Proponents of midwifery note that the widespread use of certified nurse-midwives (CNMs) in New Mexico’s hospitals has allowed the state to post the second-lowest rate of C-section delivery among low-risk pregnancies nationwide (2013).
In 2018, about 7-10.99% of births in New Mexico were attended by midwives, according to the U.S. Department of Health & Human Services, Centers for Disease Control and Prevention and the National Center for Health Statistics.
The women of New Mexico have more options than ever, due to recent legislation that now allows freestanding birth centers to be licensed to operate autonomously. These licensed birth centers are eligible to seek Medicaid reimbursement for facility fees, a benefit that hospitals already receive.
New Mexico’s green light on state licenses has even spurred the creation of the first-ever Native American birth center, which the owners hope will address the significant health disparities that Native women in the Southwest region face.
Birth centers in New Mexico adhere to the midwifery model of care, which emphasizes a natural birth for healthy women with low-risk pregnancies. As advanced practice registered nurses (APRNs) with an interdisciplinary education in both advanced practice nursing and midwifery, certified nurse-midwives work in a wide array of settings and provide women with a full range of primary health care services, from adolescence to menopause and beyond.
New Mexico’s nurse-midwives enjoy a regulatory environment that grants them autonomous practice privileges without the need for burdensome collaborative practice agreements with physicians.
Steps to Becoming a Nurse-Midwife in New Mexico
Registered nurses in New Mexico with licenses in good standing are eligible to become nurse-midwives by earning national certification in nurse-midwifery and satisfying the APRN licensure requirements set forth by the New Mexico Department of Health:
Step 1. Earn a Qualifying Master’s Degree in Nurse Midwifery
Aspiring nurse-midwives must complete a graduate degree or post-graduate certificate in nurse-midwifery in order to earn CNM certification and APRN licensure in New Mexico.
The New Mexico Department of Health only recognizes graduates of nurse-midwifery programs accredited by the American Commission for Midwifery Education (ACME).
Although there is currently just one accredited program in New Mexico, located in Albuquerque, many schools that offer ACME-accredited programs now allow students the option of completing part or all of their didactic (coursework) requirements through web-based study.
Online and campus-based nurse-midwife programs are available in a variety of formats:
- Master of Science in Nursing (MSN)/Master of Science (MS) in Nursing: These traditional programs require RNs to possess a Bachelor of Science in Nursing (BSN) for admission.
- RN-to-MSN Programs: These accelerated programs combine the coursework and clinical requirements of both the BSN and MSN, thus appealing to RNs who possess an associate’s degree in nursing.
- Post-Graduate Certificates: Post-graduate certificates in nurse-midwifery are reserved for RNs who possess an MSN and are seeking either initial APRN licensure or seeking to add the nurse-midwifery specialty to their APRN license.
- Dual Specialization: Many of today’s nurse-midwifery programs now offer students the opportunity to expand their course of study to include another APRN specialty. One such specialization is the nurse-midwife/women’s health nurse practitioner program, which provides students with a comprehensive graduate degree in all areas of women health. Graduates of these programs may seek dual APRN certification and licensure in New Mexico as a nurse-midwife (CNM credential) and a board certified women’s health nurse practitioner (WHNP-BC credential).
Nurse-Midwifery Program Structure
Nurse-midwifery programs consist of two components: didactic coursework and clinical rotations. The coursework requirements of an MSN in nurse-midwifery consists of a core that includes study in areas such as pathophysiology, leadership, health assessment, and pharmacology, as well as a cluster of midwifery courses, such as:
- Midwifery care during labor and birth
- Midwifery care during pregnancy
- Women’s health
- Primary care of women
- Midwifery care of the childbearing woman
- Midwifery care during postpartum
The clinical requirements of a nurse-midwifery program may include up to 1,000 hours of rotations at clinical sites, such as hospitals, birthing centers, private practices, and women’s health clinics. Online programs often partner with clinical sites throughout the U.S. as to allow students to satisfy the clinical components of their nurse-midwifery program close to home.
Just a few of the sites in New Mexico where nurse-midwifery students may complete part of their clinical rotation requirements include:
- Lovelace Women’s Hospital, Albuquerque
- UNM Hospitals Women’s Faculty and Midwife Clinic, Albuquerque
- Women’s Specialists of New Mexico, Albuquerque
- Dar A Luz Birth and Health Center, Los Ranchos
Admission Requirements
Conventional terminal nurse-midwifery programs accredited by ACME require incoming graduate students to possess the following:
- Registered Nurse (RN) license
- Bachelor of Science in Nursing (BSN)
- Minimum undergraduate GPA
- Personal letters of reference
Step 2. Take and Pass the National Certification Examination in Nurse-Midwifery
Graduates of ACME-accredited nurse-midwifery programs are eligible to take the CNM Certification Examination through the American Midwifery Certification Board. Candidates must apply through the American Midwifery Certification Board to receive approval to test for the CNM exam.
The CNM exam consists of 175 multiple-choice questions focused on the following topics within nurse-midwifery:
- Antepartum
- Intrapartum
- Postpartum
- Newborn
- Well-Woman/Gynecologic
- Women’s Health/Primary Care
Once candidates receive approval to test, they must schedule to take the exam through one of the Applied Measurement Professionals (AMP) testing centers located throughout the U.S. In New Mexico, candidates may take their CNM exam in Albuquerque.
