Become a Midwife

ACNM Advocacy: Advancing the Practice of Midwifery

Being or becoming a midwife requires rigorous educational preparation as well as a commitment to improving sexual and reproductive health care. This section of the ACNM website provides a multitude of resources for aspiring midwives, new midwives, and those in all stages of their careers.

Many different starting points for a career in midwifery are possible! Review information about these, and don’t miss the Frequently Asked Questions (FAQs). If you’ve received your midwifery education in another country, the pages for midwives educated abroad will highlight the steps you must take in order to practice in the US.

For midwives who are returning to practice after time away from the profession, and for all those looking for midwifery jobs, we have suggestions and resources available for you. Looking for Continuing Education information? You’ve come to the right place.

Interested in a teaching career? We have networks for midwives who teach nurses, midwives, medical students and residents, and a wealth of resources for midwifery preceptors. You’ll also find information about our sister organizations: the American Midwifery Certification Board (AMCB), which administers the national certification exam leading to the CNM and CM credentials, and to the Accreditation Commission for Midwifery Education (ACME), which accredits midwifery and nurse-midwifery education
programs.

FAQs

We encourage persons interested in becoming a midwife to spend some time with a local midwife, learning about the profession, practice settings, and prospects for the future. Use our Find-a-Midwife search engine to locate a midwife in your local community. In addition, there are a number of books that are either written by midwives about their lives or include interviews with midwives, that will provide a picture of the life of a midwife.

It is best to have a thorough grounding in basic sciences, such as chemistry, biology, and microbiology. In addition, courses in sociology and women’s studies will be very helpful for a career in midwifery. There are many pathways to midwifery education, including an undergraduate degree in nursing, an accelerated RN in route to graduate education in midwifery, or completing science prerequisites then entering graduate midwifery education directly.

All programs accredited by the Accreditation Commission for Midwifery Education (ACME) require a bachelor’s degree for entry. Many also require that applicants be registered nurses, although some programs currently have options for people with degrees in other disciplines. Many programs require that the bachelor’s degree be in nursing.

Most programs have a limited number of spaces to admit new students each year because of the intensive faculty-to-student ratio needed to graduate quality midwives. It is, therefore, not unheard of for a prospective student not to be accepted the first time she/he applies to a midwifery education program. Contact the program you are interested in directly about specific program prerequisites.

Midwifery salaries vary widely based on geographic region, responsibility and experience level. A number of variables can affect salaries for CNMs and CMs including: type of practice setting (private practice, hospital, birth center, home birth, health clinic), geographic part of the country, type of location (urban or rural), benefits packages offered with salary, hours worked per week, and type of care provided (full-scope of sexual and reproductive health services, pre-natal care, gynecologic care, etc.)

Midwives work in a variety of settings including private practices, hospitals, birth centers, health clinics, and home birth services. The numbers and types of opportunities available to new graduates often depend on the individual’s work preference and vary across the country and in different locations (urban or rural). Visit the online midwifery career center at acnm.midwifejobs.com.

It is also possible for midwives with entrepreneurial spirits to set up their own practices, establishing themselves as health care providers in the community of their choice.

CNMs have legal authority to practice in every state, the District of Columbia, and most of the US Territories. CMs are recognized in 11 states and DC (AR, CO, DE, HI, MD, ME, NJ, NY, OK, RI, VA, and the District of Columbia). Several more states are working on CM licensure.

All midwifery programs accredited by ACME teach the conduct of birth outside the hospital setting. The majority of education programs are able to offer clinical learning experiences in the community setting with midwifery preceptors who practice in birth centers and/or homes. If you are very interested in out-of-hospital birth experiences, contact the midwifery education program director before you apply to be sure that such experiences are available at that program.

Many midwifery education programs offer optional international clinical experiences. Check with individual programs for opportunities.

The type of academic credit and degree awarded may be different for each program. All ACME-accredited midwifery education programs award a Masters Degree, Doctor of Nursing Practice (DNP) or Doctor of Midwifery (DM) degree; some programs offer a master’s completion option for CNMs or CMs who do not have Master’s degrees; and several programs offer a post-graduate certificate option for those graduate-prepared advanced practice nurses who want to expand their practice to include midwifery, or for students who are becoming CMs and have an MPH or other health-relates degree.

Upon graduation from an ACME-accredited program, individuals are eligible to take the national certifying exam offered by the American Midwifery Certification Board (AMCB). Upon successful completion of this exam, individuals are granted a Certificate in either Nurse-Midwifery or Midwifery.

