How to Become a Nurse Midwife in Iowa: Complete Guide

Last Updated: May 2025 | Reviewed by Abbie Jacobs

Registered nurses in Iowa seeking to advance their careers in women’s health can pursue certification as nurse-midwives through accredited master’s degree programs nationwide. This comprehensive guide outlines the complete pathway to becoming a Certified Nurse-Midwife (CNM) in Iowa, including educational options, the state’s specialized program, licensing procedures, and career opportunities.

Iowa offers nurse-midwives independent practice authority and competitive salaries, with growing demand across the state’s healthcare systems. The state’s approach emphasizes both urban and rural healthcare delivery, making it particularly attractive for those interested in serving diverse populations across varied geographic settings.

According to recent data, approximately 11-13.69% of births in Iowa were attended by midwives, highlighting the important role these healthcare professionals play in the state’s maternity care system. Iowa’s nurse-midwives enjoy a broad scope of practice, with authorization to manage antepartum, intrapartum, postpartum, and gynecologic care, and they practice independently without requiring a collaborative practice agreement with physicians.

Steps to Becoming a Nurse-Midwife in Iowa

RNs looking to become nurse-midwives must qualify for Advanced Registered Nurse Practitioner (ARNP) licensure by meeting the requirements set forth by the Iowa Board of Nursing. Follow these essential steps to begin your journey toward becoming a certified nurse-midwife:

Earn a Qualifying Master’s Degree or Higher in Nurse-Midwifery
Take and Pass the National Certification Examination to Become a CNM
Apply for ARNP Licensure as a Nurse-Midwife through the Iowa Board of Nursing
Maintain your Nurse-Midwife Certification and ARNP License


Step 1. Earn a Qualifying Master’s Degree or Higher in Nurse-Midwifery

RNs in Iowa with their sights set on a career in nurse-midwifery must complete a master’s degree or higher in nurse-midwifery through a program accredited by the Accreditation Commission for Midwifery Education (ACME). Iowa residents have access to multiple educational pathways, including the state’s own program and numerous online and hybrid programs from accredited institutions nationwide.

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Educational Pathways for Iowa Nurse-Midwifery Students

Aspiring nurse-midwives in Iowa can choose from several educational routes depending on their current educational background and career goals. ACME-accredited programs offer flexible options designed to accommodate working nurses while providing comprehensive preparation for advanced practice.

Program Options

Program TypeDesigned ForTypical DurationFormat Options
MSN in Nurse-MidwiferyRNs with Bachelor of Science in Nursing (BSN) degrees2-3 years full-timeOn-campus, Online, Hybrid
RN-to-MSN Bridge ProgramsRNs with associate’s degrees in nursing3-4 years full-timeOnline, Hybrid
Post-Graduate Certificate ProgramsRNs with an MSN wanting to add CNM certification12-18 months full-timeOnline, Hybrid
Dual Specialization ProgramsRNs seeking both CNM and Women’s Health NP credentials2-3 years full-timeOnline, Hybrid
DNP in Nurse-MidwiferyRNs seeking the highest level of clinical preparation3-4 years full-timeOn-campus, Hybrid

Iowa’s Nurse-Midwifery Education Program

The University of Iowa operates the state’s only nurse-midwifery education program, offering a comprehensive post-baccalaureate certificate program that leads to a Certificate in Midwifery. This specialized program spans five semesters and welcomes a new cohort of students each September, maintaining small class sizes of only four midwifery students per cohort to ensure personalized attention and strong group cohesion.

“The University of Iowa’s midwifery program completely transformed my understanding of women’s healthcare. The small cohort size meant I received incredible mentorship from faculty, and the clinical experiences at UI Hospitals gave me exposure to diverse cases I never would have seen elsewhere. The program’s emphasis on serving rural populations aligned perfectly with my goal of returning to my hometown to provide midwifery care where it’s desperately needed.” – Sarah M., CNM Graduate

The program offers a distance learning articulation with the Midwifery Institute of Thomas Jefferson University, allowing for the concurrent completion of a Master of Science in Midwifery alongside the midwifery certificate. This dual pathway provides graduates with both the certificate necessary for certification and the advanced degree increasingly valued in healthcare settings.

