Under Mississippi law, the practice of midwifery is generally unregulated, prompting many expectant mothers to seek the services of certified nurse-midwives (CNM), trained in the science of evidence based healthcare and skilled in the minimally invasive practice of midwifery. Educated with a master’s degree in nurse-midwifery, and nationally certified by the American College of Nurse Midwives (ACNM), CNMs are qualified to provide care to expectant mothers through all stages of pregnancy and childbirth, as well general gynecologic well-woman care throughout the lifespan.
Licensed through the Mississippi Board of Nursing as advanced practice registered nurses (APRNs), Mississippi’s certified nurse-midwives are granted prescriptive authority and the ability to provide comprehensive care within their scope of practice under a collaborative agreement with a physician.
In 2018, less than 7% of births in Mississippi 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.
One of the top employers of Mississippi’s CNMs is Baptist Memorial Healthcare, the parent company of four hospitals providing maternity services in cities throughout Mississippi. Baptist Memorial Hospitals have come to rely on the dedicated certified nurse-midwives in their staff to overseeing high-risk pregnancies and attend childbirths, while providing obstetric and neonatal care.
Steps to Becoming a Certified Nurse-Midwife in Mississippi
Mississippi’s registered nurses with unencumbered licenses in good standing are able to become certified nurse-midwives by earning a qualifying master’s degree, national certification in nurse-midwifery and meeting the qualifications for advanced practice registered nurse (APRN) licensure through the Mississippi Board of Nursing:
Step 1. Earn a Qualifying Master’s or Higher Degree in Nurse-Midwifery
To qualify for national certification in nurse-midwifery and advanced practice licensure through the Mississippi Board of Nursing, aspiring CNMs must earn a master’s or higher degree through a program that has been accredited by Accreditation Commission for Midwifery Education (ACME).
With just 39 ACME-accredited nurse-midwife programs throughout the nation, Mississippi, like many other states, is not home to any schools with accredited campus-based programs that would qualify graduates for national certification and state licensure. As such, most aspiring nurse-midwives in Mississippi opt to enroll in accredited online programs designed to accommodate the busy schedules of working RNs while offering the same level of rigor and clinical training as a campus-based program. Students of online programs work with program advisors to arrange for placement in local facilities for their clinical sequences.
Admissions Requirements
RNs would pursue different graduate programs based on the degree they currently hold. While bachelor’s prepared RNs would enroll in a conventional master’s program in nurse-midwifery, RNs who only hold an associate’s degree would enroll in an accredited RN-to-MSN bridge program with a focus in midwifery to earn both their BSN and master’s degree in one accelerated program.
Standard admissions requirements include:
- A BSN, or a related education that includes completion of nursing prerequisites
- Current RN license
- Minimum GPA
- Personal statement or video essay
- Letters of recommendation
- GRE General Test
Program Structure, Content, and Options for Dual Specialization
Nurse midwife programs consist of two components: Didactic coursework and clinical experience. The classroom component usually consists of between 40-60 credits, while clinical sequences generally require 500-1,000 hours and are completed concurrent with didactic coursework.
