Last Updated: May 2025 | Reviewed by Abbie Jacobs
Learning how to become a nurse-midwife in Texas involves a structured education, certification, and licensure pathway designed to prepare healthcare professionals for this rewarding career. Certified nurse-midwives have been practicing in Texas since 1972, with a growing proportion of women in the state turning to CNMs for antepartum, intrapartum, and postpartum care. Countless studies acknowledge outstanding outcomes for births attended by nurse-midwives, confirming what many women already know: The evidence-based interventions, personal attention, and superb quality of care that nurse-midwives provide make them ideal healthcare providers for women during childbearing years and throughout all stages of life.
Certified nurse-midwives have been practicing in Texas since 1972. Since then, a growing proportion of women in the state have turned to CNMs for antepartum, intrapartum, and postpartum care. Countless studies acknowledge outstanding outcomes for births attended by nurse-midwives, confirming what many women already know: The evidence-based interventions, personal attention, and superb quality of care that nurse-midwives provide make them ideal healthcare providers for women during childbearing years and throughout all stages of life.
As advanced practice nurses, nurse-midwives possess the skills and knowledge necessary to manage all aspects of maternity care for women with healthy pregnancies. Their expertise extends beyond pregnancy and delivery, encompassing comprehensive healthcare for women from adolescence through menopause and beyond, providing gynecological care, obstetrical care, family planning services, and more.
“After 5 years as an L&D nurse at Texas Health Presbyterian, I knew I wanted to become a nurse-midwife. This guide was invaluable in navigating my journey. I completed Baylor’s DNP program while working part-time, passed my AMCB exam on the first attempt, and now practice at a birth center in Austin. The step-by-step process outlined here saved me countless hours of confusion about Texas requirements and helped me find clinical placements. For any Texas RN considering midwifery, this roadmap truly works!”
Table of Contents
- Overview of Nurse-Midwifery in Texas
- Steps to Becoming a Nurse-Midwife in Texas
- Step 1: Earn a Qualifying Master’s Degree in Nurse-Midwifery
- Step 2: Pass the National Certification Examination
- Step 3: Apply for APRN Licensure in Texas
- Step 4: Begin Your Career as a Certified Nurse-Midwife
- Salaries for Certified Nurse-Midwives in Texas
- Frequently Asked Questions
Overview of Nurse-Midwifery in Texas
According to the American College of Nurse-Midwives, most nurse-midwives in Texas practice in hospitals. However, these healthcare providers also work in freestanding birth centers, ambulatory care settings, and home birth practices.
As of 2022, the U.S. Bureau of Labor Statistics reported that approximately 580 certified nurse-midwives were licensed to practice in Texas. According to the Centers for Disease Control and Prevention and the National Center for Health Statistics, less than 8% of births in Texas are attended by midwives.
The demand for certified nurse-midwives continues to grow as more women seek personalized, evidence-based maternity care and as healthcare systems recognize the value of midwifery in improving maternal and infant outcomes.
Steps to Becoming a Nurse-Midwife in Texas
The Texas Board of Nursing regulates the practice of nurse-midwifery through licensure of advanced practice registered nurses (APRNs). To become a nurse-midwife in Texas, you must complete several steps to meet requirements for national certification through the American Midwifery Certification Board and APRN licensure through the Texas Board of Nursing:
Step 1. Earn a Qualifying Master’s Degree or Higher in Nurse-Midwifery
To become an APRN in nurse-midwifery in Texas, you must first become a registered nurse (RN) and then complete a graduate degree in nurse-midwifery accredited by the Accreditation Commission for Midwifery Education (ACME).
