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Online Midwifery Schools Offering CNM Masters Degrees in Montana

Expectant mothers are increasingly recognizing the value of holistic, whole-person care throughout the pregnancy and childbirth process. As a result, the time-tested practice of nurse-midwifery is increasing in popularity in Montana.

The U.S. Centers for Disease Control and Prevention (CDC) reports that 3.94% of all Montana births took place out of hospitals in 2012. That figure not only represented a significant increase since 2004, which saw 2.27% of Montana births take place outside of hospitals, it was also the second highest percentage of any U.S. state in that year. Although most certified nurse-midwives work in the obstetric departments of Montana’s hospitals, virtually all births that take place outside of the hospital setting, whether in birthing centers or in the home, are facilitated by certified nurse-midwives, which clearly points to the popularity of midwife-attended births in the state.

Credentialed as certified nurse-midwives (CNM) through the American Midwifery Certification Board (AMCB) and licensed as advanced practice registered nurses (APRN) through the Montana Board of Nursing, nurse-midwives in the state work independently and have prescriptive authority without the need to maintain a collaborative agreement with a physician.

Steps to Becoming a Certified Nurse-Midwife in Montana

To gain recognition as a certified nurse-midwife in Montana, RNs with licenses in good standing must follow these steps to meet the requirements for advanced practice registered nurse (APRN) licensure through the Montana Board of Nursing:

Earn a Qualifying Master’s Degree in Nurse-Midwifery
Pass the National Nurse-Midwife Certification Examination
Apply for Advanced Practice Licensure through the Montana Board of Nursing
Begin a Career as a Certified Nurse-Midwife and Keep Credentials Current

 


 

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

The first step to becoming nationally certified as a nurse-midwife and licensed as an advanced practice registered nurse (APRN) through the Montana Board of Nursing is to earn a master’s degree or higher in nurse-midwifery from a program recognized by the Accreditation Commission for Midwifery Education (ACME).

While there are no ACME-accredited master’s programs in nurse-midwifery housed in schools located in Montana, accredited online programs provide the ideal format for working RNs interested in pursuing a graduate degree while maintaining professional commitments.

Admissions Criteria

Bachelor’s prepared RNs are qualified to apply to traditional MSN programs with a focus in nurse midwifery.

RNs who have only earned an associate’s degree in nursing must enroll in an RN-to-MSN completion program with a focus in nurse-midwifery to earn both their bachelor’s of science in nursing and MSN in nurse-midwifery.

Among the criteria reviewed by admissions offices:

  • Letters of recommendation from past program directors or supervisors
  • GRE score
  • Undergraduate GPA
  • Admission essay

Program Structure and Dual-Specialization Options

Programs offering dual specialization in nurse midwifery and women’s health are gaining in popularity, as they better prepare CNMs to provide comprehensive primary and well-woman gynecological care in addition to maternity and obstetric care. Structured as Nurse-Midwifery/Women’s Health Nurse Practitioner (NM/WHNP) master’s degrees, graduates of these programs are able to become dually certified as a nurse-midwife (CNM) and board certified women’s health nurse practitioner (WHNP-BC) if they so choose.

Nurse midwife programs consist of both didactic coursework and clinical exposure, providing students with a broad spectrum of knowledge before seeking national certification and beginning professional nurse-midwifery practice.

The didactic coursework in these programs covers the key areas of nurse midwifery:

  • Ambulatory Care of Women
  • Midwifery Care During Pregnancy
  • Physiology & Pathophysiology
  • Newborn Care
  • Nursing Research
  • Biostatistics for Health Care Providers
  • Pharmacology
  • Family Crisis Care
  • Midwifery Care During Labor
  • Women’s Reproductive Healthcare

Clinical work is designed to compliment classroom learning by providing RNs with hands-on experience. Working under the guidance of a physician or APRN at a nearby hospital or birth center, students typically accumulate between 700-1,000 hours of work experience in the clinical setting. Students that pursue a master’s in nurse-midwifery online will work closely with a program director from their school to be placed in local facilities for the clinical component of their program.