All accredited nurse-midwife programs cover the core competences for advanced practice nursing (Pathophysiology, Physiology and Pharmacology) in addition to coursework specific to nurse-midwifery and women’s health:
- Ambulatory Care of Women
- Family Crisis Care
- Intrapartum Care
- Newborn Care
- Midwifery Care During Labor
- Midwifery Care During Pregnancy
- Biostatistics for Health Care Providers
- Women’s Reproductive Healthcare
Clinical sequences provide nurse-midwifery students with hands-on experience to compliment classroom learning. Students complete their clinical work at local hospitals and birth centers. Students in online programs would work with their program’s advisor to arrange to be placed in a local facility that meets the program’s requirements. Facilities in Mississippi that support clinical sequences for online students include:
- Baptist Medical Center in Jackson
- Baptist Memorial Hospital in locations throughout Mississippi
- Forrest General Hospital in Hattiesburg
- Garden Park Medical Center in Gulfport
- Madison River Oaks Medical Center in Canton
- Magnolia Regional Health Center in Corinth
- Memorial Hospital at Gulfport in Gulfport
- Merit Health Biloxi in Biloxi
- North Mississippi Medical Center in Tupelo
- Ocean Springs Hospital in Ocean Springs
- OCH Regional Medical Center in Starkville
- River Oaks Hospital in Flowood
- Rush Foundation Hospital in Meridian
- University of Mississippi Medical Center in Grenada
- Wesley Medical Center in Hattiesburg
- Woman’s Hospital in Flowood
- Women’s Hospital of Tupelo in Tupelo
Many of today’s bachelor’s prepared RNs are enrolling in programs that offer dual specialization in nurse midwifery and women’s health, structured as Nurse-Midwife/Women’s Health Nurse Practitioner (NM/WHNP) master’s programs. Graduates of these programs have the option of becoming certified in both nurse-midwifery (CNM credential) and board certified as women’s health nurse practitioners (WHNHP-BC credential).
As experts in women’s health and nurse-midwifery, these advanced practitioners often serve the gynecological and general care needs of women well beyond pregnancy and childbirth.
Step 2. Pass the National Nurse-Midwife Certification Examination
Upon graduating from a master’s degree program in nurse-midwifery, CNM candidates would then apply to take the Certified Nurse Midwife Exam, offered by the American Midwifery Certification Board (AMCB). The completed application form must be sent to the following address:
AMCB
849 International Drive, Suite 120
Linthicum, MD 21090
RNs have four hours to complete the Certified Nurse Midwife Exam, which consists of 175 multiple-choice questions. The exam may be taken at the AMP Testing Center in the H&R Block office in Jackson located at the following address:
Jackson H & R Block Office
5250 I-55 N Suite C
Jackson, MS 39211
The AMCB offers an online Candidate Handbook to help RNs prepare for the exam. The exam covers the following sections:
- Antepartum – 19-26 percent
- Intrapartum – 17-26 percent
- Postpartum – 15-18 percent
- Gynecology – 15-18 percent
- Women’s health and primary care – 8-16 percent
- Newborn – 7-16 percent
The AMCB grades the exam on a pass/fail scoring system. Examinees that receive a passing score receive their Certificate in Nurse Midwifery (CNM) from the AMCB.
Graduates of dual focus nurse midwife/women’s health nurse practitioner programs that wish to practice as both a certified nurse-midwife (CNM) and women’s health care nurse practitioner (WHNP-BC), would also take the Women’s Health Care Nurse Practitioner Exam through the National Certification Corporation (NCC).
The 150-question exam is divided into the following segments:
- Pharmacology – 5-10 percent
- Primary Care – 10-15 percent
- Diagnostic testing and physical assessment – 10-15 percent
- Obstetrics – 25-30 percent
- Gynecology – 35-40 percent
To prepare for the exam, exam candidates would use the WHNP Candidate Guide on the NCC website. Examinees that pass the exam will receive their WHNP-Board Certification.
Step 3. Apply for Advanced Practice RN Certification in Mississippi as a Certified Nurse-Midwife
With their national certifications in hand, CNMs must then apply to become an APRN with the Mississippi Board of Nursing. The Board uses an online program called Nurse Gateway to handle applications. APRN certification candidates must register with the program to apply for APRN certification.
The Mississippi Board of Nursing requires APRNs to complete a 720-hour residency under the guidance of a licensed physician or current APRN. Applicants must submit proof of the residency through Nurse Gateway to begin unmonitored practice.
