Certified Nurse-Midwives (CNMs) are advanced practice registered nurses specializing in comprehensive women’s healthcare throughout the lifespan, with particular expertise in pregnancy, childbirth, and postpartum care. Indiana recognizes CNMs as independent healthcare providers who must meet specific qualifications to practice legally within the state.Thanks to a growing preference for personalized maternity care, Indiana now ranks among the top states for midwife-attended births. As of 2024, approximately 12% of births were attended by midwives—a significant increase from 7-10.99% reported in 2018. This growth reflects both the expanding recognition of midwifery and the critical role CNMs play in addressing healthcare provider shortages across the state, especially in rural areas.
Steps to Become a Certified Nurse-Midwife in Indiana
 | Earn a Qualifying Master’s Degree or Higher in Nurse-Midwifery |
 | Take and Pass the National Certification Examination |
 | Apply for Indiana Nurse-Midwife Licensure |
 | Maintain Certification and State Licensure |
Step 1: Earn a Qualifying Master’s Degree or Higher in Nurse-Midwifery
The foundation of CNM practice begins with nursing education and advances to specialized midwifery training at the graduate level through programs accredited by the Accreditation Commission for Midwifery Education (ACME).
Nursing Foundation Requirements
- Bachelor of Science in Nursing (BSN) from an accredited program
- Active, unencumbered Registered Nurse (RN) license obtained by passing the NCLEX-RN examination
- Clinical nursing experience (1-2 years recommended, particularly in women’s health or labor and delivery settings)
Graduate Education Pathways
| 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 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 |
Program Selection Considerations
When evaluating nurse-midwifery programs, prospective students should examine:
- Geographical Access: Indiana hosts one campus-based program at Indiana University School of Nursing in Indianapolis. Distance education options are valuable for those in rural areas.
- Program Format: Full-time, part-time, hybrid, and entirely online options accommodate diverse student needs and circumstances.
- Dual Specialization: Programs offering dual preparation in nurse-midwifery and women’s health expand practice capabilities and marketability.
- Financial Investment: Program costs typically range from $35,000-$80,000 total depending on institution type and residency status.
“I completed my nurse-midwifery degree online while continuing to work as an RN in rural Indiana. The flexibility of distance learning combined with clinical placements at my local hospital made it possible to advance my career without relocating. Now I’m providing much-needed women’s health services in an underserved community where I’ve lived my whole life.” – Sarah M., CNM, Class of 2023
Curriculum Components
Nurse-midwifery graduate education encompasses:
- Core Graduate Coursework:
- Advanced Health and Physical Assessment
- Advanced Physiology and Pathophysiology
- Advanced Pharmacology
- Midwifery-Specific Courses:
- Reproductive Healthcare Management
- Intrapartum and Postpartum Care
- Primary Care for Women
- Newborn Management
- Clinical Education: 600-1,000 supervised clinical hours ensuring competency in the full scope of midwifery practice, aligning with the American College of Nurse-Midwives (ACNM) Standards of Practice and Core Competencies.
Indiana Clinical Training Sites
Clinical placements for nurse-midwifery students in Indiana include:
- St. Vincent’s Women’s Hospital, Indianapolis
- St. Vincent Women’s Center, Fishers
- St. Francis Spirit of Women, Indianapolis
- Parkview Women and Children’s Hospital, Fort Wayne
- IU Health Bloomington Hospital
- Community Hospital East, Indianapolis
Admission Requirements
Most master’s degree programs in nurse-midwifery require:
- Current, unencumbered RN license
- Baccalaureate degree in nursing with competitive GPA (typically ≥3.0)
- Professional letters of recommendation
- Personal statement articulating professional goals
- Resume demonstrating relevant clinical experience
- Interview (for selected candidates)
Step 2: National Certification Process
Upon completing an ACME-accredited graduate program, candidates must obtain national certification before applying for state licensure. The American Midwifery Certification Board (AMCB) is the certifying body for all CNMs in the United States.
Certification Requirements
- Graduation from an ACME-accredited nurse-midwifery program
- Verification of program completion submitted directly to AMCB
- Submission of certification application and associated fees
- Successful completion of the national certification examination
Examination Format
- Content Areas: Antepartum, intrapartum, postpartum, newborn, gynecologic, and primary care
- Question Format: 175 multiple-choice questions
- Time Allotment: Four-hour time limit
- Preparation Resources: AMCB offers study resources and content outlines for exam preparation
Testing Locations
Indiana testing centers for the AMCB certification examination are located in:
- Indianapolis
- Fort Wayne
- Evansville
- South Bend
Supplementary Certification
Graduates of dual-focus programs may pursue additional Women’s Health Care Nurse Practitioner (WHNP) certification through the National Certification Corporation. While not required for nurse-midwifery practice in Indiana, this dual certification broadens scope of practice and enhances professional marketability.
Step 3: Indiana State Licensure Process
The Indiana State Board of Nursing regulates nurse-midwifery practice through a multistep licensure process that includes specialized credentialing for prescriptive authority.
