Certified nurse-midwives (CNMs) earn a median annual salary of approximately $132,050, according to the Bureau of Labor Statistics Occupational Employment and Wage Statistics (May 2024 data, released 2025). That figure places CNMs among the higher-earning advanced practice registered nurses (APRNs), reflecting the graduate-level education, clinical responsibility, and specialized skill set the role demands. For pre-health students researching career paths in women’s health, primary care, or maternal and child health, understanding the nurse midwife salary landscape is a practical step toward informed planning.
CNM compensation varies meaningfully based on geography, work setting, and years of experience. Knowing the median alone does not give you the full picture. This article breaks down verified salary data, explains where CNMs work and what they actually do, covers job outlook projections, and addresses common questions students and career explorers tend to have.
What a Certified Nurse-Midwife Actually Does
A certified nurse-midwife is an advanced practice registered nurse who has completed a graduate-level program (Master’s or Doctorate) in midwifery and passed the national certification exam administered by the American Midwifery Certification Board. CNMs are licensed to provide a broad scope of primary healthcare for women across the lifespan, not just during pregnancy and childbirth.
Their clinical responsibilities include prenatal care, labor and delivery management, postpartum care, gynecological exams, contraception management, STI screening and treatment, and newborn care during the first 28 days of life. CNMs are trained to manage low-risk pregnancies independently and to identify complications that require physician referral. They can prescribe medications and order diagnostic tests within their scope of practice, which varies by state.
It is worth noting that CNMs are distinct from doulas and lay midwives. A doula provides non-medical emotional and physical support during labor. A lay midwife, sometimes called a direct-entry midwife, attends births with varying levels of formal training and licensure. A CNM, by contrast, holds a nursing degree, advanced midwifery credentials, and national board certification. This distinction matters when comparing compensation, scope, and career requirements.
CNM Salary Breakdown: National Data and Key Variables
National Median Compensation
The BLS groups nurse-midwives with nurse anesthetists and nurse practitioners under occupation code 29-1151. According to the most recent BLS Occupational Employment and Wage Statistics (May 2024 data), the median annual wage for this combined APRN category is approximately $132,050. When looking at midwife salary data specifically, it is important to understand that BLS reporting for this combined category reflects the broader APRN market, and individual CNM earnings may fall above or below the median depending on several factors.
Pay by State
Geographic location is one of the strongest predictors of CNM compensation. States with higher costs of living, greater demand for maternal healthcare providers, or more favorable practice authority laws tend to offer higher salaries. According to the BLS occupational employment data for nurse anesthetists, nurse midwives, and nurse practitioners (May 2024), top-paying states for the combined APRN category include California, New Jersey, and Washington, where annual mean wages exceed $145,000. States in the South and Midwest often report lower figures, though those regions may also have significantly lower costs of living, which affects real purchasing power.
Rural and underserved areas sometimes offer competitive or above-average pay to attract qualified CNMs. Federal programs through HRSA, including the National Health Service Corps, may provide loan repayment incentives for CNMs who practice in health professional shortage areas.
Pay by Experience
Entry-level CNMs typically earn less than the national median as they build clinical hours and establish their practice. The BLS reports that the bottom 10% of earners in the APRN category made less than $82,510 per year (May 2024 data), while the top 10% earned more than $212,000. Over time, CNMs who accumulate years of practice, take on leadership or educational roles, or develop subspecialty expertise tend to move toward the higher end of the pay scale. Salary growth is generally steady for APRNs, with meaningful jumps often tied to changes in setting, region, or scope of responsibility.
Pay by Work Setting
Where a CNM practices also shapes how much they earn. According to BLS data (May 2024), the most common employment settings for nurse-midwives include hospitals, outpatient care centers, and offices of physicians. Hospitals and outpatient care centers tend to offer higher base salaries, partly because of higher patient volumes and shift differentials for nights and weekends. CNMs working in birth centers or private practices may have different compensation structures, sometimes including productivity-based pay or profit-sharing arrangements.
Community health clinics and federally qualified health centers (FQHCs) may offer competitive salaries combined with benefits like loan repayment programs, making them financially attractive despite sometimes lower base pay compared to hospitals.
How CNM Salaries Compare to Other APRN Roles
CNM compensation is strong, but it is useful to see where it falls relative to other advanced practice nursing roles. Within the BLS combined APRN category (May 2024 data), nurse anesthetists (CRNAs) typically earn the highest median salaries, often exceeding $200,000 per year, while nurse practitioners (NPs) and nurse-midwives tend to fall closer to the overall category median of $132,050. The difference reflects variations in training length, clinical risk, and market demand.