Candidates of a dual specialization nurse-midwifery/women’s health nurse practitioner program may also apply to take the Women’s Health Care Nurse Practitioner Examination through the National Certification Corporation (NCC) to earn the WHNP-BC credential. Similar to the CNM exam, candidates would register through the NCC and take the exam at an AMP testing center.
Step 3. Apply for APRN Licensure as a Nurse-Midwife in New Mexico
Upon achieving the CNM designation, prospective nurse-midwives in New Mexico must complete the Application for APRN licensure and submit it, along with an application fee of $200. Applicants must have the application notarized and must provide the Department with a copy of their CNM certification.
Prescriptive Authority
APRNs in New Mexico may apply for prescriptive authority for Schedule II-V controlled substances with the New Mexico Board of Pharmacy and the U.S. Drug Enforcement Administration. CNMs must possess a DEA number before completing the Practitioner’s Controlled Substance Registration Application.
Step 4. Exploring Career Opportunities as a Nurse-Midwife in New Mexico
Nurse-midwives possess the education and experience to practice in a variety of settings, including homes, birthing centers, hospitals and midwifery practices. They may serve the needs of New Mexico’s rural and underserved populations or pursue entrepreneurship by starting their own birthing center or midwifery practice.
Just a few of the employers in New Mexico where nurse-midwives may start or expand their nurse-midwifery career include:
- Southwest Care Center, Santa Fe
- Women’s Health Institute, Taos
- La Clinica Health & Birth Center for Women & Children, Silver City
- Northern New Mexico Midwifery, Taos
- Southwest Care Center Women’s Health Services, Santa Fe
- Birth Travels, Los Alamos
APRN Licensure Renewal Requirements
Nurse midwives in New Mexico must renew their APRN licenses very two years at the same time as their RN licenses. CNMs must complete at least 30 continuing education units during their license cycle, of which 15 must be pharmacology-related. The cost of biennial renewal is $100.
During the first renewal cycle, CNMs must complete at least 5 continuing education units in the following topics:
- CNM rule as it applied to management of chronic pain
- Pharmacology and risks of controlled substances
- The problems of abuse and addiction
- State and federal regulations for the prescription of controlled substances
During subsequent license renewals, CNMs must complete at least two contact hours in the above topics.
CNM Renewal Requirements
New Mexico nurse-midwives must renew their CNM designation every five years by successfully completing one of the two options outlined in the American Midwifery Certification Board’s Certification Maintenance Program:
- Option 1: Complete at least three AMCB Certificate Maintenance Modules during each five-year certification cycle and at least 20 contact hours of approved continuing education units; pay annual fees
- Option 2: Retake the AMCB Certification Examination and pay the $500 examination fee in lieu of annual fees
WHNP Renewal Requirements
Nurse-midwives that also possess the WHNP-BC designation must take the National Certification Corporation’s continuing competency assessment at the beginning of each three-year maintenance cycle. The required number of continuing education credit hours for the next three-year cycle depends on the result of the assessment.
Salaries for Certified Nurse-Midwives in New Mexico
The average salary among the 90 certified nurse-midwives who practiced in New Mexico in 2019 was $98,750, according to the U.S. Bureau of Labor Statistics. Nurse midwives with the most experience were among the best paid, earning an average of $131,630 in 2019, compared to the average for CNMs just entering the field in New Mexico, which was $57,070 that year.
As of 2015, there were six job vacancies advertised for CNMs through some of New Mexico’s top healthcare providers (provided for informational purposes only and does not suggest a guarantee of employment):
- Presbyterian Health Services
- Department of Health and Human Services
- The University of New Mexico
- CHSPSC, LLC
Beyond the employment opportunities available to CNMs in conventional settings, many certified nurse-midwives join partner clinics or establish independent practices of their own.
How Nurse Midwives are Improving Access to OB/GYN Care in New Mexico
The 2014 annual report published by the New Mexico Health Care Workforce Committee found that the state faces significant shortages of healthcare providers, with some counties totally lacking primary healthcare providers altogether.
The report noted that advanced practice registered nurses will be essential for meeting the current and future healthcare workforce needs in New Mexico. Nurse midwives will be especially critical, since most of New Mexico has an inadequate number of physicians who specialize in obstetrics and gynecology, while CNMs in the state have full practice authority allowing them to work with total autonomy.
While New Mexico’s total number of OB/GYN physicians is comparable to that of the rest of the country, 52% of the state’s obstetrics and gynecology physicians are in Bernalillo County. Assuming that New Mexico’s OB/GYN physicians do not relocate to other parts of the state, the Committee estimates that New Mexico needs 40 more of these specialists just to be flush with the national average. The need is most critical in Sandoval and Valencia Counties.
New Mexico’s primary nursing program is increasing the number of nurse-midwifery students it admits to help ensure the state has an adequate number of CNMs to address the shortfall of OB/GYN care.
An Analysis of Certified Nurse Midwife Salaries in Albuquerque
Around half of New Mexico’s certified nurse-midwives practiced in Albuquerque as of 2019, according to the BLS. Nurse midwives in this metropolitan area earned a higher average salary than that for New Mexico overall:
- Experienced (90th percentile): $129,810
- Average annual salary: $97,440
- Entry-level (10th percentile): $71,800
(Salary data for nurse-midwives reported by the U.S. Bureau of Labor Statistics in May 2019. Figures represent state data, not school-specific information. Job growth data provided by Projections Central, a resource funded by the U.S. Department of Labor’s Employment and Training Administration. Conditions in your area may vary. Information accessed March 2021.)