Certified Nurse Midwife: Complete Guide

nurse midwife

Nurse midwife is a licensed health care provider educated in two disciplines: nursing and midwifery. Generally, nurse midwives provide primary healthcare services to women of childbearing age including labor, prenatal care, delivery care, gynecological exams and after birth care. They also help with family planning decisions, newborn care, menopausal management, preconception care and counseling in diseases prevention and health maintenance. Nurse midwives attend more than 10% of all births within the United States and 96% of the births are in hospitals.

The nurse-midwifery care philosophy focuses on needs of individuals and families for emotional, physical, social support, and active involvement of the significant others according to the personal preferences and cultural values. Nurse midwife has to listen to women and provide the information they need to form more educated and informed decisions relating to their healthcare.

All nurse midwives have to graduate from accredited education programs and also pass rigorous certification exams. In the United States, there are high established education and certification standards. Therefore, the registration of nurse midwives happens in all the 50 states and in the District of Columbia. Nurse midwives are experts who are held to rigorous practice standards that the state licensing organizations have set. They must attend continuing education that universities and hospitals provide.

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Nurse midwifes provide quality healthcare

A 2009 Cochrane meta-analysis of studies that involved 12,276 women and which looked at midwife-led care and care led by obstetrician (family physicians) showed that midwifery has better or as good results in all parameters. Under the midwife care, women had less need for instrumental birth (like vacuum or forceps), episiotomies and anesthesia. Moreover, women had increased control in labor feelings, successful breastfeeding and possibility of vaginal birth. Researchers have proved that midwife-led healthcare offers several benefits to mothers and their babies and has no adverse health effects. Studies have also indicated that midwife-attended births have lower cesarean birth rates and NICU admission rates. The patient satisfaction is also higher. And, midwifery is taken to be a better alternative to the traditional obstetrical care. The need for midwives is also increasing.

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What do nurse midwives do?

If you will have your hands full in the nurse midwife career, you should learn the different tasks they undertake. Midwives have existed for several centuries – long even before there was hospital care. Popular in many countries, nurse midwives appeared for the first time in the United Stats in 1920s. And even with the technological growth, the nurse midwife profession is still highly growing. The profession has its roots in the belief that all women should have supportive environments during pregnancy and after giving birth. It promotes traditional births for lower risk pregnancies.

To succeed as a midwife nurse, you must have the desire to care for the others and to promote health for women and that of infants. Expertise in this field should provide patients with education on forming right decisions for themselves and that of their babies.

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Nurse midwives generally work in private practices, hospitals, health maintenance organizations, birthing centers and in health departments. Therefore, you have to consider all your preferences and needs including whether you would like to work on regular hours and whether you have the interest in working on your own when deciding on a type of establishment you would like to work on.

There are several types of midwifery in existence. The primary difference between the types is the education path a person takes to become a nurse midwife. They include:

  • Certified Midwife (CM): this group of nurse-midwives have a health related background such as physician assistant but aren’t registered nurses. They operate in only a few states.
  • Certified Nurse Midwives (CNMs): these are registered nurses. They must graduate from accredited nurse-midwifery programs.
  • Direct Entry Midwife (DEM): these are healthcare providers who have received midwifery education but have a bachelor’s degree in a different field.

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Some Duties of On-the-Job Nurse Midwives Include:

  • Staying by as soon-to-be-mother’s side through labor and childbirth process
  • Look for situations or complications that may require a medical doctor
  • Educate women about birth options and unique health issues
  • Prepare mothers on what to expect during labor, childbirth and after the childbirth
  • Educate mothers on how to breastfeed their infants and on how to care for them

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The education certification you need to become a nurse midwife

To become a nurse midwife, you have to devote a decent amount of time. Well, however, you can opt for online or campus-based options. To start practicing in this area, you will require a Master of Science in Nursing (MSN). This highly depends on your healthcare background and current educational background. To earn an MSN, you can follow one of the many available routes.

Once you start looking for a nurse-midwife program, you should consider all the provided courses, how long they will take and the length of experience you will need to start practicing. Some other considerations include financial aid and job placement services. After completing the education, you will have to pass the American Midwifery Certification (AMCB) exam, so that you can become certified in nurse midwife practice.

The career paths to take in nurse-midwifery

Nurse midwives are commonly associated with offering care before, during and after the childbirth. In addition to the services they offer during pregnancy, nurse midwives are also primary healthcare providers for women in their entire life. In other words, they can order and review tests, conduct physical exams, prescribe medication and offer some other medical services. They are highly popular primarily because they do similar work to that of physicians. As a nurse midwife, you can also head down to another career path. For example, if you are interested in public health or education, you can consider one of the available degree programs that will guide you in the direction of your choice. If you have interest in offering supportive environment for women or families then becoming a nurse midwife is a great option.

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How to advance in nurse midwife career

In most fields, progressing to the next career level requires you to further your education. But because a nurse midwife must possess a Master of Science in Nursing and the relevant certification, you will not need to further you education. You can earn a doctorate in midwifery even though it’s not necessary. It will basically open your doors to leadership roles. The degree is very new in the field and even though ACNM highly supports the programs, they haven’t provided sufficient evidence that can help determine whether a doctorate can have impacts on the salary of nurse midwives.

Nurse midwife salary and job growth

After earning a degree, nurse midwifery can be remunerative. Currently, nurse midwives are enjoying extraordinary job growth. This is mainly due to their advanced background in nursing. The earning potential of midwives can highly vary depending on the employer, the education and the nurse’s area of specialty. But generally, their salary is excellent. Just like many other jobs within the medical profession, nurse midwifery may earn you prettier decent paycheck. The US Bureau of Labor Statistics 2016-17 Occupational Outlook Handbook showed that nurse midwives expect a median salary of $96,970. However, the field specialization, the years of experience, the location and some other factors may cause variation in the actual salary.