Prerequisites for Nurse-Midwifery Programs
- Complete an approved nursing program (BSN preferred)
- Pass the NCLEX-RN examination
- Obtain RN licensure in Texas
- Gain clinical experience as an RN (highly recommended)
Nurse-Midwifery Program Options
In addition to traditional nurse-midwifery programs, many institutions offer dual specialization programs for nurse-midwifery/women’s health nurse practitioners. These programs allow students to expand their knowledge and certifications, enhancing future practice options and employability.
| Program Type | Designed For | Typical Duration |
|---|---|---|
| MSN/MS Programs | RNs with Bachelor of Science in Nursing (BSN) degrees | 2-3 years full-time |
| RN-to-MSN Programs | RNs with associate’s degrees in nursing | 3-4 years full-time |
| Post-Graduate Certificate Programs | RNs with an MSN wanting to add CNM certification | 1-2 years full-time |
| DNP Programs | RNs seeking the highest level of clinical preparation | 3-4 years full-time |
Nurse-Midwifery Programs in Texas
ACME-accredited nurse-midwifery programs in Texas are limited, with options in cities such as Waco and Lubbock. However, many online programs serve Texas students, offering flexible learning options for working RNs:
| Institution | Program Type | Format | Location |
|---|---|---|---|
| Baylor University | DNP in Nurse-Midwifery | Online with in-person immersions | Waco |
| Texas Tech University Health Sciences Center | MSN in Nurse-Midwifery | Hybrid | Lubbock |
| Texas Tech University Health Sciences Center | Post-Graduate Certificate | Hybrid | Lubbock |
Admission Requirements
For RNs who possess a Bachelor of Science in Nursing (BSN), the clear path to APRN licensure is through a Master of Science in Nursing (MSN) in nurse-midwifery or a Doctor of Nursing Practice (DNP) with a nurse-midwifery focus.
Candidates for nurse-midwifery programs typically need to possess:
- Bachelor of Science in Nursing (BSN) degree
- Current and unencumbered RN license
- Minimum undergraduate GPA (usually 3.0 or higher)
- Letters of recommendation
- Clinical nursing experience (often 1-2 years minimum)
- Personal statement or admissions essay
- Interview (for some programs)
Program Components
Nurse-midwifery graduate programs prepare registered nurses to serve as expert healthcare providers to women across the lifespan. The curriculum typically includes:
Didactic Coursework
- Advanced pathophysiology
- Advanced pharmacology
- Advanced health assessment
- Research methods and evidence-based practice
- Women’s health across the lifespan
- Antepartum care
- Intrapartum care
- Postpartum and newborn care
- Healthcare policy and leadership
Clinical Training
The clinical component typically consists of 600-1,000 hours of supervised practice in various settings:
- Hospital labor and delivery units
- Birth centers
- OB/GYN practices
- Women’s health clinics
- Community health centers
While campus-based programs generally place students at clinical sites near campus, online programs often help students arrange clinical experiences closer to home. Texas nurse-midwifery students may complete clinical rotations at sites such as:
- The Woman’s Hospital of Texas, Houston
- Texas Medical Center, Houston
- Texas Children’s Hospital – Pavilion for Women, Houston
- Conroe Regional Medical Center, Conroe
- University of Texas Medical Branch at Galveston, Galveston
- Texas Health Presbyterian Hospital, Plano
- Methodist Mansfield Medical Center, Mansfield
- Baylor University Medical Center, Dallas
- St. David’s Medical Center, Austin
Step 2. Take and Pass the National Certification Examination to Become a CNM
After graduating from an ACME-accredited nurse-midwifery program, you must take and pass the Certified Nurse-Midwife (CNM) examination through the American Midwifery Certification Board (AMCB) to qualify for initial APRN licensure as a nurse-midwife in Texas.
Certification Process
- Application: Submit an application to the AMCB, providing verification of your completion of an ACME-accredited program
- Approval: Receive authorization to test from the AMCB
- Scheduling: Schedule your exam at a Prometric testing center
- Examination: Complete the computer-based test consisting of 175 multiple-choice questions
- Results: Receive your results immediately upon completion of the exam
Graduates of dual-focus nurse-midwifery/women’s health programs may also take the Women’s Health Care Nurse Practitioner (WHNP) examination through the National Certification Corporation (NCC) to earn the WHNP designation and dual APRN licensure.
Texas Testing Locations
You can take the CNM certification exam at Prometric testing centers throughout Texas, including:
| City | Number of Testing Centers |
|---|---|
| Austin | 2 |
| Dallas | 3 |
| El Paso | 1 |
| Fort Worth | 1 |
| Houston | 4 |
| Lubbock | 1 |
| McAllen | 1 |
| San Antonio | 2 |
Exam Preparation
To prepare for the certification exam, consider these resources:
- AMCB Candidate Handbook and recommended references
- Review courses offered by professional organizations
- Study guides and practice tests
- Study groups with peers from your program
Step 3. Apply for APRN Licensure as a Nurse-Midwife through the Texas Board of Nursing
After obtaining CNM certification, you must apply for advanced practice registered nurse (APRN) licensure through the Texas Board of Nursing to legally practice as a nurse-midwife in the state.
