Last Updated: June 2025 | Reviewed by Abbie Jacobs
California leads the nation in certified nurse-midwife (CNM) education and practice, offering multiple pathways for registered nurses seeking to advance their careers through specialized CNM degree programs. With approximately 880 accredited nurse midwives currently licensed to practice in the state, California provides exceptional educational opportunities and professional growth potential for those pursuing how to become a nurse midwife. These highly trained healthcare professionals attend approximately 13% of all vaginal births in California, with 95% of these births occurring in hospital settings, demonstrating the critical role certified nurse-midwives (CNMs) play in the state’s healthcare delivery system.
The pathway to becoming a certified nurse midwife in California requires systematic progression through accredited CNM degree programs, national certification examinations, and state licensure through the California Board of Registered Nursing (BRN). California’s progressive healthcare environment, established through Senate Bill 1237 effective January 1, 2021, provides CNMs with expanded scope of practice authority, prescriptive privileges, and independent practice capabilities that distinguish the state as a premier destination for midwifery professionals.
“My journey through the CNM degree program at UC San Francisco transformed my nursing career completely. The rigorous curriculum and extensive clinical rotations prepared me to provide comprehensive reproductive healthcare services. Now practicing at Kaiser Permanente, I manage my own patient panel and attend births regularly – exactly what I envisioned when I started researching how to become a nurse midwife in California.” – Michelle Rodriguez, CNM Graduate, Class of 2023
Comprehensive Guide: How to Become a Certified Nurse-Midwife in California
The process of becoming a nurse midwife in California involves multiple educational and professional milestones, beginning with a foundation in registered nursing and progressing through specialized CNM degree programs. California’s regulatory framework ensures all certified nurse midwives possess the advanced clinical competencies, theoretical knowledge, and professional skills necessary for safe, evidence-based practice in diverse healthcare settings.
Step 1: Complete an Accredited CNM Degree Program (Master’s or Doctoral Level)
The foundation for becoming a nurse midwife in California centers on completing rigorous CNM degree programs that meet both state and national accreditation standards. California registered nurses interested in becoming certified nurse midwives can fulfill education requirements by completing a master’s or higher degree in nurse-midwifery that meets one of these criteria:
- Completion of a nurse midwife program that the BRN approves
- Completion of a nurse midwife program that has equivalent standards to those of the BRN
- Completion of a nurse midwife program that is approved by the Accreditation Commission for Midwifery Education (ACME) (also known as the national certification route)
California CNM Degree Program Recognition Pathways
The California Board of Registered Nursing recognizes three distinct pathways for CNM degree programs, ensuring educational diversity while maintaining consistent professional standards:
| CNM Degree Program Pathway | Educational Requirements | California BRN Recognition |
|---|---|---|
| Method One: BRN-Approved Programs | CNM degree programs conform to California Code of Regulations Section 1462 | Direct recognition for licensure |
| Method Two: Equivalent Standards | Non-BRN-approved CNM programs meeting equivalent educational standards | Requires verification and potential remediation |
| Method Three: ACME-Accredited | Accreditation Commission for Midwifery Education approved CNM degree programs | National certification pathway acceptance |
California’s Premier CNM Degree Programs
Three distinguished institutions offer comprehensive CNM programs in California, each providing unique educational approaches while maintaining rigorous academic and clinical standards:
- California State University, Fullerton – Master of Science in Nursing (MSN) with CNM specialization, featuring integrated clinical experiences and research opportunities
- University of California, San Diego – Advanced CNM degree program with emphasis on evidence-based practice and interdisciplinary collaboration
- University of California, San Francisco – Comprehensive CNM degree program with access to premier clinical sites and faculty expertise
Working RNs often prefer the convenience and flexibility of the ACME-accredited online programs that are available through nationally renowned schools. All in-state accredited master’s, as well as many master’s in midwifery online programs, offer students the option of dual specializations in the areas of nurse midwifery and women’s health.
