Elaine Diegmann, the lead midwifery professor at Rutgers School of Nursing, has delivered over 5,000 babies during her career – including two of her own grandchildren. Diegmann, who has practiced in New Jersey for over 34 years, is happy to report that the relationship between nurse-midwives and physicians in the state have been growing ever stronger over the years. Diegmann expects that through the strength of these partnerships, New Jersey’s community of nurse-midwives will continue to thrive.
More and more women are drawn to the holistic and highly individualized approach to childbearing and well woman care that certified nurse-midwives favor in lieu of invasive and often costly interventions. Programs like “Welcoming Birth,” sponsored by The Midwives of New Jersey, offer emotional support and physical care to women by way of prenatal care, childbirth classes, and newborn care classes for new and expecting mothers. In addition to a lower average cost associated with antepartum, intrapartum and postpartum care when compared to physician-led care, The American College of Nurse Midwives (ACNM) has also reported fewer invasive procedures and a lower infant mortality rate associated with nurse-midwife attended births.
Considering these findings, it is not surprising that the New Jersey Department of Labor and Workforce Development expects there to be a 21 percent increase in job opportunities for CNMs in the state during the 10-year projection period leading up to 2022.
Steps to Becoming a Certified Nurse-Midwife in New Jersey
To become licensed as a nurse-midwife through the New Jersey Board of Nursing, RN candidates with licenses in good standing must earn a qualifying graduate degree in nurse-midwifery and the Certified Nurse-Midwife (CNM) credential through the American Midwifery Certification Board (AMCB):
Step 1. Earn a Qualifying Master’s Degree in Nurse Midwifery
All certified nurse-midwife candidates in New Jersey must earn a master’s or higher degree recognized by the Accreditation Commission for Midwifery Education (ACME).
In New Jersey, there is currently one ACME recognized on-campus program located in Newark. In addition, there are many campuses offering qualifying programs in neighboring states of New York and Pennsylvania. Online ACME-accredited master’s programs available in the U.S. offer the same academic rigor as residential CNM programs in a flexible format that is often much better suited to the busy schedules of working RNs.
Admissions Requirements for a Masters Program in Nurse-Midwifery
An RN who has already completed a BSN would be eligible to apply for a conventional MSN program in nurse midwifery. RNs who have completed an associate’s degree but have not yet completed a BSN have the option of enrolling in an RN-to-MSN bridge program. Upon completion of the RN-to-MSN program, graduates will have earned both a BSN and MSN in nurse-midwifery.
While admissions requirements differ by school, most nursing schools require the following for admission into a master’s degree program in nurse-midwifery:
- Written or video essay
- Official academic transcripts from a BSN or other relevant degree program
- Statement of purpose
- Letters of recommendation
- Proof of a current RN license
Dual Focus Options, Program Structure, and Course Content
Nursing schools with ACME-accredited nurse-midwifery programs often offer dual-focus tracks structured as Nurse Midwife/Women’s Health Nurse Practitioner (NM/WHNP) programs. Upon completing one of these dual-focus programs, graduates can choose to sit for both CNM and WHNP-BC examinations to become dually-certified and licensed as both a Certified Nurse Midwife (CNM credential) and a Women’s Health Nurse Practitioner-Board Certified (WHNP-BC credential).
Graduate degree programs in nurse midwifery consist of both didactic coursework and clinical practice hours, which are usually completed concurrently.
Both CNM and NM/WHMP masters programs will require students to become proficient in the competencies that are expected of all advanced practice nurses – pathophysiology, leadership, health assessment, and pharmacology. In addition, topics specific to nurse-midwifery and women’s health will be covered in the classroom:
- Antepartum, Intrapartum, and Postpartum Care
- Pregnancy and Labor
- Newborn Healthcare
- Research Methods
- Women’s Reproductive Health
- Ambulatory Care for Women
- Healthcare Ethics
Clinical Practice (500-1000 hours)
Clinical hours are supervised by licensed, practicing professionals at hospitals and clinics across the state. For those enrolled in an online program, advisors will work with students to coordinate clinical opportunities in a facility close to the student’s home.
Potential clinical locations for CNM students in New Jersey may include:
- Hackensack University Medical Center
- Morristown Medical Center
- Robert Wood Johnson University Hospital in New Brunswick
- Jersey Shore University Medical Center in Neptune
- Peter’s University Hospital in New Brunswick
- University Medical Center of Princeton at Plainsboro
- Riverview Medical Center in Red Bank
Step 2. Pass the National Certification Examination in Nurse-Midwifery
After completing coursework, clinical hours, and graduating from an ACME qualifying program, candidates with a master’s degree in nurse-midwifery would then apply to take the Certified Nurse-Midwife Exam through the American Midwifery Certification Board (AMCB).
