According to the Minnesota Affiliate of the American College of Nurse Midwives (ACNM), Minnesota’s 262 certified nurse-midwives oversaw 7,500 births in the state in 2013 alone. Licensed as advanced practice registered nurses (APRN) through the Minnesota Board of Nursing, CNMs have advanced training in physiology, pharmacology and health assessment, allowing them to serve in a primary care provider role, in addition to providing well-woman care and the antepartum, intrapartum, and postpartum care they are best known for.
As an independent practice state, Minnesota’s certified nurse-midwives enjoy the freedom to practice unencumbered by restrictive physician collaborative agreements. Though most certified nurse-midwives work in the obstetrics departments of hospitals, Minnesota’s progressive practice laws, which respect and support the autonomy of CNMs, have led many to establish independent women’s health and obstetric clinics throughout the state.
Steps to Becoming a Nurse Midwife in Minnesota
Certified nurse-midwives are licensed as advanced practice registered nurses (APRN) through the Minnesota Board of Nursing after earning national certification through the American Midwifery Certification Board (AMCB).
Registered nurses with an unrestricted license in good standing issued through the Minnesota Board of Nursing can pursue APRN licensure as a certified nurse-midwife by following the steps in this guide:
Step 1. Earn a Master’s Degree in Nurse-Midwifery
To qualify for the Certified Nurse-Midwife designation through the American Midwifery Certification Board so as to be eligible for advanced practice registered nurse licensure through the Minnesota Board of Nursing, candidates must first complete a master’s degree program in nurse-midwifery accredited through the Accreditation Commission for Midwifery Education (ACME).
Bachelor’s prepared RNs are able to enroll in conventional master’s programs as a means of preparing to become a certified nurse-midwife. RNs who hold an associate’s degree in nursing must enroll in an ACME-accredited RN-to-MSN program with a focus in midwifery to obtain both a BSN and MSN in one accelerated program.
Admissions requirements to nurse midwifery graduate programs are often strict. The factors school admissions offices typically consider are:
- Admission essay
- GRE score
- Letters of recommendation, including those from past advisors
- Undergraduate GPA
Nurse-midwife graduate programs prepare students through both didactic coursework and clinical sequences, which can take place concurrently. Didactic coursework usually consists of between 40-60 credits and covers such topics as:
- Ambulatory Care of Women
- Family Crisis Care
- Midwifery Care During Labor
- Intrapartum Care
- Biostatistics for Health Care Providers
- Women’s Reproductive Healthcare
- Pathophysiology & Physiology
- Newborn Care
- Midwifery Care During Pregnancy
Nurse-midwife graduate students should expect to participate in between 700 and 1,000 hours of clinical work.
Campus locations of schools that offer qualifying graduate programs can be found in Minneapolis and Saint Paul:
- Minneapolis: Doctor of Nursing Practice (DNP) with a Specialization in Nurse-Midwifery
- Saint Paul: Master of Science (MS) in Nurse Midwifery
Working RNs often prefer the flexibility and convenience of ACME-accredited online programs.
Master’s programs that offer dual-specialty tracks have become popular among graduate students interested in a broader scope of practice that includes women’s health. Graduate programs with a dual focus in Nurse-Midwifery/Women’s Health Nurse Practitioner (NM/WHNP) allow graduates to become dually certified in both roles if they choose.
Step 2. Pass the National Nurse-Midwife Certification Examination
Upon completing a graduate program in nurse-midwifery, candidates would then apply for and take the Certified Nurse Midwife (CNM) Exam, offered by the American Midwifery Certification Board (AMCB). The exam application must be completed and mailed to the following address:
849 International Drive, Suite 120
Linthicum, MD 21090
The CNM exam is offered at AMP testing centers within H&R Block offices in the following Minnesota cities:
To pass the CNM exam, RNs must meet the pass/fail standard set by the AMCB. The four-hour exam consists of 175 multiple-choice questions and covers the following areas of nurse-midwifery:
- 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
To prepare for the exams, RNs may access the Candidate Handbook on the AMCB website.
RNs who pass the exam will receive their Certificate in Nurse Midwifery (CNM) from the AMCB.
RNs who have completed dual focus Nurse-Midwifery/Women’s Health Nurse Practitioner (NM/WHNP) programs may additionally elect to take the Women’s Health Care Nurse Practitioner (WHNP) Exam to achieve their WHNP-Board Certification. The 150-question exam, administered by the National Certification Corporation (NCC), is divided into the following components:
- 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
The NCC offers a WHNP Candidate Guide to help candidates prepare for the exam, which is offered at the aforementioned AMP testing center locations. The NCC will notify examinees who have successfully passed the exam and earned their WHNP-Board Certification.
Step 3. Apply for APRN Licensure as a Certified Nurse-Midwife with the Minnesota Board of Nursing
After being notified of passing scores on the Certified Nurse Midwife Exam, applicants would then apply for advanced practice certified nurse-midwife licensure through the Minnesota Board of Nursing.
Candidates must complete the Certified Nurse Midwife application and send it along with a $105.00 application fee in the form of a cashier’s check or money order to:
Minnesota Board of Nursing
2829 University Avenue SE #200
Minneapolis, MN 55414
Graduates of dual focus Nurse-Midwife/Women’s Health Nurse Practitioner programs who have successfully passed the appropriate certifying exam may also choose to be recognized as women’s health nurse practitioners in the state after completing a minimum of 2,080 hours of postgraduate clinical work, in accordance with Minnesota Statute 148.211, Subd. 1c. Upon completion, applicants may submit the APRN Certified Nurse Specialist licensure application, along with an additional $105.00 application fee, to the Minnesota Board of Nursing at the aforementioned address.
