Last Updated: June 2025 | Reviewed by Abbie Jacobs
The District of Columbia offers exceptional opportunities for aspiring nurse-midwives, with recent legislative changes expanding practice authority and recognition of midwifery care. The DC Board of Nursing regulates CNMs as Advanced Practice Registered Nurses (APRNs), requiring specific educational credentials, national certification, and ongoing professional development. Recent amendments to DC health occupation laws have strengthened the autonomous practice framework for CNMs, positioning them as primary care providers capable of managing comprehensive maternal and gynecological health services.
The 2024 Health Occupations Revision General Amendment Act eliminated previous collaboration requirements, granting full practice authority to qualified CNMs. This regulatory shift recognizes the education, training, and competence of certified nurse midwives to practice independently while maintaining appropriate consultation and referral relationships. The regulatory environment continues to evolve, with new provisions for maternity centers and expanded Medicaid reimbursement creating additional practice opportunities for qualified midwives.
“Completing my master’s in nurse midwifery and practicing in Washington DC has been incredibly rewarding. The 2024 legislative changes granting full practice authority mean I can now practice independently while serving diverse populations in the nation’s capital. My clinical rotations at GW Hospital and MedStar prepared me for the complex cases I see daily in my current position at a leading women’s health practice.” – Sarah L., CNM, Washington DC
Steps to Becoming a Certified Nurse Midwife in Washington DC
Registered nurses with an unrestricted RN license in good standing can become certified nurse midwives in Washington, D.C., by meeting the requirements for advanced practice registered nurse (APRN) licensure through the D.C. Department of Health’s Board of Nursing:
Step 1: Earn a Qualifying Master’s Degree or Higher in Nurse-Midwifery
DC-based RNs interested in becoming certified nurse midwives start by enrolling in a graduate program in nurse midwifery approved by the Accreditation Commission for Midwifery Education (ACME).
Educational Prerequisites and Pathways
The fundamental prerequisite for becoming a certified nurse midwife in the District of Columbia is holding an active registered nurse (RN) license. Only individuals currently licensed as registered nurses under Chapter 54 of the DC health occupations regulations are eligible to apply for CNM certification. This requirement ensures that all aspiring midwives possess the foundational nursing knowledge and clinical experience necessary for advanced practice.
| Current Education Level | Recommended Pathway | Typical Duration | Prerequisites |
|---|---|---|---|
| High School Diploma | BSN → MSN in Nurse-Midwifery | 6-7 years total | College preparatory coursework |
| ADN + RN License | RN-to-MSN Bridge Program | 3-4 years | Current RN license, clinical experience |
| BSN + RN License | Traditional MSN Program | 2-3 years | 1-2 years of nursing experience |
| Bachelor’s (Non-Nursing) | Accelerated BSN → MSN | 4-5 years total | Nursing prerequisites |
Advanced Practice Education Requirements
DC regulations mandate that CNM applicants complete post-basic nursing education programs specifically accredited for midwifery practice. These programs must be accredited by the American College of Nurse Midwives (ACNM) or another nationally recognized accrediting body accepted by the Board. The educational requirement reflects the specialized knowledge and skills needed for autonomous midwifery practice, including advanced assessment, diagnosis, and management of maternal and gynecological health conditions.
Graduate Program Admissions
While every graduate program has its own admissions standards, many share common elements, which often include:
- Current, unencumbered RN license
- BSN from an accredited program or completion of nursing prerequisite courses
- Minimum GPA of 3.0 (varies by program)
- GRE General Test (some programs may waive this requirement)
- Video essay, statement of purpose, or personal essay
- Letters of recommendation from nursing supervisors or faculty
- Curriculum Vitae demonstrating relevant experience
- Clinical experience in women’s health or obstetrics (preferred)
Most candidates for nurse-midwife graduate programs hold a Bachelor of Science in Nursing (BSN). ACME also accredits accelerated RN-to-MSN bridge programs that grant both a BSN and a master’s in midwifery for candidates who hold an associate’s degree in nursing.
Structure of Graduate Programs in Nurse Midwifery and Women’s Health
Graduate programs for nurse midwives typically consist of a didactic education component and a clinical education component. The didactic education segment is between 40 and 60 semester credits, while the clinical segment consists of approximately 1,000 hours. These segments are usually completed concurrently.
Didactic Education
This segment covers important advanced topics and theory that nurse midwives use on a daily basis throughout their careers, including:
- Antepartum, intrapartum, and postpartum nurse midwifery
- Advanced pathophysiology and pharmacology
- Advanced health assessment and physical examination
- Research methods for advanced-practice nurses
- Advanced pharmacology for childbearing women
- Legal issues and ethics in maternal healthcare
- Disease prevention and health promotion
- Psychology for pregnancy and women’s health
- Women’s reproductive health across the lifespan
- Complicated pregnancies and deliveries
- Advanced integrated midwifery practice
- Mother and infant biostatistics
Clinical Education and Placement Opportunities
RNs use the clinical segment of their program to apply their advanced didactic knowledge. Online colleges and universities assign students a faculty advisor who will assist them in identifying local sites where the clinical education can take place. Online schools make a concerted effort to establish local clinical partnerships with hospitals and clinics nationwide to minimize the need for students to commute or relocate.