National Online and Hybrid Program Options

Since Iowa has limited in-state options, many Iowa residents pursue nurse-midwifery education through accredited online and hybrid programs offered by institutions nationwide. These programs are specifically designed to accommodate working nurses and often feature:

  • Flexible Scheduling: Part-time and full-time options with evening and weekend coursework
  • Clinical Placement Assistance: Programs help arrange clinical sites near students’ home locations
  • Advanced Technology Integration: Simulation labs, virtual reality training, and telehealth components
  • Intensive Residencies: Short-term on-campus experiences for hands-on skills and community building

Popular online programs among Iowa students include those from Frontier Nursing University, Georgetown University, and Vanderbilt University, all of which hold ACME accreditation and offer clinical placement support throughout the Midwest region.

Core Curriculum and Learning Domains

Regardless of the specific program chosen, all ACME-accredited nurse-midwifery programs prepare students for the full scope of midwifery practice through comprehensive curricula covering:

Advanced Clinical Knowledge:

  • Maternal-fetal-newborn physiology and pathophysiology
  • Advanced pharmacology with emphasis on pregnancy and lactation
  • Genetics and genomics in reproductive health
  • Advanced clinical assessment across the lifespan
  • Diagnosis and management in primary care

Specialized Midwifery Practice:

  • Antepartum, intrapartum, and postpartum care
  • Newborn care and breastfeeding support
  • Gynecologic and reproductive health services
  • Family planning and contraceptive management
  • Menopause and women’s health

Professional Development:

  • Healthcare policy and advocacy
  • Evidence-based practice and research utilization
  • Cultural competency and health disparities
  • Leadership and interprofessional collaboration
  • Business and practice management

Clinical Training Requirements

All nurse-midwifery programs require extensive clinical experience, typically consisting of a minimum of 1,000 hours of clinical work across diverse settings. Iowa students benefit from clinical placements in various healthcare environments:

Clinical Training Sites for Iowa Students:

  • Academic Medical Centers: University of Iowa Hospitals & Clinics, University of Iowa Women’s Health
  • Community Hospitals: Covenant Medical Center (Waterloo), Montgomery County Memorial Hospital (Red Oak)
  • Birth Centers: Freestanding birth centers in the Iowa City and Des Moines areas
  • Private Practice Settings: OB/GYN practices and midwifery group practices
  • Public Health Settings: County health departments and federally qualified health centers

The University of Iowa’s program specifically provides clinical education through UI Hospitals & Clinics, where the midwifery practice handles over 10,000 outpatient encounters and more than 600 births annually, ensuring students gain exposure to diverse clinical scenarios and develop competency in managing both routine and complex cases.

Admission Requirements and Prerequisites

While specific requirements vary by program, most nurse-midwifery programs require prospective students to possess:

Educational Foundation:

  • Current, unencumbered RN license
  • Bachelor’s degree (BSN preferred, but bachelor’s in any field may be acceptable)
  • Minimum undergraduate GPA (typically 3.0 or higher)
  • Prerequisite coursework in statistics, physical assessment, and health sciences

Professional Experience:

  • Minimum nursing experience (usually 1-2 years)
  • Maternal-child health experience (strongly preferred)
  • Current CPR certification
  • Professional references from nursing supervisors or colleagues

Application Materials:

  • Completed application with personal statement
  • Official transcripts from all institutions attended
  • GRE scores (required by some programs)
  • Letters of recommendation
  • Resume or curriculum vitae

For Iowa’s program specifically, the application window opens annually on December 9th, with completed applications due by July 1st. The program requires a $50 application fee and includes a personal interview as part of the selection process.


