As master’s-prepared RNs with national certification in nurse-midwifery, New York’s certified nurse-midwives are skilled healthcare providers who are uniquely qualified to attend child births in the state. Though nurse-midwives adhere strictly to evidence-based practices, many women are drawn to the more individualized, whole-person approach that CNMs tend to favor when developing treatment plans for the women in their care.
The American College of Nurse-Midwives (ACNM) has found that pregnant women in the care of CNMs report a lower average cost associated with childbirth due to fewer instances of costly and invasive procedures like induced labor and cesarean sections, which have become common with physician-attended deliveries.
The ACNM has also reported that nurse-midwife attended births result in a lower rate of infant mortality when compared to equally low-risk deliveries taking place under the care of a physician.
With findings like these, more woman in New York are turning to certified-nurse midwives for antepartum, intrapartum and postpartum care, driving demand for nurse-midwifery services in the state. In fact, the U.S. Department of Labor expects a 25% increase in the number of CNMs licensed to practice in the state over the 10-year period leading up to 2028.
Steps to Becoming a Certified Nurse-Midwife in New York
New York State handles licensing for nurse-midwives differently than most other states. Since earning the nationally-recognized CNM (Certified Nurse-Midwife) credential through the American Midwifery Certification Board (AMCB) requires a graduate degree, most states classify nurse-midwives as advanced practitioners under state nurse licensing laws, requiring RNs to earn additional Advanced Practice Registered Nurse (APRN) licensure at the state level, much the same as a nurse practitioner would.
In New York, however, RNs who meet the requirements to take the AMCB CNM Exam would earn the nationally-recognized CNM credential just like nurse-midwives anywhere else in the country, but would then qualify to become Licensed Midwives through the New York State Education Department (NYSED) Office of the Professions without the need to pursue a more advanced nursing license.
- Note: The NYSED Office of the Professions-Nursing Section certifies and registers Nurse Practitioners in the specialty areas of OBGYN, Neonatology, Perinatology, and Women’s Health separate from the Licensed Midwife (LM) designation. Find more information on becoming an NP certified in one of these areas through the NYSED Office of the Professions-Nursing Section.
- Note: If you do not come from a nursing background and do not hold an RN license, you can still qualify for the LM designation through the NYSED-Office of the Professions by meeting the requirements for the direct-entry Certified Midwife (CM) credential through the AMCB. New York is among just a handful of states to legally recognize the CM designation. Find more information on becoming a direct-entry CM through the NYSED Office of the Professions-Midwifery Section.
This guide provides step-by-step instructions for New York RNs interested in gaining the authority to provide midwifery services in New York state.
As an RN with national certification in nurse-midwifery and a state-issued midwife license, you will be able to use the CNM (Certified Nurse-Midwife) and LM (Licensed Midwife) credentials and perform midwifery services with the full authority granted by the NYSED Office of the Professions and Board of Regents. This would include prescriptive authority once it is certified that you have completed at least three semester hours of coursework in advanced pharmacology.
RNs with an unencumbered and unrestricted license in good standing can become Licensed Midwives through the New York State Education Department Office of the Professions by meeting the education and certification requirements detailed in this guide:
Step 1. Earn a Qualifying Master’s or Higher Degree in Nurse-Midwifery
As a New York RN interested in practicing midwifery, your first order of business will be to meet the education qualifications required to take the CNM exam, which leads to:
- The nationally-recognized Certified Nurse-Midwife (CNM) credential through the American Midwifery Certification Board (AMCB).
- The state-issued Licensed Midwife (LM) designation through the NYSED Office of the Professions.
All CNM exam candidates must earn a master’s degree in midwifery or higher degree through a program recognized by the Accreditation Commission for Midwifery Education (ACME).
Accredited nurse-midwife programs available online offer New York’s working RNs the flexibility they need to earn a master’s degree while maintaining professional commitments. With just 39 online and campus-based ACME-accredited nurse-midwife programs in the US, distance learning options that offer the same level of rigor as conventional programs have become particularly popular among aspiring nurse-midwives.
CNM candidates in New York interested in an on-campus experience can choose from five schools located in Stony Brook and the greater New York City region. There are also programs available at campus locations in the neighboring states of New Jersey, Pennsylvania, Connecticut, and Massachusetts.
