As Advanced Practice Nurse Practitioners (APRNs), Michigan’s certified nurse midwives often serve as a woman’s primary healthcare provider and gynecologist, in addition to providing gentle whole-person care to mothers and neonates throughout the birthing process and perinatal period. While most of Michigan’s certified nurse midwives are found working in hospital obstetric wards, many also work at freestanding birth centers and women’s clinics. Some even specialize in attending childbirth in the homes of the women in their care.
According to the Michigan Affiliate of the American College of Nurse Midwives (ACNM), there were over 200 certified nurse midwives (CNMs) licensed to practice in the state as of 2014. This number is expected to rise in the coming years, as more women turn to CNMs for everything from general well-woman care to facilitating home birth. In fact, the Centers for Disease Control and Prevention (CDC) reported that the percentage of out-of-hospital births in Michigan increased from 0.74% in 2008 to 1.07% in 2012. The growing demand for less invasive nurse midwifery care during childbirth and beyond is creating new employment opportunities for CNMs in conventional clinical settings, as well as a growing number of opportunities for those interested in independent practice.
Steps to Becoming a Nurse Midwife in Michigan
RNs who wish to become certified nurse midwives in Michigan must meet the qualifications for specialty certification through the American Midwifery Certification Board and advanced practice licensure through the Michigan Board of Nursing. The steps in this guide offer detailed information on how to become a certified nurse midwife in Michigan:
Step 1. Earn a Qualifying Master’s Degree or Higher in Nurse Midwifery
Bachelor’s prepared RNs who wish to specialize in nurse midwifery may apply to Master of Science in Nursing (MSN) programs with a focus in nurse midwifery or a dual focus in nurse midwifery and women’s health. RNs who only hold an associate’s degree must apply to an RN-to-MSN program with a focus in midwifery, as this path will allow them to obtain both their bachelor’s of science in nursing and their MSN. In all cases, qualifying programs must have received accreditation from the Accreditation Commission for Midwifery Education (ACME).
When reviewing applications, admissions offices typically review factors such as:
- GRE score
- Undergraduate GPA
- Admission essay
- Letters of recommendation
A growing trend among aspiring nurse midwives is to pursue graduate programs that offer a duel specialization in nurse midwifery and women’s health. Graduates of these programs may go on to earn women’s health nurse practitioner (WHNP-BC) certification through the National Certification Corporation in addition to their certified nurse midwife (CNM) credential through the American Midwifery Certification Board. Electing to pursue both certifications would also allow them to be recognized in both roles through the Michigan Board of Nursing.
In Michigan, RNs have the option to pursue the following degrees on site:
- Master of Science in Nursing with a Nurse-Midwife (NMW) Specialty (Detroit)
- Master’s in Nurse Midwifery (Ann Arbor)
RNs often choose to pursue graduate degrees through flexible online programs designed to accommodate the schedules of working professionals. This is particularly true of nurse-midwifery programs as there are relatively few available at campus locations. Examples of accredited online nurse midwife programs include:
- Registered Nurse to Master of Science (RN-to-MSN) with a Specialization in Nurse Midwifery
- Master of Science in Nurse Midwifery
- Master of Science in Nursing with a Women’s Health CNS/Nurse Midwifery Track
- Master of Science in Nursing Nurse-Midwifery/Women’s Health Nurse Practitioner (NM/WHNP)
Nurse midwife programs consist of a mix between classroom and clinical coursework. Classroom-based coursework typically consists of between 40-60 credits and covers topics including, but not limited to:
- Newborn Care
- Midwifery Care During Pregnancy
- Family Crisis Care
- Midwifery Care During Labor
- Biostatistics for Health Care Providers
- Women’s Reproductive Healthcare
- Physiology & Pathophysiology
- Ambulatory Care of Women
The clinical portion of these master’s programs are designed to give RNs hands-on experience and exposure to patients in a real-world setting. Clinicals typically consist of between 700 and 1,000 hours of work at a nearby hospital or birth clinic. Online programs partner with local hospitals in Michigan to serve as clinical training sites to ensure graduate students have convenient access to facilities that support clinical training in their area.
Step 2. Pass the National Nurse-Midwifery Certification Examination
Upon graduating from master’s program in nurse-midwifery, CNM candidates may apply to take the Certified Nurse Midwife exam through the American Midwifery Certification Board (AMCB). The completed application form must be sent to the following address:
849 International Drive, Suite 120
Linthicum, MD 21090
The CNM exam consists of 175 multiple-choice questions that cover the following areas of nurse midwifery practice:
- Antepartum – 19-26 percent
- Intrapartum – 17-26 percent
- Postpartum – 15-18 percent
- Gynecology – 15-18 percent
- Women’s health and primary care – 8-16 percent
- Newborn – 7-16 percent
RNs in Michigan may take the CNM exam at AMP testing centers, which are located in H&R Block offices in the following cities:
CNM exam candidates are encouraged to use AMCB’s online Candidate Handbook to prepare for the exam.
The AMCB uses a pass/fail system to determine candidate eligibility for certification. RNs who pass the exam receive a Certificate in Nurse Midwifery (CNM) from the AMCB directly.
RNs who wish to practice as both a CNM and Women’s Health Care Nurse Practitioner (WHNP) must also take the WHNP exam available through the National Certification Corporation (NCC).
