The path to a career in nurse-midwifery begins when qualified registered nurses complete an accredited graduate program in nurse-midwifery and demonstrate competency through a rigorous examination administered by the American Midwifery Certification Board (AMCB).
Passing the AMCB’s Certified Nurse-Midwife Examination leads to the highly esteemed and nationally recognized credential: Certified Nurse-Midwife (CNM).
All state boards of nursing require candidates for advanced practice registered nurse licensure in nurse-midwifery to hold the AMCB’s CNM credential.
Understanding the Role and Purpose of the American Midwifery Certification Board (AMCB)
The mission and vision of the American Midwifery Certification Board is to protect and serve the public by setting certification standards for nurse-midwifes practicing in the United States.
The AMCB now serves as the national certifying body for all candidates seeking advanced practice state licensure in nurse-midwifery. Although state licensure provides the legal basis for practice, all 50 states now require nurse-midwives to hold the AMCB’s Certified Nurse-Midwife (CNM) credential. According to the American College of Nurse-Midwives, there were 12,655 CNMs in the U.S. as of 2019.
The AMCB (originally called the ACNM Certification Council) began initiating certification for nurse-midwives in 1971. In 2005, the ACNM Certification Council changed its name to the AMCB. The National Commission for Certifying Agencies (NCCA) accredits the AMCB’s certified nurse-midwife (CNM) and certified midwife (CM) programs.
Qualifying for Nurse-Midwife Certification
To qualify for CNM certification, candidates must have a registered nurse (RN) license in good standing and hold a master’s or higher degree in nurse-midwifery from a program accredited by the Accreditation Commission for Midwifery Education (ACME). There are currently about 40 ACME-accredited nurse-midwifery programs in the U.S.
Most ACME-accredited programs are structured as either a Master of Science in Nursing (MSN) with a focus in Nurse-Midwifery or a Master of Science (MS) in Nurse-Midwifery, and are designed specifically for RNs who possess a Bachelor of Science in Nursing (BSN). However, a number of accredited bridge programs exist for associate’s-educated nurses who need to complete both their BSN and MSN. Post-graduate certificates and doctoral degrees in nurse-midwifery are also available for RNs who already possess a master’s degree in nursing.
Many ACME-accredited nurse-midwifery programs are offered partially or fully online. A number of accredited programs include dual specialization in related areas, the most common being Nurse-Midwife/Women’s Health Nurse Practitioner (NM/WHNP) programs. These dual specialization programs allow students of nurse-midwifery to achieve a broader foundation of knowledge in women’s health and become dually credentialed as both a certified nurse-midwife (CNM) and a board certified women’s health nurse practitioner (WHNP-BC). Board certification for women’s health nurse practitioners is conferred through the National Certification Corporation (NCC).
Applying to Take the Certified Nurse Midwife (CNM) Examination
All candidates must apply to take the CNM examination by completing either the Application for Testing and Subsequent Certification as a Nurse-Midwife or the online application through the AMCB Portal Page. The AMCB Portal Page will prompt candidates to create an account once they choose “First-Time Applicant-Certified Nurse-Midwife.”
Along with a completed application, applicants must submit a $500 examination fee (checks made payable to AMCB) and provide proof of a current RN license in good standing. Proof of having graduated from an accredited nurse-midwifery program must be submitted directly from the graduate program director to the AMCB.
The AMCB encourages all candidates to thoroughly review the Candidate Handbook before applying to take the CNM exam.
Note: Candidates must notify the AMCB of any of legal action or investigation being conducted by their state licensing board. The AMCB may deny admission to applicants who:
- Were involved in any disciplinary action, conviction, or ongoing investigation regarding the unauthorized practice of midwifery or medicine (either prior or current)
- Misrepresented themselves on the application
- Had their nursing license limited, suspended, or revoked (either prior or current)
- Are a convicted felon in any U.S. state, territory, or jurisdiction
Scheduling and Taking the CNM Examination
CNM exam candidates have 24 months from the time they complete their graduate program in nurse-midwifery to take and pass the Certified Nurse-Midwife Examination. Applicants may attempt the CNM exam a total of four times.
Once applicants have submitted their application and exam fee to AMCB, they can expect to receive notification by email of their eligibility to schedule the exam with Applied Measurement Professionals (AMP). Authorization to test notification is usually sent the week after AMCB has processed the application.
Candidates may change or reschedule their exam appointment, without penalty, provided they give AMP at least two business days’ notice. Candidates who arrive late or miss their appointment will forfeit their processing fee and must reschedule the appointment.
Successful candidates will receive a certification number and expiration date from the AMCB upon passing the exam. CNMs can expect the AMCB to mail the CNM certificate and other pertinent documents to them at the address on their application.
CNM Examination Format
Examinees for the AMCB’s Certified Nurse-Midwife Examination will take the test on a computer. Examinees receive a brief orientation before the exam begins and have the opportunity to take a short practice test to familiarize themselves with the computer, the layout, and the features of the program.
Examinees may change responses and return to previous questions during the course of the exam. All examinees have four hours to complete the exam.
The CNM examination consists of 175 multiple-choice questions, each of which presents three or four possible answers. The questions are presented in random order to replicate the real-world practice environment.
The CNM examination covers six content areas:
- Antepartum: 19 to 26 percent
- Intrapartum: 17 to 26 percent
- Postpartum: 15 to 18 percent
- Newborn: 7 to 16 percent
- Well-Woman/Gynecologic: 15 to 18 percent
- Women’s Health/Primary Care: 8 to 16 percent
Examination questions test an individual’s knowledge and judgment in all clinical areas, covering both normal circumstances and deviations. About two-thirds of all questions cover normal phenomena, with the remaining one-third devoted to deviations from normal. Further, about two-thirds of the content area tests the individual’s clinical judgment, while the remaining questions test knowledge.
Retaking the CNM Examination
Candidates who fail the CNM exam on the first attempt may reattempt the exam up to three additional times within the 24-month window of earning their graduate degree in nurse-midwifery. A candidate’s first retake may not occur sooner than 30 days following the initial exam. Any subsequent retakes may not occur sooner than 90 days following the last exam. Candidates must contact the AMCB in writing to express their desire to retake the exam. Candidates must pay the entire $500 exam fee and show proof of their RN license being in good standing each time they reattempt the exam, though there is no need to resubmit an application.
Candidates unable to pass the CNM exam after four attempts or in the 24-month time frame must complete another ACME-accredited program in nurse-midwifery.
Renewing the CNM Certification
CNMs must renew their CNM designation every 5 years upon the successful completion of the Certificate Maintenance Program. CNMs who fail to complete Certificate Maintenance Program requirements at the end of their current certification cycle cannot renew their CNM designation.
Certificate Maintenance Program Requirements
CNMs may satisfy their Certificate Maintenance Program requirements in one of two ways:
Option 1: AMCB Certificate Maintenance Module Method
CNMs must complete three AMCB Certificate Maintenance Modules during their five-year certification cycle. CNMs must complete a module in each of the following areas of practice:
- Antepartum and Primary Care of Pregnant Women
- Intrapartum, Postpartum, and Newborn
- Gynecology and Primary Care for the Well-Woman
CNMs completing this option must also complete at least 20 contact hours (2 CEUs) of ACNM Category I approved continuing education units and pay annual maintenance fees of $55 (or $247.50 if prepaying for all 5 years).
Option 2: Re-examination Method
CNM may also satisfy Certificate Maintenance Program requirements by retaking the CNM exam no sooner than the fourth year of their five-year certification cycle. This would involve paying the examination fee of $500 in lieu of annual fees.