RNs who have completed their 720 hours of residency may apply for the privilege to prescribe uncontrolled substances. To do so, they must undergo the following steps:
- Register with the U.S. Drug Enforcement Administration (DEA) and receive a Uniform Controlled Substances Registration Certificate
- Complete the appropriate application form under the Nurse Gateway program
- Pay a $100 fee to the Mississippi Board of Nursing
Step 4. Begin a Career in Nurse-Midwifery in Mississippi and Maintain Credentials
A number of Mississippi hospitals offering maternity services seek out the expertise of certified nurse-midwives and women’s health NPs. Among the top employers of nurse midwives in the state are also the organizations that support clinical training for nurse-midwife students. As such, many recent graduates pursue career opportunities at the facility in which they received their clinical training:
- Baptist Medical Center in Jackson
- Baptist Memorial Hospital in locations throughout Mississippi
- Forrest General Hospital in Hattiesburg
- Garden Park Medical Center in Gulfport
- Madison River Oaks Medical Center in Canton
- Magnolia Regional Health Center in Corinth
- Memorial Hospital at Gulfport in Gulfport
- Merit Health Biloxi in Biloxi
- North Mississippi Medical Center in Tupelo
- Ocean Springs Hospital in Ocean Springs
- OCH Regional Medical Center in Starkville
- River Oaks Hospital in Flowood
- Rush Foundation Hospital in Meridian
- University of Mississippi Medical Center in Grenada
- Wesley Medical Center in Hattiesburg
- Woman’s Hospital in Flowood
- Women’s Hospital of Tupelo in Tupelo
APRN Certification Maintenance with the Mississippi Board of Nursing
All Mississippi APRNs must renew their application with the Mississippi Board of Nursing between October and December of even numbered years. The renewal process can be completed through the Nurse Gateway program.
CNM Certification Maintenance with the American Midwifery Certification Board (AMCB)
To maintain CNM certification with the AMCB, nurses must either retake the AMCB Certification Examination or complete three AMCB Certificate Maintenance Modules and 20 AMCB-approved contact hours of CE during every five-year certification cycle.
Nurses who choose to retake the exam are required to pay a one-time $500 fee to the AMCB. Nurses who complete the modules and contact hours are subject to an annual fee, as determined by the AMCB.
WHNP-BC Certification Maintenance with the National Certification Corporation (NCC)
The National Certification Corporation (NCC) requires WHNPs to complete a continuing competency assessment every three years. The NCC also sends nurses an education plan that details their CE requirements for the three-year cycle.
Salaries for Certified Nurse-Midwives in Mississippi
The U.S. Bureau of Labor Statistics published salary information for certified nurse-midwives working in the state in a 2019 report. According to the data, nurse-midwives in the state earned an average annual salary of $119,640.
Certified nurse-midwives just entering the field in Mississippi earned starting salaries of $83,660 in the 10th percentile. Highly experienced nurse-midwives in Mississippi enjoyed a whopping annual salary of $182,550 as of 2019 in the 90th percentile.
Shortage of Advanced Practice RNs Paves the Way for More CNM Jobs in Mississippi
Despite a growing trend, which has revealed the fact that more women are interested in pursuing the safety and comfort of childbirth at home, there remains a severe shortage of Advanced Practice Nurses (APN), including nurse-midwives, in the state of Mississippi. However, the United States Department of Labor projects a 3% increase in the number of nurse anesthetists statewide during the 10-year period leading up to 2028.
Mississippi has one of the highest birth rates in the country and many prefer at-home and birthing center deliveries, especially in the state’s various rural regions. The demand for certified nurse-midwives in Mississippi has reached an unprecedented level and opportunities for employment in the field are promising.
CDC Confirms Rise in Frequency of Home Births and Acknowledges the Safety of Nurse-Midwifery
The Centers For Disease Control and Prevention (CDC) reported a 29% national increase in home births from 2004 to 2009. In fact, it stated that home births in the state were at their highest point since the CDC began collecting data in 1989.
Their findings also reported lower risk profiles in home births attended by certified nurse-midwives than those that took place in a hospital setting.
(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.)