Admissions Standards for Nurse-Midwifery Masters Program
RNs that hold a BSN are eligible to enroll in conventional ACME-accredited nurse-midwifery master’s programs. RNs that hold an associate’s degree would enroll in an ACME-accredited RN-to-MSN bridge program specific to nurse-midwifery, which would confer both a BSN and master’s in nurse-midwifery in one accelerated program.
While some master’s programs may have unique admissions requirements, most programs generally require the following:
- A current RN license
- Letters of recommendation from supervisors and professors
- Statement of purpose
- Video or written essay
- Official academic transcripts from a BSN or another relevant post-secondary program
Nurse-Midwifery Masters Program Structure and Content
Nurse-midwife graduate students would complete both didactic coursework and clinical sequences in local facilities concurrently.
Classroom Study (40-60 semester credits)
Didactic study will cover advanced competencies typically associated with advanced practice nurses, including Pathophysiology and Pharmacology, as well as key areas in nurse-midwifery:
- Research Methods for Health Care Providers
- Pharmacology
- Ethics
- Women’s Reproductive Healthcare
- Pregnancy, Labor, and Newborn Care
- Ambulatory Care of Women
- Antepartum, Intrapartum and Postpartum Care
- Newborn Care
- Biostatistics for Health Care Providers
Clinical Practice (500-1000 hours)
Clinical sequences are supervised at local hospitals and clinics throughout New York. For students of online programs, rotations at nearby clinical locations would be coordinated with a graduate program advisor to eliminate the need to relocate.
For students in the downtown New York City area, potential clinical locations include:
- New York Presbyterian University Hospital of Columbia and Cornell
- Mount Sinai Hospital
- Lenox Hill Hospital
- Beth Israel Medical Center
- NYU Langone Medical Center
- Montefiore Medical Center
Other locations in New York that facilitate clinical learning for nurse-midwife students include:
- Francis Hospital in Roslyn
- Northern Westchester Hospital in Mount Kisco
- Winthrop-University Hospital in Mineola
- North Shore University Hospital in Manhasset
- Glen Cove Hospital in Glen Cove
- Phelps Memorial Hospital Center in Sleepy Hollow
Dual Certification in Nurse Midwifery and Women’s Health
Some graduate schools allow students to choose a dual-focus Nurse-Midwife/Women’s Health Nurse Practitioner (NM/WHNP) program. Graduates of these programs would have the option of becoming dually-certified as both a nurse midwife (CNM credential) and board certified women’s health nurse practitioner (WHNP-BC credential), as well as being eligible for licensure in both specializations through the NYSED Office of the Professions.
It is important to note that in order to refer to yourself as a Women’s Health NP in New York and offer healthcare services within this role, you would need to go through a separate licensing process to earn additional Nurse Practitioner licensure through the NYSED Office of the Professions-Nursing Section.
Step 2. Pass the National Nurse-Midwife Certification Examination
Upon graduating from an ACME-accredited master’s program, CNM candidates would apply to take the Certified Nurse-Midwife Exam through the American Midwifery Certification Board (ACMB).
Candidates who have earned a dual-focus Nurse-Midwife/Women’s Health Nurse Practitioner degree have the option of also attempting the Women’s Health Care Nurse Practitioner exam through the National Certification Corporation (NCC).
Both exams are administered through Applied Measurement Professional (APM) test centers in the following locations:
- Albany
- Buffalo
- Long Island
- Queens
- Rochester
- Selden
- Ultica
- White Plains
Certified Nurse Midwife Exam
The Certified Nurse-Midwife Exam is made up of 175 questions in a multiple-choice format. Sample questions and other helpful information can be found in the Candidate Handbook. Candidates take the test via a computer, and have a time limit of four hours to complete it. Subjects covered on the exam will include:
- Midwifery
- Obstetrics
- Maternal-newborn nursing
- Gynecology
- Women’s health care
- Contraception
- Newborn care
The test is graded and scored by the following rubric:
- Primary Care – 12-16 percent
- Antepartum Care – 15-25 percent
- Intrapartum Care – 25-35 percent
- Postpartum – 5-10 percent
- Newborn Care – 10-15 percent
- Well Woman/Gynecology – 15-20 percent
- Professional Issues – up to 5 percent
To apply for the Certified Nurse-Midwife Exam, candidates can fill out an application online or print and mail an application to the following address:
The American Midwifery Certification Board
849 International Drive, Suite 120
Linthicum, MD 21090
After examinees have completed the exam, they will be granted the Certificate in Nurse Midwifery (CNM). Once certified, CNMs are eligible for the Licensed Midwife designation through the New York State Education Department Office of the Professions-Midwifery Section.
