Meet a Nurse Midwife
Certified nurse midwives (CNMs) are advanced practice registered nurses who assist expecting parents throughout the birthing process, ensuring the safety and health of both the baby and parents. CNMs provide skilled care as advanced practice nurses and require postgraduate education and extensive experience.
We interviewed Michelle Palmer, a CNM and assistant professor of nursing, to gain insights into her experiences as a nurse midwife. She shared what led her to this path, as well as the most challenging and fulfilling aspects of her career.
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Learn more about the life of a nurse midwife and find information on how to pursue this rewarding field.
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Question & Answer with a Nurse Midwife
Q: What sparked your interest in midwifery? When did you decide to specialize in this area during your nursing career?
My interest in midwifery developed after I graduated from the University of Rhode Island with a bachelor’s degree in art history. While visiting Peru with a friend to explore Peruvian architecture, my friend discovered she was pregnant. She gave birth at home in Rhode Island the following February.
Witnessing that experience made me realize that midwifery was my calling. I returned to school, completing an accelerated baccalaureate nursing program at Creighton University, a nurse midwifery certificate program from the Frontier School of Nursing, and a master’s degree from Case Western Reserve University’s Frances Payne Bolton nursing program.
Q: What does a typical day look like for a nurse midwife? Can you describe a typical shift?
Every day is different for me. Today, I worked as a clinical instructor at Landmark Medical Center and as a clinical assistant professor for the College of Nursing at URI. After teaching, I continued my role as a midwife, assisting a mother in labor. I then went on a home visit for a mother expecting in early May.
I provide a full range of midwifery care, including primary care, newborn care, and reproductive healthcare. I work in various settings, such as offices, homes, and hospitals. I also enjoy teaching nursing, medical, and midwifery students. Typically, midwives have office days and are on call for labor and birth.
On a call day at the hospital, I start by caring for postpartum parents and newborns. I might evaluate a pregnant woman in labor or provide care for reproductive health concerns. If a woman is in labor, I provide labor support and attend the birth. I can prescribe medications, order lab tests and imaging, perform minor laceration repairs, and collaborate with other healthcare professionals as needed.
I’m an expert in normal reproductive health physiology, pregnancy, birth, postpartum care, and neonatal care. I’m trained to recognize deviations from the norm and respond to emergencies, such as neonatal resuscitation or birth complications like postpartum hemorrhage or shoulder dystocia.
Q: What aspects of your career do you find most rewarding?
Continuing care with individuals over time is incredibly rewarding. Being there throughout their journey—offering family planning, primary care, pregnancy care—sustains a healthcare relationship over time.
Q: And what are some of the most challenging aspects?
There are many challenges, such as difficult conversations, supporting individuals through relationship difficulties, addressing sexuality and fertility concerns, guiding people through pregnancy loss and postpartum depression, managing abnormal diagnoses, helping individuals heal from birth trauma, and navigating healthcare politics. This work demands an open heart, persistence, patience, and stamina.
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Q: You’ve worked in various birth settings, including at-home births, hospital births, and a remote rural maternity center in New Zealand. Do these settings offer different experiences?
Yes, each setting offers unique growth opportunities. Working in a different geographic location and culture was a gift. The intimacy and agency of a family’s own space are special. Witnessing the dedication of hospital colleagues during challenging times has been heartening.
Q: Any memorable experiences that stand out from your career?
Many. Witnessing births, supporting newborns’ first moments, seeing students’ excitement during their first birth experiences, observing seamless teamwork in healthcare—these moments stand out.
Q: What advice do you have for those considering a career in nurse midwifery?
Stay open-minded and compassionate. Be patient with yourself. Recognize that challenges are part of the journey. Find an educational program that aligns with your clinical and academic goals. I’m always happy to discuss options with interested individuals.
What Does a Nurse Midwife Do?
—”I love caring for someone as they are moving through their journey—maybe providing family planning or primary care, and then maybe pregnancy labor and birth care, basically sustaining a healthcare relationship over time.” — Michelle Palmer, CNM
A CNM’s daily tasks can vary widely. One day might involve postpartum care, while another might focus on sexual health education. Nurse midwives build close relationships with their patients throughout the entire pregnancy journey.
Working alongside primary care providers and other nurses, CNMs offer routine checkups, medication prescriptions, and access to diagnostic tests.
Key skills and responsibilities include:
- Collaborating with healthcare providers for optimal patient care
- Developing strong patient relationships
- Remaining calm under pressure
- Adapting to diverse work environments
- Providing support
- Demonstrating determination
Comprehensive Guide to Pursuing a Nurse Midwife Career
How to Become a Nurse Midwife
1. Obtain a Bachelor of Science in Nursing (BSN).
Begin by completing an undergraduate nursing program from an accredited institution. This typically takes about four years, though some universities offer accelerated programs. Make sure your nursing program is accredited by reputable agencies like the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE).
2. Pass the NCLEX-RN exam for RN licensure.
The National Council Licensure Examination for Registered Nurses (NCLEX-RN) is a standardized test that assesses your readiness to provide safe and effective nursing care. Each state has its own licensing requirements, so research your state’s specific regulations.
3. Gain experience in specialized RN positions.
To build your skills and knowledge, work as an RN for 1-2 years before pursuing a specialization. Experience in neonatal or prenatal care, such as working in a newborn intensive care unit, is valuable preparation for becoming a certified nurse midwife.
4. Apply to an accredited master’s or doctoral midwifery program.
Apply to an accredited master’s or doctoral program in nurse midwifery. Different programs have varying prerequisites, but they all require a graduate degree and an active RN license. Some programs prefer applicants with a background in neonatal or prenatal care.
5. Complete your Master of Science in Nursing (MSN) or Doctorate in Midwifery.
Depending on the program you choose, earning an MSN typically takes around two years, while a doctorate may take 3-4 years. A doctorate can offer more job opportunities and higher salaries. Your education will include courses in areas like antepartal care, intrapartal care, and hands-on practice hours.
6. Pass the American Midwifery Certification Board (AMCB) Exam.
The AMCB provides certification for nurse midwives. The exam includes an in-person multiple-choice test that assesses your knowledge of patient care and assessment. Certification is available for both CNMs (requiring either an MSN or doctorate) and certified professional midwives (CPMs), which doesn’t require a college degree.
7. Obtain state licensure as a certified nurse midwife.
Just like your RN license, you’ll need a state license to practice as a CNM. Some states may require additional documentation or exams, so be sure to research your state’s midwifery laws. The Midwives Alliance of North America offers a comprehensive list of state regulations.
Becoming a nurse midwife offers a fulfilling and impactful career path. Through comprehensive education and practical experience, you can play a vital role in providing care and support to expecting parents during their pregnancy journey.
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