Step 2. Take and Pass the National Certification Examination to Become a CNM

Upon completion of an ACME-accredited master’s degree program in nurse-midwifery, RNs in Iowa seeking ARNP licensure as a nurse-midwife must take and pass the Certified Nurse-Midwife (CNM) examination through the American Midwifery Certification Board (AMCB).

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AMCB Certification Examination

The AMCB certification examination serves as the national standard for entry into midwifery practice and is required for licensure in all states, including Iowa. The computer-based examination tests knowledge and clinical judgment across the full scope of midwifery practice.

Examination Content Areas:

  • Antepartum Care (25%): Preconception counseling, prenatal care, risk assessment
  • Intrapartum Care (25%): Labor management, delivery, emergency procedures
  • Postpartum Care (20%): Maternal recovery, breastfeeding, newborn care
  • Gynecologic Care (20%): Reproductive health, contraception, screening
  • Primary Care (10%): Health promotion, disease prevention, referral management

Graduates of nurse-midwifery/women’s health dual programs may also choose to take the Women’s Health Care Nurse Practitioner (WHNP) examination through the National Certification Corporation, expanding their scope of practice and career opportunities.

Testing Centers and Logistics

Graduates must apply to take the examination and receive approval before scheduling at a Professional Service Industries testing center. PSI testing centers in Iowa are located in:

  • Davenport
  • Windsor Heights

This provides convenient access for Iowa candidates, though graduates can also test at any AMP center nationwide if scheduling or location preferences require it.


Step 3. Apply for ARNP Licensure as a Nurse-Midwife through the Iowa Board of Nursing

RNs in Iowa who have successfully completed a master’s degree in nurse-midwifery and have earned CNM certification may apply for licensure as an ARNP nurse-midwife. Iowa’s licensure requirements, as outlined in 655 IAC Chapter 7, establish specific qualifications that candidates must meet to practice as advanced registered nurse practitioners in the state.

Iowa ARNP Licensure Requirements

The Iowa Board of Nursing requires candidates to demonstrate compliance with three fundamental requirements:

  1. Current RN Licensure: Active, unencumbered licensure as a registered nurse in Iowa or holding licensure in another compact state where the candidate claims primary residency
  2. Graduate Education: Graduation from an accredited graduate or postgraduate nurse practitioner program in the certified nurse-midwife role
  3. National Certification: Advanced level certification by an approved national certifying body (AMCB for CNMs)

Application Process and Documentation

Candidates must complete the Application for Advanced Registered Nurse Practitioner and select licensure as a Certified Nurse-Midwife. Those who also hold WHNP certification may select both designations.

Required Documentation and Fees:

  • $81 application fee (or $162 for both CNM and WHNP designations)
  • Official transcripts from the institution where the graduate degree was obtained, sent directly to the Board
  • Copy of CNM certification from AMCB
  • Copy of WHNP certification (if applicable) from National Certification Corporation
  • Verification of current RN licensure

Scope of Practice and Independent Authority

Iowa nurse-midwives enjoy one of the most comprehensive scopes of practice in the United States. The state recognizes CNMs as independent practitioners who can:

  • Provide complete maternity care from preconception through postpartum
  • Manage normal and low-risk pregnancies and deliveries
  • Provide comprehensive gynecologic and reproductive health services
  • Offer primary care services for women across the lifespan
  • Practice without physician supervision or collaborative agreements
  • Establish independent midwifery practices

Prescriptive Authority

ARNP licensure with the Iowa Board of Nursing permits nurse-midwives to prescribe medications and devices, including controlled substances, providing them with comprehensive treatment capabilities. For controlled substances, nurse-midwives must obtain additional certification:

  • DEA Registration: Drug Enforcement Administration number for controlled substance prescribing
  • State Controlled Substance License: Available through the Iowa Board of Pharmacy


Step 4. Maintain your Nurse-Midwife Certification and ARNP License

Nurse-midwives in Iowa must maintain both their state ARNP license and national CNM certification through ongoing continuing education and regular renewal processes. This dual requirement ensures practitioners stay current with evolving evidence-based practices and maintain professional competency throughout their careers.

