Last Updated: January 2026 | 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. Following the implementation of Senate Bill 23-167 in July 2024, Colorado became the most recent state to offer full licensure for both credentials, providing aspiring midwives exceptional 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 2024 board certification exam and #2 national ranking, ensures that graduates are well-prepared for successful careers. The program holds Continued Accreditation status from ACME through 2029, representing one of the longest continuously accredited midwifery programs in the United States. Whether you’re a registered nurse seeking to advance into midwifery specialization or someone with a bachelor’s degree in any field interested in the new direct-entry CM pathway launching in Summer 2026, 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 across both urban centers and rural communities facing provider shortages.”
– 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 versus a bachelor’s degree in any field for CMs.
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 an RN license |
| Certified Midwife (CM) | Bachelor’s degree (any field) — New pathway available Summer 2026 | Identical to the 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. Senate Bill 23-167, which became effective July 1, 2024, formally integrated CMs into Colorado’s healthcare workforce with licensure parity, independent practice authority, and identical prescriptive authority pathways as CNMs. Both CNMs and CMs complete the same core competencies, take identical board examinations administered by the American Midwifery Certification Board (AMCB), 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.
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 2024 board certification exam, ranking #2 nationally among midwifery programs. The program holds Continued Accreditation status from ACME through July 31, 2029, representing one of the longest continuously accredited midwifery programs in the United States, with initial accreditation dating to June 1980. These accredited programs provide comprehensive preparation for both theoretical knowledge and clinical expertise.
Program Options
| Program Type | Designed For | Typical Duration | Clinical Hours |
|---|---|---|---|
| Master of Science in Nurse-Midwifery (CNM) | RNs with Bachelor of Science in Nursing (BSN) degrees | 2.5 years (7 semesters) | 720 hours |
| BS to DNP Nurse-Midwifery (CNM) | RNs seeking doctoral preparation | 4 years (11 semesters) | 1,260 hours |
| Post-Graduate Certificate (CNM) | RNs with existing master’s degrees in nursing | 1.5 years (4 semesters) | 700+ hours |
| NEW: MS Midwifery Direct-Entry (CM) | Individuals with bachelor’s degrees in any field (non-nurses) — Launching Summer 2026 | 2.5 years (8 semesters) | 720 hours |
NEW Direct-Entry Certified Midwife Program — Summer 2026
Announced in September 2025, the University of Colorado College of Nursing is launching a groundbreaking direct-entry Certified Midwife (CM) program, making it one of only three universities nationally to offer this pathway. This program provides individuals with bachelor’s degrees in any field—including those without nursing backgrounds—a route to becoming licensed midwives in Colorado and the 12 other jurisdictions that recognize the CM credential.
The 44-credit program spans 2.5 years with 720 supervised clinical hours and prepares graduates to take the AMCB certification examination. Applications opened November 15, 2025, with a priority deadline of January 15, 2026. The inaugural cohort will accept 5 students, scaling to 15 annually. Prospective students should note that while the CM credential offers an equivalent scope of practice in Colorado, it is currently recognized in only 13 jurisdictions nationwide compared to CNM licensure in all 50 states.
Admission Requirements
Admission standards maintain consistency across programs, with requirements varying by pathway:
For CNM Programs (MS, BS-DNP, Post-Graduate Certificate):
- Current RN license and BSN from a CCNE or ACEN-accredited program (MSN required for certificate)
- Minimum GPA of 3.0 in undergraduate nursing coursework
- Prerequisite courses in nursing research and statistics (grade C or higher)
- GRE General Test scores (waived for applicants meeting 3.0 GPA threshold)
- Three letters of recommendation from academic and professional references
- Personal essay and curriculum vitae
- Interview for selected applicants
For CM Direct-Entry Program (NEW — Summer 2026):
- Bachelor’s degree in any field from a regionally accredited institution
- Minimum cumulative science GPA of 3.0
- Science prerequisites completed within 5 years: Anatomy & Physiology I and II with labs, Pathophysiology, Microbiology (grade B or better), General Chemistry (grade B or better)
- Additional prerequisites within 10 years: Biology/Genetics, Nutrition, Sociology/Cultural Anthropology, Psychology, Developmental Psychology, Statistics
- Three letters of reference, a personal essay, and a resume
Curriculum and Clinical Training
Graduate programs typically include 40-60 semester credits of didactic coursework combined with 700-1,260 hours of clinical education, depending on degree level. 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, gaining hands-on experience in both urban medical centers and rural healthcare facilities, addressing Colorado’s 25 maternity care desert counties.
