According to a March 2015 article by the Bangor Daily News, nurse-midwives in Maine enjoy productive, beneficial relationships with gynecologists and obstetricians, providing patients with options and a different perspective on managing general health and pregnancy. In fact, OB/GYNs report that nurse-midwives enhance their practice and fill an important role in maternity care.
Nurse-midwives are advanced practice registered nurses. Their broad professional scope allows them to provide antepartum, intrapartum and postpartum care, as well as well-woman care throughout a woman’s lifespan, from adolescence through menopause and beyond.
Maine is an independent practice state, meaning nurse-midwives here enjoy the ability to practice autonomously without the need to enter into a collaborative practice agreement with a physician.
According to statistics published by the American College of Nurse-Midwives, Maine is a leader in midwifery care. Maine’s certified nurse-midwives attended more than 2,200 births in 2013, representing more than 25 percent of all deliveries in the state that year.
The Maine State Board of Nursing recognizes the certified nurse-midwife as educationally and clinically prepared to provide the following healthcare services:
- Primary healthcare and case management of women during pregnancy, childbirth, and the postpartum period
- Primary health care of the newborn up to age one
- Gynecological care, family planning services, and treatment of sexually transmitted diseases
Steps to Becoming a Nurse-Midwife in Maine
RNs in Maine with their sights set on becoming nurse-midwives must meet the requirements for Advanced Practice Registered Nurse (APRN) licensure through the Maine State Board of Nursing by following these steps:
|Earn a Qualifying Graduate Degree in Nurse-Midwifery|
|Take and Pass the National Certification Examinations|
|Apply for a Nurse-Midwife License through the Maine State Board of Nursing|
|Explore Career Options and Maintain Credentials|
Step 1. Earn a Qualifying Graduate Degree in Nurse-Midwifery
To become a nurse-midwife in Maine, RNs must complete a master’s degree in nurse-midwifery accredited by the Accreditation Commission for Midwifery Education (ACME).
ACME accredits a number of master’s degrees and post-graduate certificates in nurse-midwifery designed to accommodate RNs with different educational backgrounds:
- Master of Science in Nursing (MSN): The Master of Science in Nursing (MSN) with a focus on nurse-midwifery or the Master of Science (MS) in Nurse Midwifery is the standard educational route for RNs who possess a Bachelor of Science in Nursing (BSN).
- RN-to-MSN Degrees: RNs who possess an associate’s degree in nursing may pursue an RN-to-MSN degree in nurse-midwifery. These programs, which encompass both a bachelor’s and master’s degree in nursing, take into account an RN’s previous nursing education, thereby accelerating the pace of the program and allowing students to earn their BSN and MSN in a shorter period of time.
- Post-Graduate Certification Programs: Post-graduate certificate programs in nurse-midwifery appeal to currently licensed APRNs who want to add the nurse-midwifery specialty to their license or master’s-prepared RNs seeking initial APRN licensure as a nurse-midwife.
- Dual-Specialization Degree Programs: Many institutions have begun offering master’s degrees with a dual specialization in nurse-midwifery/women’s health. These dual specialization degree programs allow students to earn an APRN license in Maine with a dual specialization in both nurse-midwifery and women’s health.
Many of today’s ACME-accredited master’s degree programs in nurse-midwifery offer students the option of studying on a part-time basis or completing part or all of their didactic coursework through online study. Online programs may be particularly beneficial to RNs in Maine, as there are currently no ACME-accredited nurse-midwifery programs here.
Master’s degrees in nurse-midwifery focus on healthcare for women of all ages, including antepartum, intrapartum and postpartum care, newborn care, and gynecological care. Graduates of these programs are eligible for national certification as a Certified Nurse-Midwife (CNM) and initial APRN licensure in Maine.
Usually consisting of about two years of full-time study (or three years of part-time study), master’s degrees in nurse-midwifery consist of a didactic component and a clinical component, with the didactic component including study in the following areas:
- Midwifery perspectives
- Advanced health assessment for advanced practice nurses
- Advanced pharmacology for advanced practice nurses
- Healthcare for women and primary care
- Global perspectives of health
- AnteE care
- Intrapartum and postpartum care
- Newborn care
- Reproductive physiology
- Advanced pathophysiology
- Professional issues for nurse-midwives
A nurse-midwifery master’s degree may include up to 1,000 hours of clinical practice in a variety of settings such as hospitals, women’s clinics, rural health clinics, and OB/GYN practices. In Maine, students may complete part of their clinical practicum in settings such as:
- Southern Maine Health Care, Biddeford
- All About Women, Portland
- Blue Hill Women’s Healthcare, Blue Hill
- Mid Coast Hospital, Brunswick
- Down East Community Hospital, Machias
Institutions offering online master’s degrees in nurse-midwifery establish partnerships with clinical sites throughout the country, which allow students to satisfy their clinical requirements close to home.
Candidates for master’s degrees in nurse-midwifery typically possess a Bachelor of Science in Nursing (BSN), and must have a current and valid RN license and. Additionally, program candidates are often expected to meet the following requirements:
- Minimum undergraduate GPA
- Minimum GRE scores
- Professional experience/comprehensive resume
- Admissions essay
- Letters of recommendation
Step 2. Take and Pass the National Certification Examinations
After graduating from a master’s degree in nurse-midwifery, RNs in Maine must take and pass the American Midwifery Certification Board examination to become a certified nurse-midwife (CNM) and qualify for state licensure as a nurse-midwife.