Individuals who are registered nurses, but do not have a bachelor’s degree may become nurse-midwives either by completing a BSN or bachelor’s in another field, then attending a graduate midwifery program. Many accredited nurse-midwifery programs are in schools of nursing that offer bridge programs to facilitate progression through the bachelor’s degree in nursing to midwifery and the Master’s degree.

You have two options. You can enter your graduate midwifery program directly after meeting certain prerequisites which will lead to becoming a Certified Midwife (CM). Alternatively, you can become a Certified Nurse-Midwife (CNM) by completing an accelerated post-bachelors program that leads to a BSN, followed by your graduate midwifery education.

Resources

Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs) are educated in graduate-level midwifery programs accredited by the Accreditation Commission for Midwifery Education (ACME). CNMs and CMs pass national certification examination administered by the American Midwifery Certification Board (AMCB) to receive the professional designation of CNM (if they have an active RN at the time of the certification exam) or CM.

See how the CNM and CM credentials compare to other midwifery credentials in the United States.


Legal Recognition
Laws and regulations governing the practice of midwifery are rapidly changing. CNMs and CMs are regulated on the state level, thus professional practice and interaction with other healthcare professionals, such as physicians, can vary from state to state. CNMs are legally recognized to practice in every state in the US and in the District of Columbia. CMs are currently legally recognized to practice in Arkansas, Colorado, Delaware, Hawaii, Maine, Maryland, New Jersey, New York, Oklahoma, Rhode Island, Virginia, and the District of Columbia.

For individual state statutes and regulations, check with the regulatory agency in each state. This may be the state board of nursing, the board of medicine, the board or midwifery, or the state department of health or public health.

Midwifery as practiced by certified nurse-midwives (CNMs) and certified midwives (CMs) encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide care for all individuals who seek midwifery care, inclusive of all gender identities and sexual orientations. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. They conduct physical examinations; independently prescribe medications including but not limited to controlled substances, treatment of substance use disorder, and expedited partner therapy; admit, manage, and discharge patients; order and interpret laboratory and diagnostic tests; and order medical devices, durable medical equipment, and home health services. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. These services are provided in partnership with individuals and families in diverse settings such as ambulatory care clinics, private offices, telehealth and other methods of remote care delivery, community and public health systems, homes, hospitals, and birth centers.



This information comes from the ACNM Standard Setting Document “Definition of Midwifery and Scope of Practice of Certified Nurse-Midwives and Certified Midwives” (2021). For the full text, please see click here.

Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs)
 are educated in graduate-level midwifery programs accredited by the Accreditation Commission for Midwifery Education (ACME). CNMs and CMs pass a national certification exam administered by the American Midwifery Certification Board (AMCB) to receive the professional designation of CNM (if they have an active RN at the time of the certification exam) or CM.

There are 46 midwifery education programs in the United States accredited or pre-accredited by the Accreditation Commission for Midwifery Education (ACME). The mission of ACME is to advance excellence in midwifery education. All ACME-accredited programs adhere to standards set by the ACME Board of Commissioners (BOC) for graduates to meet competency for safe beginning practitioners of midwifery. Each program has its own admission requirements and offers different pathways and degrees. The information in the links below outlines the admission requirements, program structure, clinical opportunities, and the financial aspects of the current ACME accredited midwifery education programs.

To learn more about ACME visit ACME’s webpage which will have the most up-to-date list of accredited programs. Prospective students should reference the education program website and/or contact the program director to verify that this information is still accurate. 

Financial aid is available from a number of sources to assist you in financing your midwifery education.

The following information is by no means exhaustive, but provides initial leads and resources for financial aid.

  • Contact the financial aid officer at the schools you are considering attending. They are professionals at finding scholarships, loans and other forms of assistance and can be a very valuable resource.

  • Congress appropriates millions of dollars for a variety of programs supporting students, including loans/ scholarships for eligible applicants and service paybacks for those who work in underserved/rural areas. Extensive information on federal funds can be found at the Health Resources and Services Administration (HRSA) Web site.
  • The A.C.N.M. Foundation provides up to six scholarships every year of $2000-$4000 each to midwifery students who are ACNM members. Guidelines and applications, as well as a list of recent award winners, are available at on the foundation website. Questions can be directed to the Foundation Office at (240) 485-1850 or [email protected].
    • Student nurse-midwives/student midwives are eligible to join ACNM. To become a member, click here.