CNM Degree Program Admissions and Prerequisites
Typical admissions requirements for nurse-midwife graduate programs include:
| Prerequisite Category | Specific Requirements | Professional Standards |
|---|---|---|
| Educational Foundation | Bachelor of Science in Nursing (BSN) or equivalent prerequisite completion | Minimum 3.0 cumulative GPA |
| Professional Licensure | Current, active RN license in good standing | No disciplinary actions or restrictions |
| Clinical Experience | Minimum one year of professional nursing practice | Preference for women’s health or obstetric experience |
| Academic Documentation | Professional letters of recommendation, personal statement | Graduate Record Examination (GRE) scores (program-dependent) |
CNM Degree Program Curriculum and Clinical Training
California’s CNM degree programs integrate comprehensive theoretical foundations with extensive clinical experiences, typically requiring 18 to 24 months for full-time completion. All programs comprise the following elements:
| CNM Degree Component | Credit Requirements | Specialized Focus Areas |
|---|---|---|
| Didactic Coursework | 40-60 semester credit hours | Advanced physiology, pathophysiology, pharmacology, and research methods |
| Clinical Practicum | Minimum 1,000 direct patient care hours | Antepartum, intrapartum, postpartum, gynecology, primary care |
| Advanced Pharmacology | Graduate-level specialized course | Required for California prescriptive authority eligibility |
| Capstone Experience | Research project or evidence-based practice initiative | Quality improvement, clinical outcomes, or policy development |
Earning an accredited master’s degree with a focus in these fields will give RNs the option to pursue dual credentialing as both a certified nurse midwife (CNM) and a women’s health nurse practitioner (WHNP). Accredited dual-focus graduate programs in nurse-midwifery/women’s health nurse practitioner (NM/WHNP) are designed to meet all requirements for national certification and state board recognition in both areas.
For registered nurses seeking flexible educational pathways, numerous accredited nurse-midwifery programs in California are available through both traditional campus-based and online CNM programs. These MSN, DNP, and post-master’s CNM degrees are designed to accommodate working professionals while maintaining rigorous academic and clinical standards required for national certification.
Step 2: Pass the National CNM Certification Examination (AMCB)
After completing a qualifying graduate program, candidates for APN licensure by national certification in nurse-midwifery would then go on to take the Certified Nurse-Midwife Exam through the American Midwifery Certification Board (AMCB). This comprehensive computer-based examination serves as the national standard for entry-level midwifery practice and is required for state licensure in California.
AMCB CNM Certification Examination Details
Candidates can apply for the National Certification Examination in Nurse-Midwifery by sending an application to:
AMCB
849 International Drive, Suite 120
Linthicum, MD 21090
Candidates are encouraged to prepare for this exam by reviewing the Candidate Handbook.
| Examination Component | Details |
|---|---|
| Number of Questions | 175 multiple-choice items |
| Testing Time | 4 hours |
| Results | Immediate official results at the testing site |
| Testing Centers | 120+ locations nationwide through PSI Services |
Examination Content Areas
The test is taken on a computer and consists of 175 multiple-choice questions. Candidates have four hours to complete their test, which covers the topics of:
- Antepartum Care – 19-26% of examination content
- Intrapartum Care – 17-26% of examination content
- Postpartum Care – 15-18% of examination content
- Gynecology – 15-18% of examination content
- Women’s Health and Primary Care – 8-16% of examination content
- Newborn Care – 7-16% of examination content
After registering with the respective sponsoring organizations, exam candidates can sign up for a testing date and location through PSI Services, which proctors both exams at H&R Block Centers located throughout California in the cities of Chino, Fresno, Irvine, La Mesa near San Diego, Long Beach, Los Angeles, Modesto, Monrovia, Oakland, Palm Springs, Sacramento, San Francisco, San Jose, Santa Maria, Upland, and Van Nuys.