Women’s Health Care Nurse Practitioner Exam Process
Those who also choose to take the Women’s Health Care Nurse Practitioner (WHNP) Exam will have three hours to complete the 150 multiple-choice questions. Sample questions and other important details can be found in the WHNP Candidate Guide.
Exam topics and scoring rubric information are as follows:
- Gynecology – 35-40 percent
- Obstetrics – 25-30 percent
- Diagnostic testing and physical assessment – 10-15 percent
- Primary Care – 10-15 percent
- Pharmacology – 5-10 percent
Preliminary scores will be reported immediately after completing the exam, and official results will be mailed to examinees within 21 days of the exam date.
After examinees have successfully completed the exam, they will be granted the Women’s Health Care Nurse Practitioner-Board Certified (WHNP-BC) credential.
It is important to note that in order to refer to yourself as a Women’s Health NP in New York and offer healthcare services within this role, you would need to go through a separate licensing process to earn additional Nurse Practitioner licensure through the NYSED Office of the Professions-Nursing Section.
Step 3. Apply for Nurse-Midwife Licensure through the New York State Education Department
The final step to becoming a nurse-midwife in New York is to apply to become a Licensed Midwife (LM) through the NYSED Office of the Professions-Midwifery Section.
The Licensed Midwife application process would involve completing the application and forwarding the remaining forms to the appropriate location as noted below. An authorized representative of your school and pharmacology training program would then complete the forms before forwarding them on to the NYSED Office of the Professions for final approval:
Form 1 – Application for Licensure must be submitted along with the $322 licensure and first registration fee. Checks should be made payable to the New York State Education Department.
Form 2 – Certification of Professional Education must be sent from the graduate school attended.
Form 2A – Certification Of Pharmacology Course Or The Equivalent Of Not Less Than Three Semester Hours must be sent from the institution providing the pharmacology course attended.
Form 2B – Certification Of Instruction In New York State And Federal Laws Relating To Prescriptions And Record Keeping must be sent from the institution/organization providing the instruction in New York State and federal laws relating to prescriptions and record keeping.
All completed forms and supporting documents would be sent to the following address:
New York State Education Department
Office of the Professions
PO Box 22063
Albany, NY 12201
Dually-certified nurses who also hold the WHNP-BC credential can also elect to become licensed as Women’s Health Nurse Practitioners through the NYSED Office of the Professions-Nursing Section.
Step 4. Explore Career Opportunities and Maintain Certification
Earning an average salary of approximately $120,380 as of 2019, New York’s CNMs are among the best paid in their field nationwide. As demand grows amid a shortage of certified nurse-midwives in the state, salaries have been increasing steadily as major hospitals and integrated health systems compete for qualified CNMs in an effort to meet the needs of a more discriminating patient base.
Some of the top employers of certified nurse-midwives in New York include:
- Joan H. Tisch Center for Women’s Health
- Emily Women’s Health Center
- Manhattan Women’s Medical
- Morris Heights Health Center
- Maimonides Women’s Health Services
- Westside Women’s Medical Pavillion
- Downtown Women OB/GYN Associates, LLP
- MIC Women’s Health Services
- Sloan Womens Health
- The Center for Women’s Health
- Choices Women’s Medical Center
A survey of job vacancy announcements for certified nurse-midwives in New York performed in 2015 provides insight into the types of opportunities available to newly licensed CNMs in the state. (These job listings are provided as illustrative examples only and do not represent a job offer or the assurance of employment.):
- Women’s Health Nurse Practitioner or Certified Nurse Midwife at SUNY Downstate Medical Center in Brooklyn
- Certified Nurse Midwife at Women’s Health Center in Mount Kisco
- Nurse Practitioner OB/GYN at Focus Staff in New York City
- Advanced Practice Clinician OB/GYN at Planned Parenthood in New York City
- Nurse Practitioner OB/GYN at Garden OB/GYN in Queens and Manhattan
License Renewal Through the New York State Education Department
Nurse-midwife and RN registration certificates must be renewed every three years.