In Montana, clinical sequences take place in the following facilities:

  • Cabinet Peaks Medical Center in Libby
  • Community Medical Center in Missoula
  • Family Birth Center in Great Falls
  • Frances Mahon Deaconess Hospital in Glasgow
  • Kalispell Regional Medical Center in Kalispell
  • Livingston Memorial Hospital in Livingston
  • Marias Medical Center in Shelby
  • North Valley Hospital in Whitefish
  • Providence St. Joseph Medical Center in Polson
  • Patrick Hospital in Missoula
  • Vincent Healthcare in Billings

 


 

Step 2. Pass the National Nurse-Midwife Certification Examination

Upon earning a master’s degree in nurse-midwifery, CNM candidates may apply to take the Certified Nurse Midwife Exam, which is administered by the American Midwife Certification Board (AMCB). The completed application should be sent to the following address:

AMCB
849 International Drive, Suite 120
Linthicum, MD 21090

The Certified Nurse Midwife Exam is designed to ensure nurses are prepared for professional practice in nurse-midwifery and is required for advanced practice RN licensure through the Montana Board of Nursing.

In Montana, the Certified Nurse Midwife Exam is offered at AMP testing centers in the following cities:

  • Billings
  • Great Falls
  • Missoula

To help RNs prepare for the exam, the AMCB offers an online Candidate Handbook. The 175-question multiple-choice exam is divided into the following sections:

  • 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

The Option to Become Dual-Certified as a Women’s Health Nurse Practitioner

Candidates who have graduated from dual focus nurse-midwife/women’s health nurse practitioner programs may additionally choose to sit for the Women’s Health Care Nurse Practitioner (WHNP) Exam administered through the National Certification Corporation (NCC), to achieve their WHNP-Board Certification.

The exam, offered at the same AMP testing centers as the Certified Nurse Midwife Exam, consists of 150 multiple-choice questions covering the following topics, as detailed in the WHNP Candidate Guide:

  • 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

 


 

Step 3. Apply for Advanced Practice Licensure through the Montana Board of Nursing

Upon receiving national certification in nurse-midwifery, CNMs must apply to the Montana Board of Nursing to receive licensure to practice as an APRN in the state.

Prior to filling out the APRN application on the Montana Board of Nursing website, nurses must instruct their graduate program to send a copy of their official transcript to the Board.

Additionally, they must undergo a background check process by being fingerprinted at a local law enforcement agency. The fingerprint card must include the following information:

EMPLOYER AND ADDRESS: Board of Nursing, PO Box 200513, Helena, MT 59620-0513
REASON FINGERPRINTED: Licensure & 37-8-434, MCA
ORI: MT 920089Z

The completed fingerprint form, along with a $27.25 fee in the form of a check or money order made payable to the Montana Department of Justice, should be sent to the following address:

Montana Criminal Records
2225 11th Avenue
PO Box 20140
Helena, MT 59620-1403

Along with their completed APRN application, applicants should include:

  • A $75 fee in the form of a check, money order, or cashier’s check made payable to the Montana Board of Nursing
  • A copy of the nurse’s RN license
  • Verification of national certifications

All materials should be sent to the following address:

Montana Board of Nursing
P.O. Box 200513
Helena, MT 59620-0513

 


 

Step 4. Begin a Career as a Certified Nurse Midwife and Keep Credentials Current

Certified nurse-midwife APRN licensure candidates may check the status of their license through a Licensee Lookup program on the NURSYS website. Upon receiving their license, they may begin practicing privately or applying for nurse midwife jobs at Montana’s hospitals and birth centers.