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How do the nurse midwife salaries compare

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According to US Bureau of Labor Statistics 2016-17 Occupational Outlook Handbook, the median salary of a Registered Nurse within the United States is $66,640 while that of a Licensed Vocational or Practical Nurse is $42,490. And, that of a Physician Assistant is $95,820. The actual salaries may highly vary depending on the specialization in the nursing field, the location and some other factors including the years of experience. The national long-term employment growth projections do not reflect the local or the short-term job or economic conditions. Moreover, it doesn’t guarantee an actual job growth.

The Earning Potential of a Nurse Midwife

According to BLS, the top 10% of nurse midwives earned over $129,000.

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The career demand

Expectedly, nurse midwives will be in higher demand in the foreseeable future. This is particularly in some fields with fewer medical resources such as some rural parts and inner cities within the US. Furthermore, according to American College of Nurse Midwives estimates, certified nurse midwife will deliver at least one in every 10 babies in the US in near future. This will be a huge increase from the 3% of births in the US that nurse midwives attended around 10 years ago.

The job growth for this field

Nurse midwives, nurse anesthetists, and nurse practitioners are expecting a 31% growth in jobs until the year 2024. This is according to the US Bureau of Labor Statistics. Generally, the expected growth in jobs is faster than the average. However, you should note that the national long-term employment growth projections may not reflect on the local and the short-term job or economic conditions. Advanced training nurse midwives act as primary healthcare providers, write prescriptions, and do many other tasks similar to those of doctors but they are a lower cost to the patients and the employers. As a result, nurse midwives are an invaluable resource within the medical community.

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The competition to expect in the job industry as a nurse midwife

Registered nurses aren’t likely to face more competition in the hospital setting primarily because the turnover can be higher. But on the other hand, the nurses looking for jobs in the physician offices (where conditions are better than in hospitals and the regular hours are norm) may experience higher competition. The location of the job – such as in a city or in a rural community – may highly affect the competition.

Which institutions hire nurse midwives

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As an aspiring nurse midwife, you will have a wider range of options when selecting your work location. According to BLS report, the following are the industries which employ the largest number of nurse midwives:

  • Physician offices – 2,370
  • Surgical hospitals and general medical hospitals – 1,500
  • Outpatient care centers – 600
  • Health practitioners offices – 360
  • Universities, colleges, and professional schools – 50

 

The nurse-midwifery certification

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All aspiring nurse midwives have to fulfill several prerequisites before they can start practicing in most regions or medical settings. First, you have to fully complete a bachelor’s program particularly in nursing, and then become a registered nurse in your jurisdiction or state. The process basically involves sitting for National Council Licensure-Examination (NCLEX-RN). Nursing Practitioner Schools provide more detailed information about becoming a nurse practitioner (NP), registered nurse (RN) and the real differences between the two. However, you should note that BSN degree isn’t sufficient for a person desiring to start practicing as a nurse midwife. As mentioned earlier, the ACNM requires all candidates to earn the accredited MSN-degree and to certify through AMCB.

American College of Nurses And Midwives (ACNM) shows that the majority of the practicing nurse midwives hold graduate degrees. And, as a matter of fact, 825 of all certified nurse midwives (CNM) are master’s degrees holders while at least 4.8% have doctoral degrees. Considering all the advanced practice of the registered nurses categories, this represents the largest percentage of the high degree holders. As a result, ACNM advises candidates to enroll in the graduate programs that the Accreditation Commission for Midwifery Education (ACME) has accredited.

Currently, there are 39 ACME-accredited graduate programs within the US that confer post-graduate certificates, master’s and doctorate degrees upon the program completion. To complete the program, you will take at least 24 months, even though you may consider the accelerated options particularly if you have baccalaureate degrees. As a prospective NMs, taking an ACME-accredited program will help ensure that your training meets higher curricula, student and faculty outcome standards in addition to qualifying for the national certification.

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To be a certified nurse midwife, a student should sit for the American Midwifery Certification Board – (AMCB) exam immediately after graduation. The credentials are usually valid for 5 years. And according to AMCB, you can renew your CNM certification in one of the two available methods:

  • Complete 3 AMCB-approved certificates on maintenance modules such as Antepartum and also Primary Care (PC) for Pregnant Woman, as well as Intrapartum/Newborn & Postpartum, and also Gynecology & PC of the Well-Woman. After this you should get ACNM or ACCME 20 contact hours of approved continuing education modules/units and also complete renewal application. This includes payment of the necessary fees.
  • The other option is to re-take the ACMB which is a certification examination and pay $500. You should also complete the renewal application.

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The steps leading to becoming a registered nurse midwife

  • Graduates from high school. If you want to prepare well for a nursing undergraduate program taking classes such as chemistry, physics, biology, and psychology is advisable.
  • Enroll in a bachelors or associate program in the nursing profession. This should take 2- 4 years.
  • Become a fully registered nurse (RN) and gain at least 1-year experience. This typically involves application to local State Board of Nursing and passing National Council Licensing Examination.
  • Apply for ACME approved graduate midwifery program. The program should take 2-4 years. To become a fully licensed nurse midwife you have to complete a master’s program which takes two yeas or a doctoral program which should take 4 years.
  • Sit for national certification exam.
  • Renew the certification after every 5 years.

If you have the interest in promoting family healthcare at advanced levels, becoming a nurse midwife will be a rewarding choice.

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