Examples of potential clinical sites in the D.C. area include:
- Sibley Memorial Hospital
- MedStar Washington Hospital Center
- George Washington University Hospital
- Providence Hospital
- Georgetown University Hospital
- Children’s National Hospital
- Howard University Hospital
- Inova Health System in Alexandria and Fairfax, Virginia
- Community Health Centers throughout DC
Dual Specialization Options
Increasingly, schools are offering master’s programs in nurse midwifery that are combined with a focus on the related field of women’s health. These programs result in a dual focus master’s degree in Nurse Midwifery/Women’s Health Nurse Practitioner (NM/WHNP). In addition to meeting the requirements for the CNM credential, completing this type of dual-focus program will fulfill the education requirements for RNs interested in also earning board certification as a women’s health nurse practitioner.
For aspiring nurse midwives in Washington, DC, accredited nurse midwifery programs offer multiple pathways, including online CNM programs that accommodate working professionals. Whether pursuing MSN, DNP, or post-master’s CNM degrees, students can find programs that meet ACME accreditation standards and prepare them for successful careers in DC’s independent practice environment.
Step 2: Take and Pass the National Certification Examination to Become a CNM
The DC Board of Nursing recognizes the American Midwifery Certification Board (AMCB), sponsor of the Certificate in Nurse Midwifery (CNM), as being able to grant the national certification required for nurse midwives to become licensed as advanced practice nurses in the District.
AMCB Certification Examination Details
The path to CNM practice in DC requires successful completion of national certification through the American Midwifery Certification Board (AMCB). CNMs must pass the national certification examination administered by AMCB, which serves as the primary credentialing mechanism for midwifery practice. This examination validates the knowledge and competencies necessary for safe, independent midwifery practice across diverse clinical settings.
| Exam Component | Details |
|---|---|
| Format | Computer-based, multiple-choice |
| Number of Questions | 175 questions |
| Time Limit | 4 hours |
| Results | Immediate official results provided |
| Testing Centers | Multiple locations in the DC metro area |
| Scoring | Pass/fail system |
Certified nurse midwife exam candidates can start preparing for this exam by reviewing the Candidate Handbook. The exam covers the following content areas:
- Antepartum Care – 19-26 percent
- Intrapartum Care – 17-26 percent
- Postpartum Care – 15-18 percent
- Gynecology and Women’s Health – 15-18 percent
- Women’s Health and Primary Care – 8-16 percent
- Newborn Care – 7-16 percent
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
Testing Locations in the DC Metro Area
Candidates can register for the exam and then schedule a testing date and time with PSI Services LLC. Testing locations in the DC metropolitan area include:
- Washington, DC testing centers
- Randallstown, Maryland
- Baltimore, Maryland
- Alexandria, Virginia
- Fredericksburg, Virginia
- Norfolk, Virginia
- Richmond, Virginia
Additional Certification for Dual-Focused Practitioners
Graduates of dual focus nurse midwife/women’s health nurse practitioner master’s programs may also elect to pursue secondary certification as a Women’s Health Care Nurse Practitioner, Board Certified (WHNP-BC), through the National Certification Corporation (NCC).
The WHNP exam consists of 150 scored multiple-choice test questions and up to 25 unscored pretest questions, with a three-hour time limit for completion. The exam covers:
- Gynecology – 35-40 percent
- Obstetrics – 25-30 percent
- Primary Care – 10-15 percent
- Diagnostic Testing and Physical Assessment – 10-15 percent
- Pharmacology – 5-10 percent
Step 3: Apply for APRN Licensure as a Nurse-Midwife through the DC Board of Nursing
CNMs in DC possess broad practice authority encompassing comprehensive maternal and gynecological care without requiring collaborative agreements with physicians. The 2024 Health Occupations Revision General Amendment Act eliminated previous collaboration requirements, granting full practice authority to qualified APRNs.
APRN Licensure Application Requirements
Once RNs have gained national certification from the AMCB and/or NCC, they may complete an APRN Application for Licensure with the DC Board of Nursing through the DC Health online portal. The application process involves multiple components submitted through different channels.
| Application Component | Submission Method | Fee |
|---|---|---|
| Online APRN Application | DC Health Portal | $230 (initial application) |
| Official Transcripts | [email protected] | Included |
| AMCB Certification | Direct from AMCB or notarized copies | Included |
| Criminal Background Check | Fieldprint system | Additional fee required |
| License Verification | [email protected] | $280 (out-of-state RN endorsement) |
All CNM applicants must complete criminal background checks through the DC Health system, regardless of their application pathway. The background check process involves fingerprinting through Fieldprint, either at designated locations for US-based applicants or through international fingerprinting procedures for foreign applicants.
