Nurse midwife salary guide
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Certified Nurse Midwife Salary Guide

A certified nurse midwife (CNM) is an advanced practice registered nurse (APRN). These master’s level practitioners specialize in caring for mothers and their infants during pregnancy, birth and the postpartum period. They also counsel and treat women from adolescence through menopause, addressing areas such as contraception, fertility and menopause. If you’re interested in this rewarding career, explore our nurse midwife salary guide to learn more about the compensation you can expect in this role. 

How Much Does a Nurse Midwife Make?

Certified nurse midwives are among the highest-paid APRN specialists. The average CNM salary in May 2021, per the Bureau of Labor Statistics (BLS), was $112,540 a year. However, they had a possible range of $61,500 to $166,170, depending on their years of experience, work setting and geographic area. While this amount was slightly down from the previous year’s average annual rate of $115,540, they remain one of the top earners in the healthcare field.

According to Vivian’s salary data for staff CNMs, perm midwives earned an average of $53.77 in early November 2022, while travel nurse midwives earned an average weekly salary of $3,600 during this same period. Travel CNMs bring their knowledge and expertise to care for patients in areas with high need. Thus, medical facilities often pay travel candidates more as an enticement when they have staff shortages. Travel CNMs may also receive housing stipends from their recruiting agencies to offset some living expenses if they qualify.

Where Do CNMs Get Paid the Most?

On average, certified nurse midwives are well-paid everywhere, but compensation varies across the country. According to our salary data, California had the highest average hourly rate for CNMs in early November 2021, ranging from $67 to $91. California often pays more for most nursing specialties, potentially due to its higher cost of living. 

Other states posting above-average hourly pay ranges for CNM jobs during this period included:

  • Washington: $61 to $78
  • Hawaii: $60 to $79
  • New Jersey: $60 to $76
  • New York: $59 to $78

What States Employ the Most CNMs?

The BLS reported that California, New York, Texas, Massachusetts and Pennsylvania had the highest employment levels for nurse midwives in May 2021. In other words, these states have more nurse midwife positions than other U.S. states. However, states with the most nurse midwives per capita include Alaska, Delaware, New Mexico, Vermont and Idaho. These locations have more nurse midwife positions per 1,000 jobs than other U.S. states.

What Types of Facilities Employ the Most CNMs?

According to 2021 BLS data, most nurse midwives work in private physician offices, general medical and surgical hospitals and outpatient care centers. Some CNMs work in offices with other health practitioners as part of an interdisciplinary team or hold state or federal government jobs. However, these settings are less common.

CNMs are highly trained healthcare professionals with a state-specific scope of practice. Depending on the state, they may work independently and collaboratively with an OB/GYN or primary care provider, or they may be required to create a collaborative practice agreement with a qualified physician and have some degree of supervision.

Many CMNs care for patients during pregnancy, labor and delivery. However, they also receive training to provide broader care in gynecologic, sexual and reproductive health. Nurse midwives may:

  • Provide advice on birth control and prenatal care
  • Perform STD testing and treatment
  • Help create birth plans and coordinate with physicians or OB/GYNs
  • Monitor the health of the mother and baby during pregnancy
  • Offer emotional support to expectant mothers
  • Perform prenatal and postnatal examinations
  • Provide postpartum care
  • Care for newborns for the first 28 days of life
  • Provide education to new parents, including breastfeeding tips to new mothers
  • Care for patients through menopause

How Does CNM Pay Compare to Similar Jobs?

As you explore possible career paths, you may consider jobs similar to a certified nurse midwife involving reproductive health, pregnancy and childbirth. You can use Vivian’s salary search tool to compare salaries in different disciplines. The following table compares the average permanent and travel salaries for CNMs and related positions during the first week of November 2022 based on recent job postings.

Position Avg Perm Hourly Rate Avg Travel Weekly Rate
Nurse Midwife $70 $3,600
Obstetrics/Gynecology Nurse Practitioner $69 Info Not Available
Obstetrics/Gynecology RN $48 $2,639
Labor & Delivery RN $48 $2,906
Postpartum RN $46 $2,437

How Can You Earn More as a CNM?

If you’re interested in earning even more in this in-demand nursing field, start with the following salary-boosting ideas:

  • Consider travel nurse midwife jobs: Travel nurse midwives typically earn more than permanent staff midwives because they’re taking on temporary contracts and helping fill staffing shortfalls away from their homes. They also may receive untaxed housing stipends to help offset accommodation expenses if they qualify.
  • Look for lucrative incentives: Many hospitals and agencies offer generous sign-on bonuses for in-demand specialties and hard-to-fill geographic areas. Some companies may offer bonuses for key performance indicators such as high patient satisfaction scores. Review the whole package beyond salary when deciding whether a new role is worth your while. 
  • Be selective about shifts: If you don’t mind working evenings, weekends and holidays, you generally make more money for shifts that usually come with incentives because no one wants to work them. Employers might also offer bonus pay for certain hard-to-fill areas within the facility, so keep an eye out for those opportunities.
  • Seek subspecialty training in areas of interest: You could potentially command a higher salary by focusing on specialized areas like neonatology, lactation and breastfeeding services, genetics and risk assessment, maternal-fetal medicine or one of several other subspecialty areas within the midwifery field.

Nurse midwife salary

What Is the Difference Between a CNM and a Certified Midwife (CM)?

The  American Midwifery Certification Board (AMCB) oversees certification for midwives and offers Certified Nurse Midwife and Certified Midwife credentials. While these roles may sound the same, several differences exist. The primary difference is CMNs are also registered nurses, while CMs aren’t RNs.

Every state licenses CNMs, but only a few states recognize the CM credential. According to the American College of Nurse-Midwives (ACNM), you can work as a CM in the District of Columbia and the following states:

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

Although several other states are pursuing licensure of CMs, as of November 2022, if you live in a state not listed, you must become a licensed RN to become a CNM. Regarding Medicaid reimbursement, CNMs and CMs receive reimbursements in 18 states, but in the remaining states, Medicaid only reimburses CNMs.

However, CNMs and CMs must meet the same core competencies and have identical scopes of practice, including prescriptive privileges. Other similarities between the two include:

  • Have a bachelor’s degree from an accredited college or university program 
  • Possess a graduate degree in midwifery from a program accredited or pre-accredited by the Accreditation Commission for Midwifery Education
  • Meet the ACNM Core Competencies for Midwifery Education
  • Receive clinical education under the supervision of an ACNM-certified CNM or CM
  • Sit for the same board exam
  • Provide a range of primary healthcare services for women of all ages, starting in adolescence

Are CNMs Considered a Type of Nurse Practitioner?

CNMs aren’t a type of nurse practitioner (NP). NPs and CNMs are different types of advanced practice registered nurses. Like CNMs, NPs have advanced classroom and clinical education and different scopes of practice based on their state of practice. While some NPs specialize in women’s health with similar roles, CNMs have a wider scope of practice. Ultimately, these are two separate specialty areas under the APRN umbrella.

How Do You Become a CNM?

Certified nurse midwives must complete a high level of education, including graduate studies. Candidates must first complete an undergraduate program to become an RN. Most candidates earn a Bachelor of Science in Nursing (BSN) to meet the requirements for further graduate study. However, those who previously earned an associate degree can later complete a bridge program at some institutions.

Take the NCLEX Exam

After completing an undergraduate program, you must pass the National Council Licensure Examination for Registered Nurses (NCLEX) exam and apply for state licensure to become a registered nurse. You may want to spend time working as an RN to familiarize yourself with the clinical setting and gain valuable experience before going back to school.

Complete a Graduate Program

CNM candidates must earn an advanced degree, such as a Master of Science in Nursing, but some candidates may pursue a Doctor of Nursing Practice. Midwifery programs that confer eligibility on the graduate to take the national certification exam administered by the American Midwifery Certification Board (AMCB) must be accredited or pre-accredited by the Accreditation Commission for Midwifery Education (ACME). 

In November 2022, only 43 such programs existed nationwide, according to the ACNM. These programs adhere to the core curriculum required for entering midwifery practice and prepare graduates for the CNM exam. Each program has unique admission requirements and offers different pathways and degrees, but it generally takes three years to complete. 

Receive Your CNM Credential

You must pass the certification exam to practice as a CNM in the United States. The AMCB administers the exam, consisting of 175 multiple-choice questions about the antepartum, intrapartum and postpartum periods of pregnancy, and primary care, gynecology and newborn care. The certification fee is $500, and you must renew it every five years by completing three AMCB modules and at least 20 hours of continuing education credits or by retaking the exam.

If you’re ready to earn a nurse midwife salary, your next step is to investigate your state’s accredited programs and certification requirements. You might also want to explore available CNM jobs in the regions where you plan to practice. While it requires time and dedication to get the education you need to become a certified nurse midwife, most practitioners report satisfaction with their salary and a sense of caring for their community members.

Vivian Health

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