Professional Association

American College of Nurse-Midwives (ACNM)

General Duties:

• Provide gynecological exams, contraceptive counseling, prescriptions, and care during pregnancy, labor, delivery, and after birth.
• Educate their patients on how to lead healthy lives by discussing topics such as nutrition and disease prevention, as well as sexual health.
• Office hours providing routine gynecological services, or on-call hours where they assist women in labor and childbirth.

What environment(s) and/or settings is this profession employed?

• 47% physician offices
• 27% hospitals
• 9% outpatient care centers

What are the skills/qualities needed to be successful in this field?

Some skills that are needed to be successful as a midwife are being compassionate, patient, observant, culturally competent, and having counseling, listening, and communication skills.

What is the employment outlook? 

There are only 6,500 midwives in the US (2018). Projected employment 2028: 7,600, a 16% increase, 1000 new jobs.

What is the average salary/earnings for this profession? What is the average indebtedness of professionals entering the field? 

Median annual wage: $103,770 (May 2018). In Massachusetts: $119,380

Other healthcare professionals someone in this career may interact and/or collaborate with:

Family physicians, Obstetricians, Gynecologists, Nurses, Hospital managers/administrators

What kind of educational training/qualifications does entry into this career require? 

• Nurse-midwives should have a BSN (Bachelor of Science degree in Nursing) from an accredited institution and then pursue an advanced degree (Master’s degree) in Midwifery.
• Graduate degree is required for entry into midwifery practice
• Must take the national certification exam from the American Midwifery Certification Board (AMCB) to become certified
• CNM must recertify every 5 years.

Professional Interviewed:

Sheila Kaufman, Certified Nurse Midwife, Philadelphia Pennsylvania

How did they become interested in this field?

Sheila took pre-med classes at Brandeis and majored in Spanish. Her senior year she took a sociology class where one of the topics she learned about was midwifery and how powerful this role can be. She found that midwifery spoke to her a lot more than OB. After Brandeis, she got a fellowship teaching abroad. When she came back, she got a job working at Planned Parenthood, meanwhile finishing pre-requisites for nursing school since Brandeis did not offer some.

What do they like about what they do?

“The midwifery model of care spoke to me because it serves to improve the way we have been providing reproductive healthcare in the past century. As midwives, we approach birth as a normal process that generally needs support and only needs intervention when it ventures outside of the physiologic norm. And we approach well-person care also from that vantage point: give education to help out clients make good decisions to improve their health. This model of providing support as an ally rather than a paternalistic paradigm is what spoke to me when I was in sociology classes at Brandeis and what continues to speak to me today. Midwives are at the forefront of addressing disparities in maternal care and much of our focus recently has been working to improve outcomes in the African American community, reducing unnecessary cesarean births and incorporating gender affirming care for trans and gender non-conforming patients. At times I am exhausted, physically and emotionally, by what is in front of me and by what lies ahead. But I also can say with complete honesty that I think I have the coolest job out there. My patients inspire me with their resilience and humanity and it is a privilege to bear witness to their strength.”

How do they think their field will change in the next 10 years?

A couple of things are on the horizon. When she was in school, most people were certified by a single board and went to nursing schools. Today, there are many different paths and a separate unified group of professional midwives with their own board. There is a lot of conversation going on about how these two groups interact. Every state has their own laws about midwifery practice. Sheila sees midwifery roles becoming more legitimized in the future through doctorate degrees rather than masters. She also sees the profession increasingly expanding because it is a cost cutting profession leading to cheaper and better birth outcomes.

What is their advice for those interested in this career?

Learn more about doulas, which are a great introduction to give exposure to what the work is like. Examine what your interests are. People will ask why you did not go to medical school, so know the answer to that. The more one can explore what it really means, the better. Become a birth assistant. Gain as much exposure as you can and know what speaks to you most.

Options can be to be either a labor and delivery nurse or an outpatient nurse before being a midwife. There’s a lot of back and forth on labor and delivery nurses and whether it is worthwhile. Could be positive to see what it looks like but majority of births would be with a physician who have a different model of care and more intervention. Both options would lead to strong midwifery practice.