  • The Indian Health Service (IHS) is committed to encouraging American Indians and Alaska Natives to enter the health professions and assuring the availability of Indian health professionals to serve Indians. The IHS recruits students for the following programs: The Indian Health Professions Preparatory Scholarships; the Indian Health Professions Pregraduate Scholarships; and the Indian Health Professions Scholarships. More information is available at https://www.ihs.gov/careeropps/loanrepayment/.

  • The National Health Service Corps (NHSC) offers a loan repayment program to nurse-midwives and other health care professionals that commit to working in underserved areas across the country. The Scholarship Program offers payment of tuition and fees, books, supplies, and equipment for up to four years of education, and a monthly stipend. In return, for each year of support, the recipient must serve one year in a federally designated health professional shortage area of greatest need. For Scholarship information or a Loan Repayment application, call the NHSC Helpline at 1-800-221-9393 or e-mail [email protected]. To find out more about this program, visit http://nhsc.hrsa.gov.

  • Create your own source of funding. If you can demonstrate the need for midwifery services in your community, a local hospital, clinic or private practice may be willing to support you in full or part in return for a practice commitment.

5 Ways for High Schoolers to Prepare for a Career in Midwifery

If you are interested in becoming a midwife, there are things you can do to prepare for your career while in high school. These include:

1. Follow a college preparatory curriculum

  • Take 3 years of math, including geometry and algebra II
  • Take 3 years of science, including biology and chemistry
  • Take 4 years of English
  • Take 2 years of a foreign language 
  • Consider exploring what each educational program requires

2. Volunteer

Participate in extra-curricular activities that are related to health care, such as volunteering at local health clinics or women’s health centers.

3. Read

Read books that describe the lives of present day American midwives. (Click here for ACNM’s selected reading list.)

4. Network

Talk with practicing midwives, women’s health nurse practitioners, doulas, and childbirth educators in your local community. You can also network with ACNM on Facebook at www.facebook.com/acnmmidwives.

5. Consider the skills, talents, qualities needed for a career in midwifery

  • Specialized knowledge, such as human anatomy and physiology

  • Excellent listening and observation skills

  • Good oral and written communication skills

  • Independence and ability to work in a team

  • Patience and ability to act quickly

  • Desire to help others

Six Ways for College Students to Prepare for Midwifery School


Consider exploring what each educational program requires.
You can begin preparing for a career in midwifery as early as your freshman year. Here are smart steps to take in college if your ultimate goal is to become a midwife:


1. Choose courses that include a solid science background

Science courses like biology, microbiology, chemistry, human anatomy and physiology are typical prerequisites to most midwifery programs. Courses in nutrition, algebra and statistics, lifespan development, English composition, sociology, and psychology are also helpful and often required.

2. Consider a degree in nursing

A bachelor’s degree in nursing sets you up for a smooth transition into a graduate midwifery program. In fact, most midwifery programs are in schools of nursing, and some programs require applicants to be registered nurses (RNs) prior to entry into midwifery school.

The skills, knowledge, and expertise acquired in a professional nursing degree also provide a solid foundation for a career in nurse-midwifery, which is legal in all 50 states and the District of Columbia.

3. Consider alternative majors

If you wish to enter midwifery directly without also educating as a nurse, there are currently two accredited education programs for Certified Midwives (CMs). Graduates are eligible to take the same certification exam that nurse-midwifery graduates take. CMs are legally recognized in 9 states (DE, HI, MD, ME, NJ, NY, OK, RI, VA) and the District of Columbia.

A degree in women’s studies, anthropology, sociology, or psychology may be useful in your future work as a midwife. Many midwifery programs leading to the certified nurse-midwife credential have available accelerated nursing education prior to midwifery training. This path involves education as a nurse after your other bachelors degree, but can result in a more diverse and well-rounded education.


4. Volunteer

Participate in extra-curricular activities that are related to health care, such as volunteering at local health clinics or women’s health centers.

5. Read

Read books that describe the lives of present day American midwives. (Click here for ACNM’s selected reading list.)

6. Network

Talk with practicing midwives, women’s health nurse practitioners, doulas, and childbirth educators in your local community. You can also network with ACNM on Facebook at www.facebook.com/acnmmidwives.

Midwifery: A Natural Fit for Nurses


Interested in expanding your professional role to providing primary care for women and their newborns? Midwifery education is the next step for you!