Iowa ARNP License Renewal

Iowa combines RN and ARNP license renewals into a single process that occurs every three years, 30 days prior to the 15th of the licensee’s birth month. This synchronized renewal system simplifies the process for advanced practice nurses.

Renewal Requirements and Fees:

  • RN License Renewal: $99
  • ARNP License Renewal: $81 (or $162 for both CNM and WHNP designations)
  • Continuing Education: 36 hours from board-approved programs
  • Online Renewal: Completed through IBON Online Services

ARNPs holding current CNM certification (and WHNP certification, if applicable) are deemed to be in compliance with Iowa’s continuing education requirement, as national certification maintenance typically exceeds state requirements.

AMCB Certification Maintenance

The American Midwifery Certification Board requires CNMs to participate in their Certification Maintenance Program to maintain national certification. Practitioners can choose between two maintenance pathways:

Option 1: Continuing Education Pathway

  • Complete at least 3 AMCB Certificate Maintenance Modules during each five-year certification cycle
  • Complete at least 20 contact hours of approved continuing education units
  • Pay annual maintenance fees
  • Submit documentation of practice hours

Option 2: Re-examination Pathway

  • Retake the AMCB Certification Examination every five years
  • Pay the $500 examination fee in lieu of annual fees
  • Meet continuing practice requirements

Additional Certification Maintenance (WHNP)

Nurse-midwives who also hold Women’s Health Nurse Practitioner certification must comply with the National Certification Corporation’s continuing competency assessment requirements, which include:

  • Continuing competency assessment at the beginning of each three-year maintenance cycle
  • A specific number of continuing education credit hours based on assessment results
  • Specialty-focused education in women’s health topics


Salaries for Certified Nurse-Midwives in Iowa

Certified nurse-midwives in Iowa enjoy competitive compensation that reflects their advanced education, specialized expertise, and the growing demand for their services throughout the state. Salary ranges vary based on practice setting, experience level, geographic location, and additional certifications held.

CNM Salary Data for Iowa (2023)

PercentileAnnual SalaryHourly Wage
10th percentile$61,130$29.39
25th percentile$85,960$41.33
50th percentile (Median)$104,420$50.20
75th percentile$128,200$61.63
90th percentile$161,590$77.69

Factors Influencing Salary Potential

Practice Setting Impact:

  • Academic Medical Centers: Typically offer higher base salaries with comprehensive benefits
  • Private Practice: Potential for higher earnings through partnership opportunities
  • Birth Centers: May offer competitive salaries with more flexible scheduling
  • Rural Practice: Often includes loan forgiveness programs and recruitment incentives
  • Hospital Employment: Provides stable income with standard healthcare benefits

Additional Factors:

  • Dual Certification: CNMs with WHNP certification often command higher salaries
  • Experience Level: Significant salary increases typically occur with 3-5 years of experience
  • Geographic Location: Urban centers may offer higher base salaries, while rural areas provide incentive packages
  • Call Requirements: Positions with extensive call schedules typically offer higher compensation

Growing Career Opportunities and Market Demand

Iowa’s healthcare landscape presents exceptional opportunities for certified nurse-midwives, driven by several converging factors that create strong demand for midwifery services across the state.

Healthcare Provider Shortage Solutions:

A study conducted by the Iowa Advanced Practice Nurse Tracking System of the University of Iowa documented a remarkable 215% increase in primary care advanced practice nurses (including certified nurse-midwives) between 1999 and 2014, while the number of physicians decreased by 10% during the same period. This trend reflects the state’s strategic reliance on advanced practice nurses to address challenges in healthcare access.

Iowa faces significant physician shortages in rural areas, with 62% of the state’s counties designated as federally underserved areas due to a shortage of physicians. The shortage is particularly acute in obstetrics, creating substantial opportunities for certified nurse-midwives to fill critical gaps in maternal healthcare delivery.