RN Licensure Requirements
- Indiana RN License: An Active license is required; out-of-state RNs may apply through endorsement
- Multistate Practice Option: Indiana participates in the Nurse Licensure Compact (NLC), allowing practice across state lines when Indiana is the primary state of residence
Nurse-Midwife License Application
- Required Documentation:
- Completed Application for a Limited License to Practice Nurse-Midwifery
- Official graduate transcripts demonstrating program completion
- Verification of AMCB certification
- Verification of any licenses held in other states
- Application fee ($50)
- Processing Time: Typically 2-4 weeks after submission of a complete application
Prescriptive Authority
For CNMs seeking medication prescribing privileges, additional requirements include:
- Submission of the Application for Prescriptive Authority as an Advanced Practice Nurse ($50 fee)
- Establishment of a collaborative practice agreement with a licensed physician
- Acquisition of Indiana State Controlled Substances Registration (CSR) ($60 fee)
- Obtainment of the federal Drug Enforcement Administration (DEA) registration
Collaborative Practice Agreement Specifications
Required elements of a comprehensive collaborative practice agreement include:
- Complete identifying information for both the nurse-midwife and collaborating physician
- Practice locations and settings
- Professional qualifications and scope parameters
- Specific collaboration protocols and communication methods
- Geographic proximity arrangements
- Coverage contingencies for absences and emergencies
- Prescribing review procedures and documentation standards
- Any practice limitations specified by the collaborating physician
The Indiana State Board of Nursing provides a collaborative practice agreement template that satisfies regulatory requirements.
Ongoing Documentation Requirements
After establishing prescriptive authority, CNMs must:
- Submit prescribing documentation to the collaborating practitioner within seven days
- Include at least a five percent random sampling of charts and medications prescribed
- Maintain records according to agreement specifications
Step 4: Credentials Maintenance
Maintaining CNM credentials requires ongoing professional development and regular renewal of both national certification and state licensure.
Indiana License Renewal Schedule
- Renewal Cycle: Every two years, by October 31 of odd-numbered years
- Nurse-Midwife License Fee: $50
- Prescriptive Authority Renewal Fee: $10 (if applicable)
- Renewal Platform: Indiana’s Online Licensing portal
Continuing Education Requirements
- CNMs WITH Prescriptive Authority: 30 hours every two-year renewal cycle, with 8 hours specifically in pharmacology
- CNMs WITHOUT Prescriptive Authority: No continuing education required for license renewal (though recommended for professional development)
AMCB Certification Maintenance
The AMCB Certification Maintenance Program offers two pathways:
- Continuing Education Pathway:
- Complete 3 AMCB Certificate Maintenance Modules per five-year cycle
- Obtain 20 contact hours of approved continuing education
- Submit annual certification maintenance fees
- Re-Examination Pathway:
- Retake the AMCB Certification Examination
- Pay the examination fee in lieu of annual fees
WHNP Certification Maintenance (If Applicable)
- Complete a continuing competency assessment at the beginning of each three-year maintenance cycle
- Fulfill continuing education requirements based on assessment results
- Pay the associated maintenance fees
Collaborative Practice Management
For CNMs with prescriptive authority:
- Maintain current collaborative practice agreements
- Update agreements promptly when practice parameters change
- Notify the Board of modifications to collaborative relationships
- Adhere to the documentation requirements specified in the agreement
Professional Practice Environments
Indiana’s growing midwifery landscape offers diverse practice opportunities in:
- Hospital-based midwifery services
- Physician group practices
- Freestanding birth centers (five facilities statewide as of 2024)
- Community health centers
- Private midwifery practices
- Academic medical centers
- Women’s health clinics
Major healthcare systems employing CNMs include IU Health, St. Vincent Health System, Parkview Health, Community Health Network, and various independent women’s health centers throughout the state.
Compensation and Market Outlook
Certified Nurse-Midwives in Indiana maintain competitive compensation while addressing critical healthcare needs, particularly in underserved communities.
Salary Data (May 2023)
- Annual Mean Salary: $124,570 (increased from $110,890 in 2019)
- Entry-level (Bottom 10%): $98,240
- Experienced (Top 90%): $152,330
Geographic location, practice setting, and experience level significantly influence compensation, with urban facilities typically offering higher base salaries. Rural practitioners may qualify for loan repayment programs and other incentives designed to address healthcare shortages in underserved areas.
Healthcare Impact
Nurse-midwives address critical healthcare needs in Indiana, where:
- Over half of the counties are designated as medically underserved
- The physician-to-population ratio remains below national averages
- Rural communities face persistent healthcare provider shortages
- Specialized populations, including the state’s significant Amish communities, prefer midwifery care
Scope of Practice
Indiana CNMs provide comprehensive women’s healthcare services across the lifespan, including:
- Primary care for adolescents through postmenopausal women
- Family planning and reproductive health services
- Preconception, antepartum, intrapartum, and postpartum care
- Normal newborn care through the first 28 days of life
- Health promotion and disease prevention
- Medication prescribing (with collaborative agreement)
(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
How long does it take to become a Certified Nurse-Midwife in Indiana?
The complete educational pathway typically requires 6-8 years: 4 years for BSN completion, 1-2 years of recommended clinical nursing experience, and 2-3 years for graduate education in nurse-midwifery. Accelerated and part-time options may adjust this timeline.
Can I practice as a CNM in Indiana without physician supervision?
Yes, CNMs in Indiana may practice independently for core midwifery services. However, prescriptive authority requires establishing a collaborative practice agreement with a licensed physician that outlines the parameters of medication management.
Are there any nurse-midwifery programs physically located in Indiana?
Yes, Indiana University School of Nursing in Indianapolis offers an ACME-accredited nurse-midwifery program. However, many Indiana residents choose distance education programs offered by out-of-state institutions that arrange local clinical placements.
What is the difference between a CNM and other types of midwives in Indiana?
In Indiana, Certified Nurse-Midwives (CNMs) are registered nurses with graduate-level education and AMCB certification. They maintain the broadest scope of practice and can work in all healthcare settings. Certified Professional Midwives (CPMs) and lay midwives follow different educational pathways and practice under more restricted parameters.
How often do I need to renew my Indiana nurse-midwife license?
Indiana nurse-midwife licenses must be renewed biennially, by October 31 of odd-numbered years. CNMs with prescriptive authority must complete 30 continuing education hours per renewal cycle, including 8 hours in pharmacology.