Last Updated: May 2025 | Reviewed by Abbie Jacobs
Colorado stands out as one of only thirteen jurisdictions in the United States that recognize both pathways to midwifery practice: the traditional Certified Nurse-Midwife (CNM) route and the alternative Certified Midwife (CM) pathway. This unique recognition offers aspiring midwives flexibility in their educational journey while upholding the highest standards of practice. With nurse midwives attending 13.7% of all births statewide and practicing in approximately 70 facilities across Colorado, the profession offers significant opportunities for meaningful careers in maternal and reproductive healthcare.
Colorado’s robust midwifery education infrastructure, exemplified by the University of Colorado College of Nursing’s exceptional 100% pass rate on the board certification exam, ensures that graduates are well-prepared for successful careers. Whether you’re a registered nurse seeking to advance into midwifery specialization or someone with a different healthcare background interested in the CM pathway, Colorado provides comprehensive pathways to achieve your professional goals.
“The University of Colorado’s midwifery program transformed my career and gave me the confidence to provide comprehensive women’s healthcare. The faculty mentorship and clinical experiences in Denver and Aurora prepared me exceptionally well for independent practice. Today, I’m proud to be part of Colorado’s growing community of midwives making a difference in women’s lives.” – Lisa Chen, CNM, Class of 2023
Understanding Colorado’s Dual Pathways to Midwifery Practice
Colorado’s progressive approach to midwifery education offers two distinct yet equally respected pathways to professional practice. Both the CNM and CM credentials require identical educational standards, national certification, and scope of practice, with the primary difference being the prerequisite nursing licensure for CNMs.
Midwifery Pathways in Colorado
| Credential | Prerequisites | Scope of Practice | License Renewal |
|---|---|---|---|
| Certified Nurse-Midwife (CNM) | Current Colorado RN License | Full midwifery scope including prescriptive authority | Every 2 years with RN license |
| Certified Midwife (CM) | Bachelor’s degree (any field) | Identical to CNM scope and privileges | Every 2 years |
The CM credential, developed in 1994 and first licensed in 1997, represents an innovative approach to expanding access to midwifery care. Both CNMs and CMs complete the same core competencies, take identical board examinations, and maintain equivalent standards for continuing education and professional development.
Steps to Becoming a Nurse Midwife in Colorado
The journey to becoming a certified nurse midwife in Colorado requires completion of graduate-level education, national certification, and state licensure. The following steps provide a comprehensive roadmap for both CNM and CM pathways:
Step 1. Earn a Qualifying Master’s Degree or Higher in Nurse-Midwifery
Both CNM and CM pathways require completion of a master’s degree or higher from a program accredited by the Accreditation Commission for Midwifery Education (ACME). These programs must be recognized by agencies approved by the Council for Higher Education Accreditation or the U.S. Department of Education, ensuring the highest educational standards.
University of Colorado College of Nursing Programs
The University of Colorado College of Nursing offers multiple pathways to meet Colorado’s educational requirements, all of which achieve an exceptional 100% pass rate on the board certification exam. These accredited programs provide comprehensive preparation for both theoretical knowledge and clinical expertise:
Program Options
| Program Type | Designed For | Typical Duration |
|---|---|---|
| Master of Science in Nurse-Midwifery | RNs with Bachelor of Science in Nursing (BSN) degrees | 2.5 years (7 semesters) |
| BS to DNP Nurse-Midwifery | RNs seeking doctoral preparation | 4 years (11 semesters) |
| Post-Graduate Certificate | RNs with existing master’s degrees in nursing | 1.5 years |
| Dual Focus NM/WHNP Programs | RNs seeking dual specialization | Varies by program structure |
Admission Requirements
Admission standards maintain consistency across campus-based and online programs, with requirements typically including:
- Current RN license (for CNM pathway) or bachelor’s degree (for CM pathway)
- BSN or completion of nursing prerequisite courses
- Minimum GPA requirements (typically 3.0 or higher)
- GRE General Test scores
- Personal essay, video essay, or statement of purpose
- Letters of recommendation from academic and professional references
- Clinical experience in women’s health or maternal care (preferred)
Curriculum and Clinical Training
Graduate programs typically include 40-60 semester credits of didactic coursework combined with approximately 1,000 hours of clinical education. The comprehensive curriculum covers essential topics in midwifery practice:
- Advanced pathophysiology and pharmacology
- Legal issues and ethics in maternal healthcare
- Advanced clinical assessment and diagnostic reasoning
- Labor, birth, and newborn care procedures
- Complicated pregnancies and high-risk management
- Women’s health across the lifespan
- Research methods and evidence-based practice
- Healthcare policy and leadership
Clinical education takes place in diverse healthcare settings throughout Colorado, with the University of Colorado offering guaranteed clinical placements at its Denver and Aurora midwifery clinics. Students work alongside faculty mentors and experienced practitioners in hospitals, birth centers, and outpatient clinics.