Application Process
To earn initial APRN licensure as a nurse-midwife in Texas, complete the following steps:
- Complete an Application for Licensure as an Advanced Practice Registered Nurse or use the online application system
- Submit official transcripts from your nurse-midwifery program
- Provide evidence of current national certification as a CNM
- Pay the application fee ($100, or $150 if applying for APRN licensure with prescriptive authority)
If applying for multiple APRN specialties (such as nurse-midwife and women’s health nurse practitioner), you must submit separate applications for each specialty.
Prescriptive Authority
Nurse-midwives in Texas frequently seek prescriptive authority, including the ability to prescribe controlled substances. To obtain prescriptive authority:
- Apply for APRN licensure with prescriptive authority through the Texas Board of Nursing
- Meet requirements set forth by the Texas Medical Board (TMB)
- After receiving approval, apply for a DEA registration number to prescribe controlled substances
Processing Time
The typical processing time for APRN applications in Texas is 4-6 weeks, though this can vary depending on application volume. You can check your application status through the Texas Board of Nursing’s online portal.
Step 4. Explore Nurse-Midwife Career Options in Texas and Maintain Credentials
Once licensed as a nurse-midwife in Texas, you’ll need to maintain both your national certification and state APRN licensure while exploring diverse career opportunities.
APRN License Renewal Requirements
Maintaining an APRN license in nurse-midwifery in Texas requires:
- Completing at least 20 contact hours of targeted continuing nursing education in nurse-midwifery every two years
- For those with prescriptive authority, completing at least 5 additional contact hours in pharmacotherapeutics
- Maintaining current national certification as a CNM
- Renewing RN and APRN licenses online through the Texas Board of Nursing
CNM Certification Maintenance
The American Midwifery Certification Board offers a Certification Maintenance Program requiring CNMs to choose one of two pathways:
| Option | Requirements |
|---|---|
| Option 1: Continuing Education | Complete 3 AMCB Certificate Maintenance Modules and 20 contact hours of approved continuing education units during each five-year certification cycle; pay annual fees |
| Option 2: Retake Examination | Retake the AMCB Certification Examination and pay the examination fee in lieu of annual fees |
WHNP Certification Maintenance
For nurse-midwives who also hold WHNP certification, the National Certification Corporation requires:
- Completion of a continuing competency assessment at the beginning of each three-year maintenance cycle
- Fulfillment of continuing education requirements based on assessment results
Career Opportunities for Texas Nurse-Midwives
Certified nurse-midwives in Texas can pursue diverse career paths in settings such as:
| Practice Setting | Typical Roles |
|---|---|
| Hospitals | Staff CNM, Director of Midwifery Services, Clinical Educator |
| Birth Centers | Staff CNM, Birth Center Director, Owner |
| OB/GYN Practices | Staff CNM, Women’s Health Provider |
| Community Health Centers | Primary Women’s Health Provider, Public Health Midwife |
| Home Birth Practices | Home Birth Midwife, Practice Owner |
| Universities/Colleges | Nurse-Midwifery Faculty, Clinical Instructor |
| Military/Government | Military CNM, Public Health Service CNM |
Texas Facilities Employing Nurse-Midwives
Texas nurse-midwives may find employment opportunities at locations such as:
- The Women’s Specialists of Houston, Houston
- Austin Area Birthing Center, Austin
- Birth & Women’s Center, Dallas
- Women’s Care Center, Houston
- West Houston Birth Center, Houston
- Corpus Christi Birth Center, Corpus Christi
- House of Birth, Sherman
- Childbirth Services, Tyler
- Texas Health Resources, multiple locations
- Baylor Scott & White Health, multiple locations
- UT Health System, multiple locations
Recent Job Listings for Texas Nurse-Midwives
Recent job postings for nurse-midwives in Texas (as of 2023) include:
- Certified Nurse-Midwife, Texas Health Physicians Group, Dallas-Fort Worth area