Step 3: Obtain California APRN Licensure as a Certified Nurse-Midwife
Upon completing the appropriate certification exam(s), applicants for APN licensure would complete the appropriate licensing application form to be submitted to the California Board of Registered Nursing:
Candidates can submit all application materials to the following address:
Board of Registered Nursing
Advanced Practice Unit – Nurse Midwife/Nurse Practitioner Certification [choose relevant unit]
PO Box 944210
Sacramento, CA 94244-2100
California CNM Licensure Requirements
| Licensure Component | Specific Requirements | Processing Considerations |
|---|---|---|
| Foundation Licensure | Current, clear, and active California RN license | Must be in good standing without restrictions |
| National Certification | Successful AMCB examination completion | Official certification documentation is required |
| Application Submission | Completed online CNM certification application | Electronic submission with supporting documentation |
| Certification Fee | $500 nurse-midwife certification fee | Non-refundable earned fee structure |
Prescribing Medications
The California BRN allows both nurse-midwives and women’s health NPs to prescribe or furnish medications. To be eligible for this, APNs must complete a BRN-approved graduate course in advanced pharmacology. They can then submit the appropriate application(s) to the BRN to receive a furnishing number:
- Application for a Nurse Midwife Furnishing Number
- Application for a Nurse Practitioner Furnishing Number
| Prescriptive Authority Level | Educational Requirements | Additional Regulatory Steps |
|---|---|---|
| Standard Medication Furnishing | BRN-approved advanced pharmacology course (CNM degree program component) | Submit a furnishing number application with certification fee |
| Schedule II Controlled Substances | Additional pharmacology training on addiction risks and neonatal abstinence syndrome | DEA registration and enhanced continuing education requirements |
Step 4: Launch Your CNM Career and Maintain Professional Credentials
Applicants can check the status of their APN application on the Board of Registered Nursing’s processing times webpage. Once they have received their designation from the BRN, they can begin working as certified nurse-midwives in the state.
California CNM Practice Settings and Professional Opportunities
California’s diverse healthcare infrastructure provides certified nurse midwives with exceptional career flexibility and professional growth potential. The following are among the top employers of certified nurse-midwives in California:
- Integrated Healthcare Systems – Kaiser Permanente, UC Health, Sutter Health, Dignity Health networks
- Academic Medical Centers – UCSF Medical Center, UCLA Medical Center, UC Davis Medical Center, Stanford Healthcare
- Community Health Organizations – Los Angeles Center for Women’s Health, Beach Area Women’s Health Center in San Diego, Women’s Community Clinic in San Jose
- Specialized Birth Centers – The Birth Center in Sacramento, Beach Cities Midwifery in Long Beach, Sacred Birth Place in Oakland
- Private Practice Settings – Natural Birth Center and Women’s Wellness in Anaheim, Mercy Family Birth Center in Bakersfield
Professional Credential Maintenance and Continuing Education
APN licensure does not need to be renewed, and there are no continuing education requirements, save for those required to renew the basic RN license every two years. The respective national certifying bodies do require the CNM and WHNP-BC credentials to be renewed regularly.
| Credential Maintenance Component | Renewal Cycle | Continuing Education Requirements |
|---|---|---|
| California RN License | Biennial renewal | 30 hours of approved continuing education |
| AMCB CNM Certification | Five-year cycle | Certificate maintenance modules and continuing education |
| Prescriptive Authority | Concurrent with RN renewal | 3 hours controlled substance prescribing education (if applicable) |
| DEA Registration | Three-year renewal | Enhanced training on addiction risks and prevention |
Renewing the Certificate in Nurse Midwifery (CNM) through the AMCB:
- CNM renewal is completed on a five-year cycle through the AMCB’s Certificate Maintenance Program, which requires one of the following:
- Re-examination
- Completion of 3 certificate maintenance modules and 20 hours of continuing education
California CNM Salary and Employment Outlook
California consistently demonstrates the most comprehensive and competitive compensation structure for certified nurse midwives in the United States, with employment data and salary analysis based on the most recent Bureau of Labor Statistics occupational employment survey. The state’s progressive healthcare policies, expanded scope of practice legislation, and robust healthcare infrastructure contribute to exceptional earning potential and professional growth opportunities for graduates of the CNM degree program.