The 150-question exam is divided into the following portions:
- Pharmacology – 5-10 percent
- Primary Care – 10-15 percent
- Diagnostic testing and physical assessment – 10-15 percent
- Obstetrics – 25-30 percent
- Gynecology – 35-40 percent
To prepare for the exam, WHNP candidates are encouraged to use the WHNP Candidate Guide on the NCC website. The exam is offered at the same aforementioned Michigan AMP testing centers.
Successful completion of the exam will lead to WHNP certification from the NCC.
Step 3. Apply for Advanced Practice Licensure with Nurse Midwife Recognition in Michigan
The Michigan Department of Licensing and Regulatory Affairs (LARA) provides a nurse specialty certification packet on its website that includes both application instructions and the application form necessary to obtain a Nurse Midwife Specialist Certification in the state.
Nurse midwife specialist certification candidates must complete the first section of the application themselves. The second section must be completed by the American Midwifery Certification Board (AMCB) and sent to the Michigan Board of Nursing.
Those choosing to obtain certification to practice as a Women’s Health Nurse Practitioner in addition to their Nurse Midwife Specialist Certification must complete section one of the Nurse Practitioner Specialty Certification form on the LARA website. The National Certification Corporation (NCC) must complete section two of the form and forward it to the Michigan Board of Nursing to confirm the candidate’s certification.
Applicants must submit an application fee of $38 or $52 in the form of a check or money order made payable to the State of Michigan, depending on the date of their application. The completed form and fee should be sent to the following address:
Michigan Department of Licensing and Regulatory Affairs (LARA)
Board of Nursing
PO Box 30193
Lansing, MI 49809
Step 4. Explore Career Options Available to Certified Nurse Midwives in Michigan
Upon receiving a nurse midwife specialty certification from the Michigan Board of Nursing, CNMs in the state may begin exploring career opportunities in one of Michigan’s many hospitals and birth clinics. Examples of potential CNM employers in Michigan include:
- Borgess Women’s Health in locations throughout Michigan
- Bronson Methodist Hospital in Kalamazoo
- Covenant Medical Center Harrison in Saginaw
- Greenhouse Birth Center in Okemos
- Henry Ford Hospital in Detroit
- Henry Ford West Bloomfield Hospital in West Bloomfield Township
- Holland Hospital in Holland
- Huron Valley-Sinai Hospital in Charter Township
- Hutzel Women’s Hospital in Detroit
- Karmanos Center for Natural Birth at Beaumont Hospital in Royal Oak
- Midwifery Matters in Greenville
- North Ottawa Community Health System in Grand Haven
- Providence Park Hospital in Southfield
- Simply Born in Grand Rapids
- Joseph Mercy Ann Arbor Hospital in Ypslanti
- Mary Mercy Hospital in Livonia
- UP Health System in Marquette
Job listings help illustrate the range of nurse midwife careers available in Michigan (Not meant to imply the assurance or availability of jobs. These listings were taken from a survey of job vacancy announcements in December 2015 and are shown as illustrative examples only):
- Active Nurse Midwife at U.S. Army Healthcare Team in Detroit
- Certified Nurse Midwife at Botsford Hospital in Royal Oak
- Certified Nurse Midwife-OB/ED Triage at Hutzel Hospital in Detroit
- Certified Nurse Midwife at Women’s Excellence in Lake Orion
- Nurse Midwife – Certified at Botsford Hospital in Dearborn
- Nurse Midwife – Certified at Oakwood Hospital in Dearborn
Salaries for Certified Nurse-Midwives in Michigan
In 2014, the United States Department of Labor reported that the average annual salary for nurse-midwives in Michigan was $95,560, the approximate average hourly equivalent of $45.94.
Certified nurse-midwives in Michigan who were just entering the field in 2014 earned annual salaries between $75,890 and $86,040, on average (between $36.49 and $41.36 hourly). Nurse-midwives practicing at the mid-career level reported average earnings of $97,460 annually ($46.85 per hour). Michigan’s most experienced nurse-midwives earned an average of $119,420 that same year ($57.41 per hour).
New University of Michigan Health Center Promises Job Growth for Certified Nurse-Midwives
The University of Michigan’s Von Voigtlander Women’s Hospital Nurse-Midwifery Service is known statewide for its exceptional level of care and for the growing number of patients seeking the services of certified nurse-midwives to assist in their labor and delivery.
The clinic had just nine certified nurse-midwives on staff as of 2015, but the University has plans to expand the practice, with a stunning $46 million project that is being built just west of Ann Arbor. This new facility promises to usher in many employment opportunities for certified nurse-midwives entering the field in this area.
Detroit is Home to the First Nurse-Midwifery Practice in Michigan, which Still Boasts Competitive Salaries
The first certified nurse-midwifery clinic in the state of Michigan began welcoming patients in 1980. It was located at Hutzel Hospital in Detroit. Since its groundbreaking opening, the practice of nurse-midwifery has thrived throughout Michigan. It is no surprise, then, that about 42% of Michigan’s licensed certified nurse-midwives are employed in the Detroit-Warren-Livonia metropolitan area. The region’s median annual salary for CNMs in 2014 was $95,200, or approximately $45.77 per hour.
More detailed salary information for certified nurse-midwives in Michigan by region can be found in the table below (U.S. Department of Labor, 2014):