Graduates who have completed a master’s degree in nurse-midwifery/women’s health also have the option of taking the Women’s Health Care Nurse Practitioner (WHNP) examination through the National Certification Corporation to earn the WHNP credential.
Both examinations consist of about 175 multiple-choice questions. Candidates must apply to take the exams and receive approval before scheduling their exams through an Applied Measurement Professionals (AMP) testing center.
In Maine, candidates may take the CNM and WHNP (if applicable) examinations at the AMP testing centers located in Holden and Portland.
Step 3. Apply for a Nurse-Midwife License through the Maine State Board of Nursing
To become a nurse-midwife in Maine, RNs (with a valid and unencumbered RN license in Maine) must complete an Application for Licensure as a Nurse-Midwife and submit it to the Board, along with the following:
- Application fee of $100
- Recent passport-style photograph (2×2)
- Verification of certification as a CNM
- Final nursing transcript with degree from advanced practice nursing program
Candidates who want to add the WHNP specialty to their APRN license must complete an Application for an Additional Specialty to an Existing Nurse Practitioner or Clinical Nurse Specialist License.
Candidates desiring prescriptive authority in Maine may apply for their DEA number after they receive their license. CNMs in Maine may prescribe schedules II-V. It is the choice of the CNM whether or not to prescribe narcotics as part of their nurse-midwifery practice.
Step 4. Explore Career Options and Maintain Credentials
Nurse-midwives must complete all renewal requirements necessary to maintain their RN license, APRN license, and national certification(s) so as to continue to practice nurse-midwifery in Maine.
APRN Renewal Requirements
CNMs in Maine must ensure they maintain their RN and APRN licenses by completing at least 75 continuing education hours during every two-year renewal cycle and applying for license renewal through the Maine Regulatory Licensing and Permitting online portal.
CNM Renewal Requirements
The American Midwifery Certification Board has a Certification Maintenance Program that allows CNMs to meet continuing education requirements by completing one of the following:
- Option 1: Complete at least 3 AMCB Certificate Maintenance Modules during each five-year certification cycle and at least 20 contact hours of approved continuing education units; pay annual fees
- Option 2: Retake the AMCB Certification Examination and pay the $500 examination fee in lieu of annual fees
WHNP Renewal Requirements
WHNPs must take a continuing competency assessment through the National Certification Corporation at the beginning of each three-year maintenance cycle and complete a specific number of continuing education credits hours based on the results of the assessment.
Resources for Nurse-Midwives in Maine
Recent job postings (sourced in December 2015) for certified nurse-midwives in Maine, although for illustrative purposes only, provide job seekers with a great deal of insight on the many opportunities available in nurse-midwifery:
- Certified Nurse Midwife, MDI Hospital Organization, women’s health center, Bar Harbor
- Certified Nurse-Midwife, Eastern Maine Healthcare Systems, Bangor
- Certified Nurse-Midwife, Lincoln County Healthcare, Damariscotta
Just a few of the settings where Maine nurse-midwives may find exciting and fulfilling jobs in nurse-midwifery include:
- Women to Women’s Healthcare Center, Yarmouth
- Maine Medical Partners, Women’s Health, Portland
- Coastal Women’s Healthcare, Scarborough
- Calais Regional Hospital, Calais
Salaries for Certified Nurse-Midwives in Maine
Certified nurse midwives are exceptionally well paid in Maine. In fact, CNMs with salaries that fell within the bottom 10% (typically those new to the field) earned an average of $80,280 as of 2014 according to the Maine Center for Workforce Research and Information. This value is more than $14,000 higher than the national average for nurse midwives whose salaries fell within this percentile.
The median salary among nurse midwives in Maine was $98,290 in 2014, while nurse midwives with salaries that fell within the top 10% earned an average of $119,730 that year.
Job Growth Trends and Projections for Maine’s Certified Nurse-Midwives
According to the Maine Association of American College of Nurse Midwives, approximately 75 certified nurse midwives were licensed to practice in Maine as of 2015, working collaboratively with doctors, therapists, or public health agencies to make referrals and consultations as needed. However, the number of jobs for certified nurse-midwives in Maine is expected to increase by 13.3% during the ten-year period leading up to 2022.
Maine’s nurse midwives serve as primary care providers who make substantial contributions to the health of women in their care, enjoying full autonomy and the authority to prescribe medication and order imaging or lab tests as needed. Certified nurse-midwives in Maine provide care in birthing centers, independent women’s clinics, in clients’ homes and obstetric units, and have delivery privileges in 22 of the state’s hospitals.
The services that certified nurse-midwives provide are considered a mandatory benefit under Medicaid. In Maine, this means that pregnant women with incomes up to 214% of the federal poverty level are eligible to obtain Medicaid coverage for their pregnancy care according to the American College of Nurse-Midwives.
How Certified Nurse-Midwife Salaries Differ by Location in Maine
Shown below are salaries for certified nurse-midwives throughout Maine as of 2014 (Maine Center for Workforce Research and Information):
- 90th Percentile: $120,670
- 50th Percentile: $97,283
- 10th Percentile: $83,684
- 90th Percentile: $108,306
- 50th Percentile: $86,917
- 10th Percentile: $66,118
- 90th Percentile: $119,827
- 50th Percentile: $98,956
- 10th Percentile: $83,763
- 90th Percentile: $121,920
- 50th Percentile: $99,110
- 10th Percentile: $83,890
Southwest Balance of State
- 90th Percentile: $117,700
- 50th Percentile: $98,770
- • 10th Percentile: $83,290