Many aspiring midwives choose dual specialization programs that prepare graduates for both Certified Nurse-Midwife and Women’s Health Nurse Practitioner credentials, thereby expanding their career opportunities and the scope of their practice.
Step 2. Take and Pass the National Certification Examination to Become a CNM
National certification through the American Midwifery Certification Board (AMCB) represents a crucial milestone in becoming a practicing midwife. Both CNM and CM candidates take the identical examination, ensuring equivalent standards across pathways.
AMCB Certification Examination
The comprehensive examination consists of 175 multiple-choice questions covering the full spectrum of midwifery practice. Candidates have four hours to complete the examination, which evaluates competency in:
Examination Content Areas
| Content Area | Percentage of Exam | Focus |
|---|---|---|
| Antepartum Care | 19-26% | Prenatal care, risk assessment, and health promotion |
| Intrapartum Care | 17-26% | Labor management, delivery, and emergency procedures |
| Postpartum Care | 15-18% | Maternal recovery, breastfeeding support |
| Gynecology | 15-18% | Reproductive health, contraception, and screening |
| Women’s Health & Primary Care | 8-16% | Preventive care, health maintenance |
| Newborn Care | 7-16% | Immediate newborn assessment and care |
Examination Preparation and Testing
Candidates can register for the examination through the AMCB website and prepare using the comprehensive Candidate Handbook. Testing is conducted through Professional Service Industries (PSI) at testing centers located in:
- Aurora
- Grand Junction
Upon successful completion, candidates receive their CNM or CM certification, which is valid for five years and can be renewed through the AMCB’s Certificate Maintenance Program.
Step 3. Apply for Advanced Practice Registration through the Colorado Board of Nursing
Following successful completion of educational requirements and national certification, candidates must apply for licensure through the Colorado Department of Regulatory Agencies’ Board of Nursing.
Application Process
Applications must be submitted through the Division of Professions and Occupations Online Services Portal. The comprehensive application includes:
- Proof of AMCB certification
- Official transcripts from ACME-accredited programs
- Fingerprints for FBI and Colorado Bureau of Investigation background checks
- Application fees and required documentation
- Professional references and work history
Within 24 hours of application submission, candidates must create a Healthcare Professional Profile (HPP) with DORA.
Prescriptive Authority
Advanced Practice Registration does not automatically include prescriptive authority. Midwives seeking prescription privileges must apply separately and meet additional requirements:
- Active and unencumbered Colorado RN license or compact state license
- Completion of a 750-hour mentorship program with a physician or APN with prescriptive authority
- Professional liability insurance of at least $500,000 per claim
- Graduate-level coursework in pharmacology, pathophysiology, and patient assessment
- DEA registration for controlled substance prescriptions
The mentorship requirement ensures that new practitioners gain supervised experience before engaging in independent prescriptive practice, thereby enhancing patient safety and professional competence.
Professional Liability Insurance
Colorado law requires midwives engaged in independent practice to maintain professional liability insurance with minimum coverage of:
- $500,000 per claim
- $1,500,000 aggregate annual liability
This requirement applies specifically to independent practice settings, with employed midwives typically covered through institutional policies.
Step 4. Explore Career Options and Maintain Professional Credentials
Colorado’s diverse healthcare landscape presents numerous opportunities for certified nurse midwives in both urban and rural settings. With midwifery care covered by most insurance types statewide, practitioners can establish sustainable practices while providing essential women’s healthcare services.
