worth being a midwife if you’re passionate about women’s health, reproductive health, and providing care. Logistically speaking, becoming a midwife is worth it due to its promising career outlooks and salary.

Final Thoughts

While the path to becoming a midwife is often long and challenging, it is often a rewarding one. As healthcare professionals, midwives are able to care for and empower the patients they work with. They offer a holistic approach to maternal care and medical care overall. 

If you’re considering a career as a midwife, ensure that you are passionate about the work you do!

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