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 scope of practice across various healthcare settings.
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 and Grand Junction.
The University of Colorado College of Nursing’s 2024 graduates achieved a 100% first-time pass rate on the AMCB examination, significantly exceeding the national average of 80% and maintaining the program’s #2 national ranking for midwifery education. The three-year average pass rate stands at 94%, demonstrating consistent excellence in preparing graduates for certification.
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, requiring continuing education or re-examination.
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 — Updated Requirements Effective 2024
Advanced Practice Registration does not automatically include prescriptive authority. Under regulations updated January 24, 2024 (effective March 16, 2024), midwives seeking prescription privileges must apply separately and meet specific requirements:
Provisional Prescriptive Authority Requirements:
- Active and unencumbered Colorado RN license (CNMs) or CM license
- Current AMCB certification
- Professional liability insurance of at least $500,000 per claim and $1.5 million aggregate annually
- Registration with the Colorado Prescription Drug Monitoring Program (PDMP)
- Identification of a qualified mentor for supervised practice
- Graduate-level coursework in pharmacology, pathophysiology, and patient assessment
Full Prescriptive Authority Requirements:
- Completion of a 750-hour mentorship program with a Colorado-licensed physician, advanced practice nurse with prescriptive authority, or CM with full prescriptive authority
- Three years of combined clinical experience as a licensed midwife
- Mentor must hold an unrestricted DEA registration and an active Colorado license
- Mentorship hours must be completed within three years of receiving provisional authority
- DEA registration required for controlled substance prescriptions
The updated mentorship requirement of 750 hours (increased from previous standards) ensures that new practitioners gain comprehensive supervised experience before engaging in independent prescriptive practice, thereby enhancing patient safety and professional competence. Remote synchronous communication through audio, web, or video conferencing is permitted for mentorship interactions, though email does not qualify as acceptable mentorship communication.
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 centers and the 25 rural counties designated as maternity care deserts. 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 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 addressing provider shortages
Major employers and practice models throughout Colorado include:
- University of Colorado Hospital and Anschutz Medical Campus
- Denver Health System
- Presbyterian/Saint Luke’s Medical Center
- The Birth Center of Boulder
- Mountain Midwifery Center (Englewood)
- Bloomin’ Babies Health Services (Grand Junction)
- Memorial Hospital North (Colorado Springs)
- Parkview Medical Center (Pueblo)
- Rural healthcare facilities in Adams, Mesa, Pueblo, and Weld counties
Colorado faces a significant maternal healthcare crisis, with 25 of its 64 counties classified as maternity care deserts—lacking hospital deliveries, birthing centers, and obstetric providers. These underserved regions, concentrated in eastern and southern Colorado, present exceptional opportunities for midwives committed to expanding access to care. The University of Colorado’s Rural Midwifery Workforce Expansion Program, funded by a $2 million HRSA grant through 2027, aims to produce 3-5 CNM graduates annually dedicated to rural practice.
License Renewal and Continuing Education
Professional credentials require ongoing maintenance to ensure competency:
Renewal Requirements
| Credential | Renewal Cycle | Requirements |
|---|---|---|
| Colorado APRN/CM License | Every 2 years (September 30) | Maintenance of national AMCB certification; 2 hours substance use prevention training if holding opioid prescriptive authority |
| AMCB Certification | Every 5 years | Continuing education hours or re-examination through the Certificate Maintenance Program |
| Prescriptive Authority | Renewed with APRN/CM license | Completion of 750-hour mentorship and 3 years of experience for full authority; ongoing PDMP compliance |
Colorado does not currently require specific continuing education hours for RN or APRN license renewal, though practitioners must maintain their national AMCB certification (which does require continuing education) and complete substance use prevention training if holding opioid prescriptive authority. Practitioners are strongly encouraged to pursue ongoing professional development through conferences, specialized certifications, and clinical training programs.