Diverse Practice Opportunities:

Nurse-midwives in Iowa find employment opportunities across a wide range of healthcare settings:

  • Academic Medical Centers: University of Iowa Hospitals & Clinics
  • Regional Medical Centers: Covenant Medical Center (Waterloo), Mercy Medical Center
  • Women’s Health Clinics: Iowa Clinic Women’s Center (Des Moines), Waverly Health Center Women’s Clinic
  • Specialty Practices: Edgerton Women’s Health Center (Davenport), Unity Point Clinic Women’s Center (Fort Dodge)
  • Community Health Centers: Federally Qualified Health Centers throughout Iowa
  • Independent Practice: Serenity Women’s Clinic (Knoxville), private midwifery practices

(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.)


Professional Resources and Support Networks

Iowa’s nurse-midwifery community benefits from strong professional organizations and support networks that provide continuing education, advocacy, and career development opportunities. These organizations play crucial roles in advancing the profession and supporting practitioners throughout their careers.

Professional Organizations:

Continuing Education and Professional Development:

  • Annual Iowa Nurses Association conventions and conferences
  • Midwifery-specific workshops and seminars
  • Online continuing education through professional organizations
  • University of Iowa continuing education programs
  • Interstate collaboration with neighboring state organizations

Frequently Asked Questions

How long does it take to become a nurse midwife in Iowa?

The pathway typically takes 3-5 years after earning your RN license. This includes completing a bachelor’s degree (if not already obtained), followed by a master’s degree in nurse-midwifery (2-3 years), and then obtaining national certification and state licensure. Iowa’s program specifically takes 5 semesters (approximately 2.5 years) for the post-baccalaureate certificate, while online programs may offer more flexible timelines.

Can nurse midwives practice independently in Iowa?

Yes, Iowa allows certified nurse-midwives to practice independently without requiring a collaborative practice agreement with a physician. They have full prescriptive authority, including for controlled substances after obtaining appropriate DEA certification, and can establish independent midwifery practices.

What is the job outlook for nurse midwives in Iowa?

The job outlook is excellent, with a 215% increase in advanced practice nurses (including CNMs) between 1999 and 2014. Iowa’s rural physician shortage, with 62% of counties designated as physician shortage areas, and growing recognition of midwifery care create strong demand for qualified nurse-midwives throughout the state.

Does Iowa have any nurse-midwifery schools?

Yes, the University of Iowa operates the state’s only nurse-midwifery education program, offering a post-baccalaureate certificate program. However, Iowa residents can also pursue accredited online and hybrid programs from institutions nationwide, with many programs providing clinical placement assistance in Iowa.

What is the average salary for nurse midwives in Iowa?

According to 2023 BLS data, the median annual salary for nurse-midwives in Iowa is $104,420, with the 90th percentile earning $161,590 annually. Salaries vary based on experience, location, practice setting, and additional certifications, such as those in Women’s Health Nurse Practitioner.

What are the admission requirements for nurse-midwifery programs?

Requirements typically include a bachelor’s degree, current RN licensure, a minimum GPA (usually 3.0 or higher), prerequisite coursework in statistics and physical assessment, professional references, a personal statement, and 1-2 years of nursing experience. Iowa’s program specifically requires a personal interview and a $50 application fee, with applications due July 1st annually.

Can I complete nurse-midwifery education online while living in Iowa?

Yes, many Iowa residents successfully complete accredited online and hybrid nurse-midwifery programs from national institutions. These programs typically provide clinical placement assistance and maintain the same accreditation standards as on-campus programs, making them excellent options for working nurses in Iowa.

What clinical experiences are required for nurse-midwifery programs?

All ACME-accredited programs require a minimum of 1,000 clinical hours across diverse settings, including hospitals, birth centers, private practices, and community health centers. Iowa students have access to clinical sites throughout the state, including the University of Iowa Hospitals, Covenant Medical Center, and various community-based practices.

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