Key Professional Insights:
- California employs 880 certified nurse-midwives across diverse healthcare settings
- The annual mean wage of $179,630 represents competitive compensation reflecting advanced practice scope
- Significant regional salary variations based on metropolitan area market dynamics
- Employment concentration demonstrates steady workforce integration within healthcare delivery systems
Statewide Employment and Compensation Analysis
| Experience Level and Career Stage | Annual Salary (2024 BLS) | Hourly Wage Rate | Career Significance |
|---|---|---|---|
| Entry-Level CNMs (10th Percentile) | $111,800 | $53.75 | New graduate compensation reflecting advanced practice credentials |
| Lower Mid-Career CNMs (25th Percentile) | $152,470 | $73.30 | Developing expertise and clinical competency advancement |
| Median CNM Salary (50th Percentile) | $196,700 | $94.57 | Established practice with comprehensive clinical responsibilities |
| Experienced CNMs (75th Percentile) | $207,780 | $99.90 | Senior practitioners with specialized expertise and leadership roles |
| Top-Earning CNMs (90th Percentile) | $226,840 | $109.06 | Advanced practice leaders, educators, and specialized practitioners |
Metropolitan Area Salary Analysis and Regional Market Dynamics
| Metropolitan Statistical Area | Employment | Annual Mean Wage | Median Annual Wage | 75th Percentile |
|---|---|---|---|---|
| Los Angeles-Long Beach-Anaheim | 190 CNMs | $190,340 | $190,230 | $223,800 |
| San Francisco-Oakland-Fremont | 200 CNMs | $188,930 | $204,980 | $207,780 |
| Riverside-San Bernardino-Ontario | 60 CNMs | $186,420 | $201,870 | $226,430 |
| San Diego-Chula Vista-Carlsbad | 80 CNMs | $157,720 | $155,030 | $223,800 |
California’s nurse-midwives benefit from 100% Medi-Cal reimbursement at physician fee levels and the absence of restrictive collaborative practice agreements, which contributes to the state’s competitive compensation structure and professional autonomy.
(Salary data for nurse-midwives reported by the U.S. Bureau of Labor Statistics in May 2024. 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 June 2025.)
Frequently Asked Questions: How to Become a CNM
How long do CNM degree programs take to complete in California?
CNM degree programs in California typically require 18 to 24 months for full-time completion, with part-time options extending to 36 months. The complete pathway from beginning RN education to CNM practice generally spans 6-8 years: 2-4 years for initial nursing education, a minimum of one year of clinical experience, and 2-3 years for graduate CNM degree completion.
What types of CNM degree programs are available in California?
California offers diverse CNM degree options, including Master of Science in Nursing (MSN) programs, Doctor of Nursing Practice (DNP) degrees, and post-master’s certificate programs for practicing nurse practitioners. Many programs offer dual-focus specializations that combine CNM with women’s health nurse practitioner credentials.
Can I complete a CNM degree program online while living in California?
Yes, numerous ACME-accredited online CNM degree programs accept California residents and provide clinical placement assistance throughout the state. These programs maintain identical academic rigor and clinical requirements as traditional campus-based programs.
What is the job outlook for CNM degree program graduates in California?
California offers excellent employment prospects for CNM degree program graduates, with significantly faster-than-average job growth projected through 2032. The state’s aging population, emphasis on preventive care, expanded healthcare access, and progressive scope of practice legislation drive continued demand for qualified certified nurse midwives.
Do CNM degree programs in California prepare graduates for prescriptive authority?
Yes, California’s accredited CNM degree programs include required advanced pharmacology coursework that qualifies graduates for prescriptive authority through the furnishing number application process. Graduates can prescribe medications and devices by approved, standardized procedures.
What clinical experiences are included in California CNM degree programs?
California CNM degree programs require minimum 1,000 direct patient care hours across antepartum, intrapartum, postpartum, gynecology, and primary care settings. Clinical sites include major healthcare systems like Kaiser Permanente, UC Health, academic medical centers, community health organizations, and specialized birth centers throughout the state.
Are there prerequisites for applying to CNM degree programs in California?
CNM degree program prerequisites include a current RN license, Bachelor of Science in Nursing (BSN) or equivalent coursework, a minimum 3.0 GPA, professional letters of recommendation, a personal statement, and typically one year of clinical nursing experience.
How much do CNM degree programs cost in California?
CNM degree program costs vary significantly based on institution type, program length, and delivery method. Public university programs typically range from $25,000-$45,000 for state residents, while private institutions may charge $60,000-$100,000. Many students utilize federal financial aid, scholarships, and employer tuition assistance programs.