Midwife Education & Career Guide
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What You Can Earn as a Nurse Midwife
Certified nurse midwives are highly educated and earn salaries that reflect their broad duties and responsibilities.
With their advanced education and skills, certified nurse midwives (CNMs) typically rank among the highest-paid nurses, with a median salary of $111,130, according to the U.S. Bureau of Labor Statistics (BLS).
While the majority of midwives in the U.S. are CNMs, there are midwives who aren’t registered nurses, including certified professional midwives, licensed midwives, and lay midwives. The BLS reports a median annual salary of $51,840 for these midwives, who have less education and authority and fewer responsibilities.
Median Salary: $111,130
Top 10%: $179,770
Projected job growth: 11.6%
|State||Median Salary||Bottom 10%||Top 10%|
|District of Columbia||$83,010||$58,350||$125,170|
Source: U.S. Bureau of Labor Statistics (BLS) 2020 median salary; projected job growth through 2029. Actual salaries vary depending on location, level of education, years of experience, work environment, and other factors. Salaries may differ even more for those who are self-employed or work part time.
How Do CNM Salaries Compare?
A certified nurse midwife is an advanced practice registered nurse (APRN) who has completed a nursing program in midwifery at the master’s level or above. While they specialize in gynecological and obstetrical care, many CNMs also provide primary care for women and can operate their own practices in many circumstances.
In addition to certified nurse midwives, APRNs include nurse practitioners, nurse anesthetists, and clinical nurse specialists. Because APRNs have at least a master’s in their field, they’re well paid for the knowledge and expertise they bring to their jobs.
Here’s how CNM salaries stack up against other APRN roles:
|Occupation||Annual Median Salary|
|Certified nurse midwife||$111,130|
Demand for this Career
The American College of Nurse-Midwives (ACNM) reports that CNMs attended 9.1% of all U.S. births in 2017, according to the most recent data available from the National Center for Health Statistics (NCHS). The demand for certified nurse midwives, along with other APRNs, is expected to increase 45% through 2029, according to the BLS.
This is partly because the U.S. has a shortage of primary care providers, and APRNs are expected to fill the gap. Like other APRNs, a CNM can provide a full range of health services, including primary care, depending on the state in which they practice.
As primary care providers, certified nurse midwives can perform many of the same duties as physicians, including ordering and reviewing lab tests and prescribing medications and treatments. Depending on the state, a CNM may also be able to operate a private practice without physician supervision.
Women’s changing attitudes toward health care and pregnancy may be another factor in an increase in CNM jobs.
As primary care providers, certified nurse midwives can perform many of the same duties as physicians, including ordering and reviewing lab tests and prescribing medications and treatments.
“I think demand is growing because people are asking for midwives and realizing the benefits and holistic care they can receive,” says Amber Wilson, CNM, DNP, host of the “Journey to Midwifery” podcast. “Midwives tend to lean toward a more hands-off approach to birth, and people enjoy not having their pregnancy over-managed with interventions. This allows people who are low risk that should have a normal birth to be supported.”
Competition for Jobs
Where you work can affect the degree of competition for CNM positions. For instance, a position in a hospital may be more attractive to many CNMs because of shift work, predictable schedules, and generous benefits. But there is a tradeoff for those who want the autonomy that can come with working in a birth center or as a private practitioner.
Demand for CNM services may be higher in rural areas, where healthcare resources commonly are scarce—but there’s a catch because many rural areas don’t have facilities to accommodate a certified nurse midwife practice, says Sarita Bennett, DO, CPM, president of the Midwives Alliance of North America (MANA).
You can expect competition as a CNM working in private practice, but there are ways to stand out, including promoting patient satisfaction and excellent outcomes.
“In my experience, word-of-mouth among the women of childbearing age in a given location is a powerful driver of client behavior,” says Kathleen Bell, RN, MSN, CNM, AHN-BC, MS1-BC, special advisor to the board of directors of the Oregon Holistic Nurses Association. “Much more so than pricing or third-party payment for care.”
Earning Potential and Job Outlook
CNMs can choose from a wide variety of work environments across the country. While the annual median salary for CNMs is $111,130, the top 10% earn $179,770 versus $67,710 for the lowest 10% of earners, according to the BLS.
Like most other occupations, experience, geographical location, and workplace can affect a certified nurse midwife’s salary.
Here are the top five places of employment for CNMs:
CNM salaries vary by location. According to the BLS, here are the top five states by annual salary:
|State||Annual Median Salary|
Advancing Your Career
After earning your certification as a CNM, you can pursue a fulfilling career providing health care for women in office settings and at the bedside. However, there are also opportunities to expand your options and pursue other types of employment within midwifery.
Some midwives pursue positions in areas such as education, politics, or healthcare policy. Others write books, publish journal articles, or have businesses that counsel other midwives on their careers. Depending on your interests, the career opportunities you find as a CNM can be whatever you desire, says Wilson.
Earning a Doctor of Philosophy (PhD) or Doctor of Nursing Practice (DNP) can help you move your career to the next level. These are the highest degrees for CNMs and all APRNs.
Some midwives pursue positions in areas such as education, politics, or healthcare policy. Others write books, publish journal articles, or have businesses that counsel other midwives on their careers.
A PhD can prepare you to conduct research, develop healthcare policies, and teach the next generation of CNMs at the university level. CNMs who earn a DNP can advance to positions such as clinical and program directors and often teach at post-secondary institutions.
While it’s common for a midwife with a doctorate to hold a faculty position in a CNM program, it may not be the initial motivation for pursuing the degree. “As a CNM, more and more people are getting their doctorate, but that’s typically so they can be heads of programs rather than teachers,” says Bennett.