Compared to physicians specializing in obstetrics and gynecology, CNM salaries are lower, but so are the years of training required. An OB/GYN completes four years of medical school plus four years of residency, while a CNM completes a graduate midwifery program (typically two to three years) after earning a BSN and gaining RN experience. For students weighing different paths into maternal health, the time-to-practice and total educational debt are important parts of the financial equation.
Job Outlook for Certified Nurse-Midwives
The BLS projects that employment of nurse-midwives will grow approximately 6% from 2022 to 2032, a rate roughly in line with the average for all occupations (BLS Occupational Outlook Handbook for nurse midwives, 2022 to 2032 projections). This translates to about 1,000 openings for nurse-midwives each year over the decade, driven by retirements, workforce attrition, and growing demand for women’s health services.
Several factors support sustained demand. The ongoing shortage of OB/GYNs in rural and underserved areas creates opportunities for CNMs to fill critical gaps in maternal care. States that have expanded APRN practice authority, allowing CNMs to practice independently without physician oversight, are seeing increased utilization of nurse-midwifery services. Additionally, growing patient interest in low-intervention, patient-centered approaches to childbirth aligns well with the CNM model of care.
The World Health Organization’s reporting on the global midwifery workforce underscores the broader importance of midwifery in reducing maternal and infant mortality worldwide. For students with an interest in global health, understanding the CNM role in the U.S. provides a useful lens for comparing maternal healthcare delivery across different systems.
Steps to Becoming a Certified Nurse-Midwife
For students considering this career path, the educational trajectory is straightforward but requires commitment. You must first earn a Bachelor of Science in Nursing (BSN) and pass the NCLEX-RN to become a licensed registered nurse. Most applicants then gain clinical experience as an RN, often in labor and delivery, postpartum care, or women’s health settings, before applying to a graduate midwifery program.
Graduate programs accredited by the Accreditation Commission for Midwifery Education (ACME) confer a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) with a midwifery concentration. After completing the program, graduates must pass the certification exam administered by the American Midwifery Certification Board (AMCB) to earn the CNM credential. State licensure requirements vary, so it is important to check the rules in the state where you plan to practice.
The entire process, from starting a BSN to earning CNM certification, typically takes seven to nine years, depending on how quickly you move through each stage and how much clinical experience you accumulate before graduate school.
What This Means for Pre-Health Students Considering Midwifery
If you are a pre-health student comparing career options, CNM salary data tells part of the story, but fit matters just as much as compensation. Midwifery appeals to students who want long-term relationships with patients, a focus on physiological processes, and clinical autonomy within a collaborative healthcare model. It is a career that rewards strong communication skills, comfort with clinical decision-making, and genuine interest in women’s health across the lifespan.
Gaining early exposure to maternal health settings, whether through shadowing, clinical observation, or structured pre-health programs, helps you evaluate whether midwifery aligns with your professional goals. Observing how CNMs interact with patients, manage labor, counsel families, and collaborate with physicians gives you practical insight that salary figures alone cannot provide.
For students interested in seeing maternal and child health delivery in international settings, programs like those offered by International Medical Aid provide structured opportunities to observe healthcare professionals, including those in maternal care roles, across different health systems. These experiences are observational and professionally supervised, designed to build perspective rather than clinical skills, and they can strengthen your understanding of how healthcare systems vary around the world.
Certified nurse-midwives are advanced-practice nurses. For how their pay compares with other nursing roles, see our nursing salary guide.
Frequently Asked Questions
How much does a midwife make compared to a nurse practitioner?
CNMs and nurse practitioners (NPs) fall within the same BLS occupational category, with a combined median annual salary of approximately $132,050 (BLS, May 2024 data). Individual earnings depend on specialty, location, and experience. In practice, NPs in high-demand specialties like psychiatric-mental health or acute care may earn more or less than CNMs depending on regional market conditions. The two roles share similar educational requirements but differ significantly in clinical focus and patient populations.
Is the CNM salary enough to justify the cost of a graduate midwifery program?
For most CNMs, the return on investment is favorable. Graduate midwifery programs typically take two to three years to complete, and total costs vary widely by institution. With a median salary above $130,000 and strong job stability, most CNMs are well positioned to manage educational debt, especially if they take advantage of loan repayment programs through HRSA or the National Health Service Corps. Financial fit depends on your specific program costs, living expenses, and practice setting after graduation.
What is the difference between a CNM and a CPM?
A Certified Nurse-Midwife (CNM) is an advanced practice registered nurse with a graduate degree in midwifery and national certification from the AMCB. A Certified Professional Midwife (CPM) is credentialed through the North American Registry of Midwives (NARM) and does not require a nursing degree. CPMs primarily attend home and birth center births, and their licensure and scope of practice vary by state. CNMs have a broader scope, including prescriptive authority, and can practice in hospitals, clinics, and birth centers. Compensation for CPMs is generally lower than for CNMs.