- Certified Nurse-Midwife, Texas Children’s Hospital, Houston
- Nurse-Midwife Faculty, UT Health Science Center, Houston
- Certified Nurse-Midwife, Parkland Health & Hospital System, Dallas
- APRN Nurse-Midwife, Department of the Army, El Paso
- Certified Nurse-Midwife, Community Health Network, Austin
- CNM/Women’s Health NP, Baylor Scott & White Health, Temple
Professional Organizations for Texas Nurse-Midwives
Joining professional organizations can provide valuable networking, continuing education, and advocacy opportunities:
- Association of Texas Midwives
- North Texas Midwives
- Consortium of Texas Certified Nurse-Midwives
- Texas Nurse Practitioners
- North Texas Nurse Practitioners
- American College of Nurse-Midwives
Salaries for Certified Nurse-Midwives in Texas
Nurse-midwives in Texas enjoy competitive salaries that reflect their advanced education and specialized skills. According to the U.S. Bureau of Labor Statistics, the salary range for nurse-midwives in Texas as of May 2022 was:
| Experience Level | Annual Salary |
|---|---|
| Entry-Level (10th percentile) | $79,820 |
| Early Career (25th percentile) | $92,450 |
| Mid-Career (50th percentile/median) | $108,710 |
| Experienced (75th percentile) | $126,940 |
| Highly Experienced (90th percentile) | $142,580 |
Salary Variations by Metropolitan Area
Nurse-midwife salaries in Texas vary by location, with differences between major metropolitan areas:
| Metropolitan Area | Entry-Level | Median | Experienced |
|---|---|---|---|
| Houston-The Woodlands-Sugar Land | $85,640 | $115,970 | $145,280 |
| Dallas-Fort Worth-Arlington | $78,320 | $104,790 | $132,640 |
| Austin-Round Rock | $82,450 | $108,260 | $139,720 |
| San Antonio-New Braunfels | $76,910 | $102,340 | $129,480 |
Job Outlook for Texas Nurse-Midwives
The employment outlook for nurse-midwives in Texas is very positive. The U.S. Bureau of Labor Statistics projects a 30% growth rate nationally for nurse-midwives between 2022 and 2032, significantly faster than the average for all occupations.
Several factors contribute to this strong outlook:
- Greater recognition of the cost-effectiveness and quality outcomes of midwifery care
- Increased consumer demand for low-intervention birth options
- Growing awareness of the benefits of midwifery care for reducing maternal mortality and morbidity
- Expanded insurance coverage for midwifery services
- Texas’s growing population, particularly in metropolitan areas
(Salary data for nurse-midwives reported by the U.S. Bureau of Labor Statistics in May 2022. 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.)
Frequently Asked Questions About Becoming a Nurse-Midwife in Texas
What education is required to become a nurse-midwife in Texas?
To become a nurse-midwife in Texas, you must first become a registered nurse (RN) by completing a nursing program and passing the NCLEX-RN exam. Then you must earn a graduate degree (MSN, DNP, or post-graduate certificate) from a nurse-midwifery program accredited by the Accreditation Commission for Midwifery Education (ACME).
How do I get licensed as a nurse-midwife in Texas?
After completing an accredited nurse-midwifery program, you must pass the American Midwifery Certification Board (AMCB) national certification examination to become a Certified Nurse-Midwife (CNM). Then, apply for Advanced Practice Registered Nurse (APRN) licensure through the Texas Board of Nursing, submitting proof of your education, certification, and paying the required fee.
What is the average salary for nurse-midwives in Texas?
According to the U.S. Bureau of Labor Statistics (2022), the median annual salary for nurse-midwives in Texas is approximately $108,710. Entry-level positions start at around $79,820, while experienced nurse-midwives can earn up to $142,580 or more, depending on the metropolitan area and practice setting.
Are there nurse-midwifery programs in Texas?
Yes, Texas has ACME-accredited nurse-midwifery programs, including Baylor University in Waco, which offers a DNP in Nurse-Midwifery, and Texas Tech University Health Sciences Center in Lubbock, which offers both MSN and post-graduate certificate programs in nurse-midwifery. Many online programs from out-of-state universities also serve Texas students.