Scope of Practice


The skills, knowledge, and expertise you’ve acquired in your nursing education are a solid foundation for a career in nurse-midwifery. As a certified nurse-midwife (CNM), you will be qualified to manage prenatal, delivery, and postpartum care. You will also be able to provide most of the primary care, family planning and gynecological needs of women throughout the lifespan.

Education Requirements


To become a CNM, you’ll need to earn a graduate degree from an Accreditation Commission for Midwifery Education (ACME) accredited midwifery program.  Midwifery education programs are located throughout the U.S. Many programs allow part-time study and others offer distance-based midwifery education.

If you are an RN and you do not yet have a Baccalaureate degree, you have an option of applying to an RN to BSN/CNM graduate degree program, which is a midwifery program that offers a “bridge” to a BSN for RNs who have Associate degrees or diplomas.  Alternatively, you may choose to obtain your BSN from the many nursing schools that offer such options as the RN to BSN, and then apply to any midwifery education program.

Consider exploring what each educational program requires by clicking here


After Graduation

All graduates of ACME accredited midwifery programs are eligible to take the national certification exam to become a CNM. CNMs are legally recognized to practice in all 50 states and the District of Columbia.

Midwifery education involves a graduate degree. ACNM does not endorse the proposal that a Doctor of Nursing Practice (DNP) degree become the entry to practice requirement. For more information, see the ACNM Position Statement on Midwifery Education and the Doctor of Nursing Practice Degree. 

For Career Changers

Midwifery attracts people from all walks of life. No matter what your age, lifestyle, or professional background, there’s an educational path that will help you to become a midwife.

If you have a BA/BS degree and want to become a Certified Nurse-Midwife (CNM):

  1. There are many programs that first offer the courses necessary to become a registered nurse (RN) and follow with graduate courses in midwifery. Most of these programs require 3 years of full-time study or its part-time equivalent. See the complete list of programs.
  2. Alternatively, you may first attend a nursing education program at a location near you and then apply to midwifery education programs. 
  3. When you graduate from an Accreditation Commission for Midwifery Education (ACME)-accredited program, you are eligible to take the national certification exam administered by the American Midwifery Certification Board (AMCB).
  4. As a CNM, you will be legally qualified to practice in all 50 states and the District of Columbia.
If you have a BA/BS degree and want to become a Certified Midwife (CM):

  1. There are currently two accredited education programs with a CM option: The Midwifery Institute at Philadelphia University, and the State University of New York, Downstate. These programs require a solid science background from courses like biology, microbiology, chemistry, human anatomy, and physiology.
  2. As a graduate of one of these midwifery programs, you will be eligible to sit for the same national certification exam that nurse-midwifery graduates take.
  3. As a CM, you will be legally qualified to practice in 11 states (Arkansas, Colorado, Delaware, Hawaii, Maine, Maryland, New York, New Jersey, Oklahoma, Rhode Island, and Virginia) and Washington, DC.
If you do not have a college degree:

Midwifery requires graduate-level education.

Distance-Based Midwifery Programs

If you are unable to relocate, there are many fully distance and partially distance midwifery education programs that may meet your needs. Distance programs require you to receive your clinical education from a practicing CNM/CM in your home or nearby community. Contact the program of your choice for more specific information about requirements.

The American College of Nurse-Midwives (ACNM) welcomes your interest in the profession of midwifery in the United States. We acknowledge the contributions that midwives educated abroad (MEAs) have made to the health of women and babies around the world. Today, as in the past, MEAs who become certified and join the ACNM enrich the profession of midwifery with their diversity.

In order to practice midwifery in the US, an individual must take a national certification exam. In order to take the exam that is offered by the American Midwifery Certification Board (AMCB),
which leads to the credential CNM or CM, the individual must have a graduate degree from a US midwifery education program that is accredited by the Accreditation Council for Midwifery Education (ACME). This means that most midwives educated abroad will need to take at least one additional course from an ACME-accredited program.

Once the individual has successfully passed the AMCB exam, they must then obtain a license from the state in which they intend to practice. Each state has a different licensing procedure. Midwives are licensed by boards of nursing, boards of midwifery, boards of medicine, departments of health, etc., depending on the state licensing regulations. For information about the appropriate licensing agency, go to the state government website for each state.

For more detailed information, please see our document, Information for Midwives Educated Abroad.

Welcome...

To the new website for the American College of Nurse-Midwives. If you need to access a resource from the previous website, please click below.