Practice Settings and Employment Opportunities
Certified nurse midwives practice in approximately 70 facilities across Colorado, serving diverse populations in settings including:
- Hospital labor and delivery units
- Freestanding birth centers
- Outpatient women’s health clinics
- Community health centers
- Private practice groups
- Academic medical centers
- Rural healthcare facilities
Major employers and practice models throughout Colorado include:
- University of Colorado Hospital and Anschutz Medical Campus
- Denver Health Medical Center
- Presbyterian/Saint Joseph Hospital System
- The Birth Center of Boulder
- Mountain Midwifery Birth Center (Englewood)
- Bloomin’ Babies Birth Center (Grand Junction)
- Memorial Hospital North (Colorado Springs)
- Parkview Medical Center (Pueblo)
License Renewal and Continuing Education
Professional credentials require ongoing maintenance to ensure current competency:
Renewal Requirements
| Credential | Renewal Cycle | Requirements |
|---|---|---|
| Colorado APRN License | Every 2 years (September 30) | Maintenance of national certification |
| AMCB Certification | Every 5 years | Continuing education or re-examination |
| Prescriptive Authority | With an APRN license | Additional mentorship and safety planning |
Colorado does not currently require specific continuing education hours for license renewal, though practitioners are strongly encouraged to pursue ongoing professional development through conferences, certifications, and specialized training.
Salaries and Career Outlook for Nurse Midwives in Colorado
Colorado offers competitive compensation for certified nurse midwives, reflecting the high demand for these specialized healthcare providers. The Denver-Aurora-Lakewood metropolitan area employs approximately 90 nurse midwives with favorable salary ranges across experience levels.
Colorado CNM Salary Data (2023)
| Percentile | Annual Salary | Hourly Wage |
|---|---|---|
| 25th Percentile | $93,540 | $44.97 |
| Average (Mean) | $109,900 | $52.83 |
| 90th Percentile | $150,750 | $72.48 |
Job Growth and Market Demand
The U.S. Department of Labor’s Employment and Training Administration projects exceptional growth for nurse midwives in Colorado, with employment expected to increase by 31% between 2018 and 2028. This significant growth rate far exceeds the average for all occupations, reflecting:
- Increasing consumer preference for midwifery care
- Growing recognition of midwifery’s safety and cost-effectiveness
- Rural healthcare provider shortages
- Expansion of the birth center and home birth services
Healthcare Workforce Needs
Colorado faces significant shortages of healthcare providers, particularly in rural areas and for specialized women’s health services. According to the American Congress of Obstetricians and Gynecologists, half of Colorado’s counties lack OB-GYN physicians, creating critical opportunities for certified nurse-midwives to address these gaps.
The Colorado Center for Nursing Excellence identifies particularly high demand for healthcare workers in these counties:
- Adams County
- Arapahoe County
- Boulder County
- Denver County
- Douglas County
- Jefferson County
- Mesa County
- Pueblo County
- Weld County
(Salary data for nurse-midwives reported by the U.S. Bureau of Labor Statistics in May 2023. 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 May 2025.)
Frequently Asked Questions
What’s the difference between a CNM and CM in Colorado?
Both credentials have identical scopes of practice, educational requirements, and examination standards. The primary difference is that CNMs must maintain an active RN license, while CMs do not require nursing licensure. Colorado is one of only 13 jurisdictions recognizing the CM credential.
How long does it take to become a nurse midwife in Colorado?
The timeline varies by pathway: Master’s programs typically take 2.5 years, BS to DNP programs require 4 years, and post-graduate certificates take 1.5 years. Additional time is required for licensure processing and completion of mentorship requirements for prescriptive authority.
Can I practice midwifery in Colorado with an online degree?
Yes, Colorado accepts graduates from ACME-accredited online programs. However, all programs require extensive clinical training, which must be completed in approved healthcare facilities. The University of Colorado offers hybrid online programs with guaranteed clinical placements.
What is the mentorship requirement for prescriptive authority?
Colorado requires a 750-hour mentorship program with a physician or advanced practice nurse who has prescriptive authority in the same specialty area. This mentorship must be completed in Colorado and includes supervised clinical practice.
Do I need malpractice insurance to practice as a midwife in the state of Colorado?
Yes, midwives engaged in independent practice must maintain professional liability insurance with minimum coverage of $500,000 per claim and $1,500,000 aggregate annual liability. Employed midwives are typically covered through institutional policies.
How much do nurse midwives earn in Colorado?
The average annual salary for nurse midwives in Colorado is $109,900, with entry-level positions starting around $93,540 and experienced practitioners earning up to $150,750 or more.
Ready to begin your journey toward becoming a certified nurse midwife in Colorado? Explore comprehensive midwifery education resources and take the first step toward a rewarding career providing essential women’s healthcare services throughout the state.