Step 4. Explore Career Options Available to Nurse-Midwives and Maintain Credentials
According to the Minnesota Affiliate of the American College of Nurse Midwives (ACNM) there are 123 independent nurse-midwifery clinics and birth centers and hospitals that staff CNMs located throughout Minnesota. Some of the top employers of CNMs in the state include:
- Abbott Northwestern Hospital in Minneapolis
- Buffalo Hospital in Buffalo
- Fairview Southdale Hospital in Edina
- Maple Grove Hospital in St Paul
- Minnesota Birth Center in Minneapolis
- Minnesota Birth Center in St Paul
- Regions Hospital in St Paul
- Francis Regional Medical Center in Shakopee
- The Birthplace at Fairview in Minneapolis
- The Mother Baby Center in Minneapolis
- United Hospital in St Paul
- Unity Hospital in Fridley,
- Woodwinds Health Campus, HealthEast Care System in Woodbury
A December 2015 survey of nurse-midwife job vacancy announcements in Minnesota revealed some of the opportunities available to CNMs in the state (shown for illustrative purposes only and does not constitute a job offer)
- WHCNP/Certified Nurse Midwife– GYN Outpatient at Advanced Practice Solutions, LLC in Saint Paul
- On-Call Nurse Midwife at West Side Community Health Services in Saint Paul
- Nurse Midwife at Minnesota Women’s Care in Maplewood MN
- Certified Nurse Midwife at North Metro Midwives in Plymouth
- Certified Nurse Midwife – Lactation Consultant at Fairview Health Services in Minneapolis
- Certified Nurse Midwife at Allina Health System in Fridley
Renewing APRN Licensure with the Minnesota Board of Nursing
Minnesota APRNs are licensed to practice for two years following the issue date of their license. At that point, nurses must renew their license online through the Minnesota Board of Nursing website. The Board requires an $85 renewal fee.
APRN licensees must continue to meet the requirements for RN license maintenance by completing 24 hours of Continuing Education (CE) during each renewal period. While the Minnesota Board of Nursing does not require nurses to submit CE documentation voluntarily, RNs may be audited by the Board and required to present documents verifying their CE hours. Details regarding the Board’s CE requirements may be found on the Board website.
Maintaining the CNM Credential through the American Midwifery Certification Board (AMCB)
Maintaining CNM certification through the American Midwifery Certification Board requires certificate holders to satisfy one of the following requirements during each five-year certification cycle:
- Three AMCB Certificate Maintenance Modules and 20 AMCB-approved contact hours of CE
- Re-take the AMCB Certification Examination
Those who choose to complete the modules and contact hours must submit annual fees to the AMCB. Those choose to take the certification examination must pay a one-time fee of $500 and will not be required to pay the annual fees.
Maintaining the WHNP-BC Credential through the National Certification Corporation
To maintain certification as a WHNP, certificate holders must take a continuing competency assessment administered by the National Certification Corporation (NCC) once during each three-year maintenance cycle. WHNP certificate holders will also be mailed an education plan with details on CE requirements.
Salaries for Certified Nurse-Midwives in Minnesota
Nurse-midwives in Minnesota earned average salaries in 2014 that were comparable to the national averages. According to the United States Department of Labor, Minnesota’s certified nurse-midwives earned an average annual salary of $94,690 that year. This was equivalent to approximately $45.52 per hour.
Those with minimal experience in the profession entered the field that same year with an annual salary of between $55,640 and $69,800, or between about $26.75 and $33.56 per hour. Average salaries rose to $97,420 ($46.84/hour) by mid-career, while highly experienced nurse-midwives in Minnesota earned upwards of $133,850, annually ($64.35/hour).
Shortage of Physicians in Minnesota Causes High Demand for Advanced-Practice Nurse-Midwives
In 2014, the University of Minnesota received $10 million to enhance their Doctor of Nursing Practice program. This came in the wake of a drastic shortage of physicians across the state. The goal was to equip and employ more Advanced Practice Nurses (APN), including nurse-midwives, to fill the deficit.
A new bill allowing nurse-midwives to practice independently took effect in January 2015, and promises a surge in employment opportunities throughout Minnesota. In fact, in light of this new provision, the University of Minnesota Health Nurse Practitioners Clinic opened its doors in Minneapolis, becoming the state’s first nurse practitioner led facility.
More clinics like this are projected to open by 2020 and job growth for nurse midwives in Minnesota is expected to rise as a result.
Minnesota’s Capital City and Surrounding Areas Expecting Increases in CNM Salaries
Nurse-midwives in the Minneapolis – St, Paul – Bloomington metropolitan area earned an annual median salary of $92,190 ($44.32/hour), according to a report published by the United States Department of Labor in 2014. Those in the region who earned salaries within the 90th percentile enjoyed annual earnings of $132,980 ($63.93/hour), and, since the opening of the U. of M. Health Nurse Practitioners Clinic, that number is set to increase by the year 2020.
A detailed analysis of region-specific nurse-midwife salary information is found below (United States Department of Labor, 2014):