Candidates can indicate if they are applying for a nurse midwife license and/or a women’s health nurse practitioner license on the same application. Processing the application takes between 30 and 45 days. Candidates can verify if their application is complete by logging into their DC Department of Health account.
Prescriptive Authority Requirements
CNMs in DC possess prescriptive authority for legend drugs and controlled substances, subject to specific regulatory requirements. This authority includes prescribing drugs in Schedules II through V under the District of Columbia Uniform Controlled Substances Act. However, CNMs must obtain both federal Drug Enforcement Administration (DEA) registration and DC controlled substances registration before prescribing controlled substances.
APRNs in DC are permitted to prescribe controlled substances after taking these two steps:
Step 4: Explore Nurse-Midwife Career Options in Washington DC and Maintain Credentials
Applicants can see if their APRN license has been approved and is active by checking its status on the DC Department of Health license verification page. Once this is activated, the license will be mailed to the new APRN within 10 business days. At this point, APRNs can begin pursuing employment throughout the D.C. area.
Employment Opportunities and Practice Settings
The Washington, D.C. metropolitan area offers diverse employment opportunities for certified nurse-midwives across various healthcare settings. Practice settings include hospitals, birth centers, private offices, community health centers, and telehealth platforms. The diversity of practice environments allows CNMs to choose settings that align with their professional interests, patient population preferences, and desired work-life balance.
Potential practice models and significant employers in the D.C. area include:
- Labor and Delivery at Sibley Memorial Hospital
- The Family Birth Place at MedStar Washington Hospital
- George Washington Women’s Center at the GW University Hospital
- Midwifery Services at George Washington University Hospital
- Jacobs Institute of Women’s Health
- Providence Hospital’s Center for Perinatal Advocacy
- Community of Hope’s Family Health and Birth Center
- Developing Families Center
- Capital Women’s Care
- BirthCare & Women’s Health
- M.A.M.A.S. Midwives
- Howard University Hospital Women’s Services
- Georgetown University Hospital Obstetrics
Scope of Practice and Professional Autonomy
Certified nurse-midwives in DC possess broad practice authority, encompassing comprehensive maternal and gynecological care. The scope of practice includes managing the care of normal obstetrical patients, performing minor surgical procedures, conducting deliveries (including amniotomy and episiotomy), and managing newborn care. CNMs are authorized to provide gynecological care for women, including family planning services, sexually transmitted disease management, and primary health care services.
However, certain restrictions apply to CNM practice in DC. Specifically, nurse midwives may not perform cesarean sections or surgical abortions. These limitations reflect the collaborative nature of maternal care and the importance of appropriate referral relationships with physicians for procedures outside the midwifery scope of practice.
Credential Maintenance Requirements
License Renewal with the DC Board of Nursing
APRN licenses in DC, including CNM certification, expire on June 30 of even-numbered years. The renewal process requires the timely submission of renewal applications, payment of renewal fees ($145 for timely renewal), and documentation of completed continuing education requirements. Late renewals incur additional fees ($85), while licenses expired more than 60 days require reinstatement applications.
To be eligible for renewal, APRNs must meet these requirements:
- Have a valid DC RN license
- Maintain national certification with the AMCB and/or NCC
- Complete 24 contact hours of continuing education in the APRN’s field of specialization every two years
- Complete 2 credits of continuing education focused on cultural competency or LGBTQ patient care
CNM Certification Maintenance with the American Midwifery Certification Board (AMCB)
Maintaining national certification with the AMCB involves a five-year cycle. Maintaining AMCB certification requires recertification every five years, ensuring that practicing Certified Nurse-Midwives (CNMs) remain current with evolving standards of care and evidence-based practices. To maintain certification, APRNs enroll in the AMCB’s Certificate Maintenance Program and complete one of the following:
- Re-examination with the National Certification Examination in Nurse Midwifery
- Completion of three certificate maintenance modules and 20 hours of continuing education
WHNP-BC Certification Maintenance with the National Certification Corporation (NCC)
NCC certification is on a three-year maintenance cycle, which APRNs can complete by first taking the NCC’s Continuing Competency Assessment. Depending on the results of this assessment, APRNs must complete between 10-50 hours of approved continuing education during each maintenance cycle.
Certified Nurse Midwife Salaries and Job Outlook in Washington DC
The DC metropolitan area offers competitive compensation for certified nurse midwives, reflecting the specialized skills and autonomous practice authority of CNMs in the healthcare marketplace. Current market analysis indicates strong demand for midwifery services in the nation’s capital, with opportunities across diverse healthcare settings.