Just some of the state’s top employers of nurse midwives include:

  • Billings Clinic Hospital in Billings
  • Bozeman Birth Center in Bozeman
  • Cabinet Peaks Medical Center in Libby
  • Community Birth Center in locations throughout Montana
  • Community Medical Center in Missoula
  • Family Birth Center in Great Falls
  • Frances Mahon Deaconess Hospital in Glasgow
  • Kalispell Regional Medical Center in Kalispell
  • Livingston Memorial Hospital in Livingston
  • Marias Medical Center in Shelby
  • North Valley Hospital in Whitefish
  • Providence St. Joseph Medical Center in Polson
  • Patrick Hospital in Missoula
  • Vincent Healthcare in Billings

Active CNMs must undergo several renewal processes on the state and national level to maintain their state license and national certification.

License Maintenance through the Montana Board of Nursing

In Montana, APRN licenses expire on December 31st of even-numbered years. Nurses are mailed renewal forms 45 days prior to the expiration of their license.

APRNs must complete 24 hours of Continuing Education contact hours before each license renewal date. Details on the contact hours are described in rule 24.159.1469 of the Administrative Rules of Montana (ARM).

CNM Credential Maintenance through the American Midwifery Certification Board

The AMCB has its own certification renewal requirements, which requires CNMs must complete one of the following Continuing Education options:

  • Three AMCB Certificate Maintenance Modules and 20 AMCB-approved contact hours of CE during every five-year certification cycle (CNMs must also submit annual fees to the AMCB)
  • The AMCB Certification Examination (CNMs must pay a one-time fee of $500, but are not subject to annual fees)

WHNP-BC Credential Maintenance through the National Certification Corporation

To maintain WHNP Board Certification, women’s health NPs must take a continuing competency assessment given by the National Certification Corporation (NCC) every three-year maintenance cycle. The NCC also establishes CE requirements on an individual basis based on the results of the assessment.


Salaries for Certified Nurse-Midwives in Montana

The average salary for a certified nurse-midwife in Montana was $92,070 as of 2013 according to the American College of Nurse-Midwives; however, those working in specialty clinics often earn considerably more. For example, an OB practice in Montana recruiting for an experienced certified nurse-midwife in 2015 offered a total compensation package worth $110,000 to $150,000, as well as relocation assistance and a possible sign-on bonus.

Job Growth Projections for Montana’s Certified Nurse-Midwives

The number of jobs for certified nurse-midwives in Montana has been growing dramatically in recent years. The 2011 Montana Healthcare Workforce Statewide Strategic Plan produced by the Montana Healthcare Workforce Advisory Committee (MHWAC) reported that 40 certified nurse-midwives practiced in the state in 2010. By 2015, this number had grown to 67 according to the American Association of Colleges of Nursing.

The MHWAC strategic plan identified the location of Montana’s certified nurse-midwives by county and revealed a critical shortage of CNMs in the eastern part of the state. Roosevelt County was the only county in eastern Montana in which certified nurse-midwives were found practicing in 2010.

In contrast, Yellowstone County had a number of CNMs in the Billings area. Other counties with multiple locations for nurse-midwife practices included:

  • Flathead County
  • Chouteau County
  • Missoula County
  • Jefferson County
  • Silver Bow County

How CNMs Help Compensate for Montana’s Critical Shortage of OB/GYNs

Most of Montana’s residents lack adequate access to healthcare. In 2011, the Montana Office of Primary Care documented Health Professions Shortage Areas (HPSA) in all but four of Montana’s counties.

In particular, OB/GYN physicians are in low supply in Montana creating a void that certified nurse-midwives are expected to fill. The state was home to only 99 OB/GYN physicians according to the American Congress of Obstetricians and Gynecologists (ACOG) 2014 ACOG Workforce Fact Sheet: Montana.

On a population basis, this number is 8.3% below the national ratio for the number of OB/GYN physicians per 10,000 women. Even more critical is the fact that 35 of Montana’s counties had no OB/GYNs in 2014.

Montana’s certified nurse-midwives have full practice authority allowing them to practice to the full extent of their education and training. As of 2011, only 18 other states and the District of Columbia allowed certified nurse-midwives to enjoy this level of autonomy.

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