Certificate in Nurse Midwifery (CNM) Renewal Through the American Midwifery Certification Board (AMCB)
CNMs must complete the AMCB’s Certificate Maintenance Program every five years. This process requires CNMs to choose one of the following certificate renewal options:
- Re-take the exam
- Complete three Certificate Maintenance Modules throughout the five-year cycle and 20 hours of continuing education
Women’s Health Care Nurse Practitioner (WHMP-BC) renewal through the National Certification Corporation
- Certificate must be renewed every three years
- Current Women’s Health NPs must take the Continuing Competency Assessment, then 10-50 hours of continuing education will be assigned according to the assessment results
Additional Resources and Advocacy for Licensed Midwives in New York
The New York State Association of Licensed Midwives (NYSALM), a local affiliate of the ACNM, serves as a professional association for LMs in New York that operates independent of any state government agency or licensing body. Whether you’re still a student in a midwifery graduate program or a veteran CNM, consider joining NYSALM to support their work in legislative advocacy and to gain access to all the networking and learning opportunities, news, and professional support the organization offers its members.
At the national level, NYSALM’s umbrella organization, the American College of Nurse-Midwives (ACNM), serves as the standards bearer for midwifery education and practice in the U.S. and the leading advocate for legislative change designed to strengthen the profession. ACNM’s Accreditation Commission for Midwifery Education (ACME) is the only organization authorized to accredit midwifery graduate programs, verifying they meet the requirements to produce graduates eligible for national certification through the American Midwifery Certification Board (AMCB). ACNM’s Committee for the Advancement of Midwifery Practice (CAMP) works to draft and support state-level legislation that advances the midwifery profession, and welcomes student members interested in lending their support to the professional community they’ll be part of after graduation.
Salaries for Certified Nurse-Midwives in New York
As of 2019, certified nurse-midwives in New York State earned a median salary of $116,040 according to the U.S. Department of Labor, Bureau of Labor Statistics. Experience continues to be the biggest factor contributing to higher CNM salaries, as is evident in the fact that the state’s most experienced certified nurse-midwives received salaries that fell within the 90th percentile, earning an average of $161,820. In comparison, certified nurse-midwives who were new to the field earned an average of $83,130 that year.
The Growing Demand for Certified Nurse-Midwives in New York
The U.S. Department of Labor expects the number of jobs for CNMs in the state to increase by 25% between 2018 and 2028. Even with such a strong job growth projection, current trends suggest the possibility of an even faster rate of growth.
In 2018, about 7-10.99% of births in New York 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.
New York’s certified nurse-midwives enjoy the ability to practice independently after meeting requirements for obtaining prescriptive authority. This level of autonomy allows the state’s CNMs to provide care to the full extent of their training and education, which is particularly important in rural parts of the state with a recognized shortage of OB-GYN physicians.
While New York State has a high ratio of OB-GYN physicians on a population basis, these physicians are not evenly distributed in the state. In its 2014 workforce fact sheet for New York, the American Congress of Obstetricians and Gynecologists identified nine counties in New York with no OB-GYN specialists:
- Delaware County
- Essex County
- Hamilton County
- Livingston County
- Schoharie County
- Seneca County
- Tioga County
- Yates County
- Washington County
Salaries of Certified Nurse-Midwives in New York’s Major Metropolitan Areas
On average, certified nurse-midwives in New York City earned more than what was other parts of the state as of 2019, according to the BLS.
New York-Newark-Jersey City
- Entry-level: $84,910
- Average: $117,680
- Experienced: $155,760
Buffalo-Cheektowaga-Niagara Falls
- Entry-Level: $90,710
- Average: $114,950
- Experienced: $138,030
(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.)