Current Salary Information for DC Metro CNMs
| Experience Level | Annual Salary Range | Hourly Rate Range |
|---|---|---|
| Entry Level (New Graduates) | $110,000 – $125,000 | $53 – $60 |
| Mid-Career (3-7 years) | $125,000 – $145,000 | $60 – $70 |
| Experienced (8+ years) | $145,000 – $170,000 | $70 – $82 |
| Senior/Private Practice | $170,000+ | $82+ |
Factors Influencing CNM Salaries in Washington DC
Several factors influence certified nurse midwife salaries in Washington DC:
- Practice Setting: Hospital-employed CNMs typically earn higher base salaries than those in community health centers
- Geographic Location: DC proper generally offers higher compensation than suburban areas
- Experience Level: Advanced practitioners with specialized skills command premium salaries
- Independent Practice Authority: DC’s full practice authority increases earning potential significantly
- Federal Employment: Government positions may offer comprehensive benefits packages
- Dual Certification: CNM/WHNP credentials expand practice opportunities and income potential
- Call Responsibilities: CNMs taking call may receive additional compensation
- Administrative Roles: Leadership positions in large healthcare systems offer salary premiums
Job Growth and Market Demand
The number of jobs for certified nurse midwives is rising dramatically throughout the country. The DC metropolitan area presents particular opportunities for CNMs due to its diverse population, high education levels, and demand for specialized healthcare services. Recent legislative changes supporting independent practice authority have created additional opportunities for entrepreneurial CNMs interested in establishing their own practices.
Employment opportunities extend beyond clinical practice to include roles in health departments, community centers, public health systems, and educational institutions. These diverse career paths enable CNMs to contribute to population health initiatives, policy development, education, and research while maintaining their clinical expertise and patient care focus.
(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 About Becoming a CNM in Washington DC
How long does it take to become a certified nurse midwife in Washington, DC?
The total pathway typically requires 6-8 years, depending on your starting education level. If you already have a BSN and RN license, you can complete a master’s program in 2-3 years. If you have an ADN, an RN-to-MSN bridge program typically takes 3-4 years. After graduation, you’ll need to pass the national certification exam and complete the DC licensure application process, which takes 30-45 days.
What are the benefits of DC’s independent practice authority for CNMs?
The 2024 Health Occupations Revision General Amendment Act eliminated collaboration requirements, granting full practice authority to certified nurse-midwives (CNMs) in DC. This means CNMs can establish private practices, make independent clinical decisions, prescribe medications autonomously (including controlled substances), and provide comprehensive care without physician oversight, positioning DC CNMs among the most autonomous midwifery practitioners in the nation.
Are there local CNM programs available in Washington DC?
While DC doesn’t have campus-based ACME-accredited CNM programs within the district, nearby options include programs in Washington and Winchester, Virginia. Most DC-area students pursue accredited online programs that include clinical placements at Local hospitals, such as GW Hospital, MedStar Washington Hospital Center, and other major medical centers.
Can CNMs prescribe controlled substances in Washington DC?
Yes, CNMs in DC can prescribe controlled substances in Schedules II through V after obtaining both federal DEA registration and DC controlled substance registration. However, CNMs cannot issue refillable prescriptions for controlled substances, and must follow specific regulatory requirements for controlled substance prescribing.
What is the application fee for CNM licensure in DC?
The initial APRN application fee is $230. Additional costs include criminal background checks through Fieldprint and potentially $280 for out-of-state RN license endorsement if you’re not already licensed in DC. License renewal fees are $145 for timely renewal, with a late fee of $85 if renewal is made after the deadline.
What continuing education is required for DC CNMs?
DC CNMs must complete 24 contact hours of continuing education every two years to maintain their APRN license. Additionally, all healthcare professionals in DC must complete 2 credits of continuing education focused on cultural competency or LGBTQ patient care. CNMs must also maintain AMCB certification through either recertification every five years or re-examination.
What clinical facilities in DC accept CNM students?
Major facilities include MedStar Washington Hospital Center, George Washington University Hospital, Georgetown University Hospital, Sibley Memorial Hospital, Providence Hospital, Howard University Hospital, and numerous community health centers throughout the District of Columbia. Online program advisors assist in arranging clinical placements at facilities that meet the program’s requirements.
How competitive are CNM salaries in DC compared to the cost of living?
CNM salaries in DC range from $110,000 for new graduates to $170,000+ for experienced practitioners. While DC has a higher cost of living than many areas, the combination of competitive salaries, independent practice authority, federal employment opportunities, and diverse patient populations makes it an attractive market for CNMs seeking career advancement and professional autonomy.