Students who have completed a dual-focus nurse-midwife/women’s health nurse practitioner program will also be eligible to take the Women’s Health Nurse Practitioner (WHNP) exam through the National Certification Corporation (NCC).
Both the CNM and WHNP exams are administered through the third party exam service Applied Measurement Professionals (AMP). Those seeking a test center in New Jersey can register to take the exam in the cities of Trenton or Wayne.
Taking the Certified Nurse Midwife Exam
Candidates must take the exam within 24 months of graduating from their master’s programs, and have a maximum of four attempts to pass the exam.
The American Midwifery Certification Board
849 International Drive, Suite 120
Linthicum, MD 21090
Detailed exam information and sample questions can be found in the Candidate Handbook, a great resource for potential test-takers. Examinees have four hours to take the exam via computer, which is made up of 175 multiple-choice questions. The exam is graded by the following rubric:
- Well Woman/Gynecology – 15-20 percent
- Antepartum Care – 15-25 percent
- Intrapartum Care – 25-35 percent
- Postpartum Care – 5-10 percent
- Newborn Care – 10-15 percent
- Primary Care – 12-16 percent
- Professional Issues – up to 5 percent
Upon completing the exam, examinees will be granted a Certificate in Nurse Midwifery (CNM). Under this certification, CNMs are able to apply to become licensed as nurse-midwives through the New Jersey Board of Nursing.
Taking the Women’s Health Care Nurse Practitioner Exam
A licensed RN who has completed a dual degree program – a Certified Nurse Midwife/Women’s Health Nurse Practitioner degree – can also choose to sit for the national Women’s Health Care Nurse Practitioner (WHNP) Exam through the National Certification Corporation (NCC).
Candidates may apply to take the exam online. Examinees have three hours to complete the exam, which is made up of 150 multiple-choice questions. Topics covered on the exam include:
- Pharmacology: 5-10 percent
- Primary Care: 10-15 percent
- Obstetrics: 25-30 percent
- Diagnostic testing and physical assessment: 10-15 percent
- Gynecology: 35-40 percent
Once candidates have completed the exam, they can view their preliminary scores immediately. Official results will be mailed to examinees within three weeks of completing the exam. After successfully completing the WHNP exam, examinees will be granted the Women’s Health Care Nurse Practitioner-Board Certified (WHNP-BC) credential, which allows them to apply for advanced practice licensure through the New Jersey Board of Nursing.
Step 3. Apply for Licensure through the New Jersey Board of Nursing
In order to practice as a nurse midwife and/or a women’s health nurse practitioner in New Jersey, candidates must apply for licensure through the New Jersey Board of Nursing.
Certified Nurse Midwife
The New Jersey Board of Nursing requires CNMs to complete and send in an Application for Licensure as a Nurse-Midwife. The board requires the following items to be sent along with the application:
- Official transcripts from an ACME recognized MSN program in nurse midwifery
- A valid RN license
- Three passport-sized photos
- Application fees
- Verification of CNM certification
- Criminal history background check
- Resume or CV
- Proof of U.S. citizenship
The application includes the option to apply with or without prescriptive authority. To be granted prescriptive authority, CNM candidates must complete the Verification of Pharmacology Education portion of the application attesting to having completed at least 30 contact hours of pharmacology education.
These documents, along with the completed and notarized application, can be sent to the following address:
New Jersey Office of the Attorney General
Division of Consumer Affairs
State Board of Medical Examiners
Midwifery Liaison Committee
140 East Front Street, 2nd Floor, PO Box 183
Trenton, NJ 08625
Women’s Health Nurse Practitioner
Those applying to practice as a women’s health nurse practitioner in New Jersey must apply for an advanced practice nurse (APN) license through the New Jersey Board of Nursing. Applications must be requested via email by contacting APN@dca.lps.state.nj.us. A reply email will follow soon after the request is made with an application form and further instructions.
Once candidates have received the application, the following items must be sent to the New Jersey Board of Nursing:
- $100 application fee
- Proof of a valid RN license
- Official transcripts
- A copy of WHNP certification
Applications and required documents can be sent to the following address:
New Jersey Board of Nursing
P.O. Box 45010
Newark, NJ 07101
After taking the required exams and applying for an Advanced Practice Nursing certification, candidates will hear back within a few weeks that they are allowed to practice in New Jersey.
Step 4. Discover Potential Job Opportunities and Maintain Licensure and Certification
There are approximately 350 CNMs practicing in New Jersey, but due to the fact that this field is in high demand and quickly growing, New Jersey nurse-midwives have the opportunity to earn highly competitive salaries. According to the New Jersey Department of Labor and Workforce, nurse-midwives earn an average annual salary of $109,900. As more major healthcare institutions partner with nurse-midwives, it is expected that even more opportunities will become available for CNMs.