Step 5. Understand Salary Expectations for Midwives in Colorado
Colorado offers highly competitive compensation for certified nurse midwives, reflecting strong market demand and recognition of their specialized healthcare expertise. According to the U.S. Bureau of Labor Statistics (BLS) data from May 2024, Certified Nurse-Midwives in Colorado earn a mean annual wage of $143,600, significantly exceeding the national mean of $128,110 by $15,490 (12.1% premium). The mean hourly wage stands at $69.04 compared to the national average of $61.59.
CNM Salary Data for Colorado (May 2024)
| Percentile | Annual Salary | Hourly Wage |
|---|---|---|
| 10th Percentile | $123,660 | $59.45 |
| 25th Percentile | $128,880 | $61.96 |
| 50th Percentile (Median) | $137,149 | $65.94 |
| 75th Percentile | $151,600 | $72.88 |
| 90th Percentile | $166,370 | $79.99 |
CNM Salary Data for Denver-Aurora-Lakewood, CO (May 2024)
| Percentile | Annual Salary | Hourly Wage |
|---|---|---|
| 10th Percentile | $122,204 | $58.75 |
| 25th Percentile | $127,345 | $61.22 |
| 50th Percentile (Median) | $135,531 | $65.16 |
| 75th Percentile | $149,876 | $72.06 |
| 90th Percentile | $164,416 | $79.05 |
Factors influencing salary variations include:
- Practice setting (hospital vs. clinic vs. birth center vs. rural facility)
- Geographic location (urban centers vs. rural counties with provider shortages)
- Years of experience and additional certifications
- Volume of deliveries and patient load
- Additional responsibilities (teaching, administration, program development)
- Rural loan repayment and workforce incentive programs
The slightly lower wages in the Denver-Aurora-Lakewood metro area compared to statewide averages suggest that rural and suburban practice locations may offer competitive or higher compensation packages to address critical workforce shortages in maternity care desert counties.
Job Growth and Market Demand
The Bureau of Labor Statistics projects exceptional 33% job growth for nurse-midwives in Colorado from 2023-2033, substantially exceeding the 3% average for all occupations. This represents one of the strongest growth rates for any healthcare profession and reflects multiple converging factors:
- Consumer preference for midwifery care and natural birth options
- Growing recognition of midwifery’s safety outcomes and cost-effectiveness
- Critical OB/GYN physician shortages affecting 50% of Colorado counties
- Expansion of the birth center and home birth services
- Rural healthcare workforce development initiatives
- An aging population and chronic disease prevalence are increasing healthcare needs
National projections anticipate a shortage of 22,000 maternity care providers by 2050, positioning midwives as essential healthcare professionals addressing maternal health access gaps.
Healthcare Workforce Needs and Employment Concentration
Colorado employs approximately 280 nurse-midwives with a location quotient of 2.15—meaning the state has more than double the national concentration of CNMs relative to total employment. This ranks Colorado 4th nationally for midwife concentration. Despite this relatively strong workforce, significant gaps remain: certified nurse-midwives attend approximately 13.7% of Colorado’s 61,494 annual births (about 8,400 deliveries), while 25 counties remain maternity care deserts.
The Colorado Center for Nursing Excellence identifies the highest demand in Adams, Arapahoe, Boulder, Denver, Douglas, Jefferson, Mesa (Grand Junction), Pueblo, and Weld counties. However, three-quarters of Colorado’s counties are classified as rural or frontier, with 43 rural hospitals (fewer than half offering labor and delivery services) and 13 counties lacking any hospital facility.
For comprehensive salary information and regional comparisons, explore our CNM salary guide covering all 50 states.
(Salary data for nurse-midwives reported by the U.S. Bureau of Labor Statistics in May 2024. Figures represent state and regional 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. Data accessed January 2026.)
Step 6. Explore Frequently Asked Questions About Becoming a Midwife in Colorado
Below are answers to common questions about becoming a Certified Nurse-Midwife (CNM) or Certified Midwife (CM) in Colorado.
What’s the difference between a CNM and a CM in Colorado?
Both CNM and CM credentials have identical scopes of practice, educational requirements through ACME-accredited programs, and examination standards through AMCB. Following Senate Bill 23-167’s implementation in July 2024, both credentials now have equal licensure parity in Colorado with independent practice authority and prescriptive privileges. The primary difference is that CNMs must maintain an active RN license, while CMs require a bachelor’s degree in any field, but not nursing licensure. Colorado is one of only 13 jurisdictions recognizing the CM credential, compared to CNM recognition in all 50 states.
How long does it take to become a midwife in Colorado?
The timeline varies by pathway: Master’s programs (MS Nurse-Midwifery and the new MS Midwifery Direct-Entry) take approximately 2.5 years, BS to DNP programs require 4 years, and post-graduate certificates take 1.5 years. Additional time is needed for licensure application processing (typically 4-8 weeks) and completing the 750-hour mentorship requirement over 3 years for full prescriptive authority.
Can I practice midwifery in Colorado with an online degree?
Yes, Colorado accepts graduates from ACME-accredited online and hybrid programs, provided they complete the required supervised clinical training (700-1,260 hours, depending on program) in approved healthcare facilities. The University of Colorado offers hybrid online programs combining distance education with guaranteed clinical placements at Denver and Aurora midwifery clinics.
What is the new direct-entry CM program at the University of Colorado?
Announced in September 2025 and launching in Summer 2026, the University of Colorado is one of only three universities nationally offering a direct-entry Certified Midwife program for individuals with bachelor’s degrees in any field. This 44-credit, 2.5-year program allows non-nurses to become licensed midwives in Colorado and the 12 other jurisdictions recognizing the CM credential. The program requires completion of science prerequisites and 720 supervised clinical hours. Prospective students should note the credential’s limited interstate portability compared to CNM licensure.
What are the prescriptive authority requirements in Colorado?
Under regulations updated in January 2024 (effective March 16, 2024), Colorado requires completion of a 750-hour mentorship with a qualified Colorado-licensed physician, APRN with prescriptive authority, or CM with full prescriptive authority, plus 3 years of combined clinical experience within three years of receiving provisional authority. Provisional prescriptive authority requires active AMCB certification, professional liability insurance ($500,000 per claim, $1.5 million aggregate), and PDMP registration. Mentorship may be conducted through remote synchronous audio, web, or video communication.
Do I need malpractice insurance to practice as a midwife in Colorado?
Yes, midwives in independent practice must maintain professional liability insurance with minimum coverage of $500,000 per claim and $1,500,000 aggregate annually. This requirement applies to both CNMs and CMs engaged in independent practice. Employed midwives are typically covered by institutional policies through their healthcare facility employers.
What is the job outlook for midwives in Colorado?
The job outlook is exceptional, with the BLS projecting 33% growth in midwife positions from 2023-2033, substantially exceeding the 3% average for all occupations. This strong demand is driven by OB/GYN physician shortages affecting 50% of Colorado counties, 25 counties classified as maternity care deserts, consumer preference for midwifery care, and national projections of a 22,000 maternity care provider shortage by 2050. Colorado’s mean annual wage of $143,600 exceeds the national average by 12.1%.
Can midwives in Colorado attend home births?
Yes, both CNMs and CMs can attend planned home births in Colorado, provided they maintain appropriate licensure, prescriptive authority, and professional liability insurance meeting state requirements. Midwives also practice in hospitals, freestanding birth centers, outpatient clinics, and community health centers throughout the state.
Are midwifery services covered by insurance in Colorado?
Yes, Colorado Medicaid and most private insurance plans cover midwifery services, including prenatal care, delivery (hospital, birth center, or home), postpartum care, and well-woman services. Coverage scope may vary by plan, so patients should verify specific benefits with their insurance provider.
Where are the greatest opportunities for midwives in Colorado?
While urban areas like Denver, Aurora, Boulder, and Colorado Springs offer established practice opportunities, the greatest need exists in Colorado’s 25 maternity care desert counties, concentrated in eastern and southern regions. The University of Colorado’s Rural Midwifery Workforce Expansion Program (HRSA-funded through 2027) provides pathways for graduates committed to rural practice, with potential loan repayment and workforce incentive programs available for providers serving underserved areas.
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, from urban medical centers to rural communities facing critical provider shortages.