New Jersey is home to many hospitals with obstetric departments and independent clinics devoted to women’s healthcare, childbirth, and obstetrics and gynecology. The following list represents some of the top employers of certified nurse-midwives and women’s health nurse practitioners in New Jersey:
- Hunterdon Healthcare in Flemington
- The Valley Hospital in Ridgewood
- Clara Maass Medical Center in Belleville
- Saint Peter’s Healthcare System in New Brunswick
- Jersey Shore Women’s Health Care Center in Neptune
- CarePoint Health Women’s Services in Hoboken
- Star and Barry Tobias Women’s Health Center in Freehold
- New Jersey Birth Center in Clifton
- Women First Health Center in West Orange
- Women’s Choice in Hackensack
- Liberty Women’s Health Care in Flushing
Those who have completed each step to become a CNM or a women’s health NP can then apply for jobs like the ones listed below. (These examples have been gathered from job postings across the state as of December 2015 and are listed for illustrative purposes only. They do not represent job offers or the assurance of employment.):
- Certified Nurse Midwife at Newark Beth Israel Medical Center in Newark
- Certified Nurse Midwife at Regional Women’s Health Group, LLC in Voorhees
- Registered Nurse OB/GYN at Barnabas Health Care System in Manahawkin
- Clinician Advanced Practice Nurse at Planned Parenthood of Southern New Jersey in Camden
- Certified Nurse Midwife at Artemis OB/GYN in Union
- Advanced Practice Nurse OB/GYN at Rutgers University in New Brunswick
Advanced Practice Nursing Renewal Through the New Jersey Board of Nursing
- CNM and CRNP licenses must be renewed every other year
- 30 hours of Continuing Education (CE) credits are required during each two year period
Certificate in Nurse Midwifery Renewal Through the American Midwifery Certification Board (AMCB)
- The AMCB’s Certificate Maintenance Program requires that a Certificate in Nurse Midwifery must be renewed every five years
- The Certification Maintenance Program requires that current CNMs do one of the following in order to renew their certificate:
- Retake the National Certification Examination
- Complete three Certification Maintenance Modules and obtain 20 hours of continuing education
Women’s Health Care Nurse Practitioner (WHMP-BC) Renewal Through the National Certification Corporation
- License must be renewed every three years
- The maintenance cycle requires candidates to take the Continuing Competency Assessment
- Depending on the results of the assessment, 10-50 hours of continuing education will be required
Salaries for Certified Nurse-Midwives in New Jersey
Certified nurse-midwives in New Jersey are highly paid compared to their colleagues in the rest of the country according to the US Bureau of Labor Statistics. This is particularly true when comparing starting salaries for certified nurse-midwives (typically those in the bottom 10%). Certified nurse-midwives in New Jersey who were new to the field earned $86,550 as of 2014, more than $20,000 higher than the national average for CNMs in this category.
The overall average salary for certified nurse-midwives in New Jersey was $109,460 that year—12% higher than the national average. Certified nurse-midwives with salaries in the top 10% earned an average of $133,370—3.2% more than the national average for this category.
Job Growth Projections and Employment Opportunities for CNMs in New Jersey
Forty-seven certified nurse midwives practiced in New Jersey in 2013 according to the New Jersey Nurse Workforce Report for 2013-2014 published by the New Jersey Collaborating Center for Nursing. However, their numbers are expected to grow dramatically, with the New Jersey Department of Labor and Workforce Development projecting that the number of jobs for CNMs in the state will increase by 21.1% between 2012 and 2022.
Camden was home to the 8th highest concentration of nurse-midwives of any city in the nation according to the US Bureau of Labor Statistics (2014).
New Jersey has a number of practices for alternative or home-based childbirth experiences, and some of these are shown below. These practices are shown for informational purposes only and do not constitute a guarantee of employment.
Hospital-Based Birthing Centers:
- The Center for Women’s Health at Jersey Shore University Medical Center—Avon, Brick
- The Midwifery Services at Trinitas Regional Medical Center—Elizabeth
CNM Practices Associated with Hospitals:
- Babcatcher—Morristown, Rockaway
- North Jersey Midwifery Care—Union City
- ONE to ONE FemaleCare—Morristown
- The Midwives of New Jersey—Hackettstown, Madison
- Avalon Midwives—Caldwell, Morristown
- The Childbirth & Women’s Wellness Center—Clifton, Montclair
- Holistic Women’s Healthcare Midwifery Practice—Jersey City, Hoboken
- Lauren Pine-Bildner—Teaneck
- Risa Lynn Klein—Clifton
- Evelina Tuers–Clifton
Individual CNM Midwife Practices:
- Carole Shipman—New Milford
- Valeriana Pasqua-Masback—Chestnut Ridge
An Analysis of Salaries for Certified Nurse Midwives in Camden
The US Bureau of Labor Statistics provides a detailed analysis of the salaries for nurse-midwives who practiced in Camden during 2014: