As master’s-prepared advanced practitioners, New York’s certified nurse-midwives are skilled healthcare providers that serve the obstetric and gynecologic care needs of women during pregnancy, and throughout the lifespan. Though nurse-midwives adhere strictly to evidence-based practices, many women are drawn to the more individualized, whole-person approach that CNMs tend to favor when developing treatment plans for the women in their care.
The American College of Nurse-Midwives (ACNM) has found that pregnant women in the care of CNMs report a lower average cost associated with childbirth due to fewer instances of costly and invasive procedures like induced labor and cesarean sections, which have become common with physician-attended deliveries. The ACNM has also reported that nurse-midwife attended births result in a lower rate of infant mortality when compared to equally low-risk deliveries taking place under the care of a physician.
With findings like these, more woman in New York are turning to certified-nurse midwives for antepartum, intrapartum and postpartum care, driving demand for nurse-midwifery services in the state. In fact, the New York State Department of Labor expects a 19 percent increase in the number of CNMs licensed to practice in the state over the ten-year period leading up to 2022.
Steps to Becoming a Certified Nurse-Midwife in New York
RNs with an unencumbered and unrestricted license in good standing can become licensed as certified nurse-midwives through the New York State Education Department Office of the Professions Board of Nursing by meeting the education and certification requirements detailed in this guide:
Step 1. Earn a Qualifying Master’s or Higher Degree in Nurse-Midwifery
To qualify for the Certified Nurse-Midwife (CNM) credential through the American Midwifery Certification Board and to become eligible for nurse-midwife licensure through the New York State Education Department, CNM candidates must earn a master’s or higher degree through a program recognized by the Accreditation Commission for Midwifery Education (ACME).
Accredited nurse-midwifery programs available online offer New York’s working RNs the flexibility they need to earn a master’s degree while maintaining professional commitments. With just 39 online and campus-based ACME-accredited nurse-midwife programs in the US, distance learning options that offer the same level of rigor as conventional programs have become particularly popular among aspiring nurse-midwives.
CNM candidates in New York interested in an on-campus experience can choose from five schools located in Stony Brook and the greater New York City region. There are also programs available at campus locations in the neighboring states of New Jersey, Pennsylvania, Connecticut, and Massachusetts.
Admissions Standards for Nurse-Midwifery Masters Program
RNs that hold a BSN are eligible to enroll in conventional ACME-accredited nurse-midwifery master’s programs. RNs that hold an associate’s degree would enroll in an ACME-accredited RN-to-MSN bridge program specific to nurse-midwifery, which would confer both a BSN and master’s in nurse-midwifery in one accelerated program.
While some master’s programs may have unique admissions requirements, most programs generally require the following:
- A current RN license
- Letters of recommendation from supervisors and professors
- Statement of purpose
- Video or written essay
- Official academic transcripts from a BSN or another relevant post-secondary program
Nurse-Midwifery Masters Program Structure, Content and Dual Focus Options
Some graduate schools allow students to choose a dual-focus Nurse-Midwife/Women’s Health Nurse Practitioner (NM/WHNP) program. Graduates of these programs would have the option of becoming dually-certified as both a nurse midwife (CNM credential) and board certified women’s health nurse practitioner (WHNP-BC credential), as well as being eligible for licensure in both specializations through the New York State Education Department.
Nurse-midwife graduate students would complete both didactic coursework and clinical sequences in local facilities concurrently.
Classroom Study (40-60 semester credits)
Didactic study will cover the competencies expected of all advanced practice nurses (Physiology, Pathophysiology and Pharmacology), as well as key areas in nurse-midwifery:
- Research Methods for Health Care Providers
- Women’s Reproductive Healthcare
- Pregnancy, Labor, and Newborn Care
- Ambulatory Care of Women
- Antepartum, Intrapartum and Postpartum Care
- Newborn Care
- Biostatistics for Health Care Providers
Clinical Practice (500-1000 hours)
Clinical sequences are supervised at local hospitals and clinics throughout New York. For students of online programs, rotations at nearby clinical locations would be coordinated with a graduate program advisor to eliminate the need to relocate.
For students in the downtown New York City area, potential clinical locations include:
- New York Presbyterian University Hospital of Columbia and Cornell
- Mount Sinai Hospital
- Lenox Hill Hospital
- Beth Israel Medical Center
- NYU Langone Medical Center
- Montefiore Medical Center
Other locations in New York that facilitate clinical learning for nurse-midwife students include:
- Francis Hospital in Roslyn
- Northern Westchester Hospital in Mount Kisco
- Winthrop-University Hospital in Mineola
- North Shore University Hospital in Manhasset
- Glen Cove Hospital in Glen Cove
- Phelps Memorial Hospital Center in Sleepy Hollow
Step 2. Pass the National Nurse-Midwife Certification Examination
Upon graduating from an ACME-accredited master’s program, CNM candidates would apply to take the Certified Nurse-Midwife Exam through the American Midwifery Certification Board (ACMB).
Candidates who have earned a dual-focus Nurse-Midwife/Women’s Health Nurse Practitioner degree have the option of also attempting the Women’s Health Care Nurse Practitioner exam. National Certification Corporation (NCC).
Both exams are administered through Applied Measurement Professional (APM) test centers in the following locations:
- Long Island
- White Plains
Certified Nurse Midwife Exam
The Certified Nurse-Midwife Exam is made up of 175 questions in a multiple-choice format. Sample questions and other helpful information can be found in the Candidate Handbook. Candidates take the test via a computer, and have a time limit of four hours to complete it. Subjects covered on the exam will include:
- Maternal-newborn nursing
- Women’s health care
- Newborn care
The test is graded and scored by the following rubric:
- Primary Care – 12-16 percent
- Antepartum Care – 15-25 percent
- Intrapartum Care – 25-35 percent
- Postpartum – 5-10 percent
- Newborn Care – 10-15 percent
- Well Woman/Gynecology – 15-20 percent
- Professional Issues – up to 5 percent
The American Midwifery Certification Board
849 International Drive, Suite 120
Linthicum, MD 21090
After examinees have completed the exam, they will be granted the Certificate in Nurse Midwifery (CNM). Once certified, CNMs are eligible to become licensed as nurse-midwives through the New York State Education Department Office of the Professions Board of Nursing.
Women’s Health Care Nurse Practitioner Exam Process
Those who also choose to take the Women’s Health Care Nurse Practitioner (WHNP) Exam will have three hours to complete the 150 multiple-choice questions. Sample questions and other important details can be found in the WHNP Candidate Guide.
Exam topics and scoring rubric information are as follows:
- Gynecology – 35-40 percent
- Obstetrics – 25-30 percent
- Diagnostic testing and physical assessment – 10-15 percent
- Primary Care – 10-15 percent
- Pharmacology – 5-10 percent
Preliminary scores will be reported immediately after completing the exam, and official results will be mailed to examinees within 21 days of the exam date.
After examinees have successfully completed the exam, they will be granted the Women’s Health Care Nurse Practitioner-Board Certified (WHNP-BC) credential.
Step 3. Apply for Nurse-Midwife Licensure through the New York State Education Department
The final step to becoming a nurse-midwife in New York is to apply for nurse-midwife licensure through the NYSED Board of Nursing.
The nurse-midwife application process would involve completing the application and forwarding the remaining forms to the appropriate location as noted below. An authorized representative of your school and pharmacology training program would then complete the forms before forwarding them on to the NYSED Board of Nursing for final approval:
Form 1 – Application for Licensure must be submitted along with the $322 licensure and first registration fee. Checks should be made payable to the New York State Education Department.
Form 2 – Certification of Professional Education must be sent from the graduate school attended.
Form 2A – Certification Of Pharmacology Course Or The Equivalent Of Not Less Than Three Semester Hours must be sent from the institution providing the pharmacology course attended.
Form 2B – Certification Of Instruction In New York State And Federal Laws Relating To Prescriptions And Record Keeping must be sent from the institution/organization providing the instruction in New York State and federal laws relating to prescriptions and record keeping.
All completed forms and supporting documents would be sent to the following address:
New York State Education Department
Office of the Professions
PO Box 22063
Albany, NY 12201
Dually-certified nurses who also hold the WHNP-BC credential can also elect to become licensed as Women’s Health Nurse Practitioners through the NYSED Board of Nursing.
Step 4. Explore Career Opportunities and Maintain Certification
According to the U.S. Bureau of Labor Statistics, there were just 650 certified nurse-midwives licensed to practice in New York as of 2014. Earning an average salary of approximately $101,000 that year, New York’s CNMs are among the best paid in their field nationwide. As demand grows amid a shortage of certified nurse-midwives in the state, salaries have been increasing steadily as major hospitals and integrated health systems compete for qualified CNMs in an effort to meet the needs of a more discriminating patient base.
Some of the top employers of certified nurse-midwives in New York include:
- Joan H. Tisch Center for Women’s Health
- Emily Women’s Health Center
- Manhattan Women’s Medical
- Morris Heights Health Center
- Maimonides Women’s Health Services
- Westside Women’s Medical Pavillion
- Downtown Women OB/GYN Associates, LLP
- MIC Women’s Health Services
- Sloan Womens Health
- The Center for Women’s Health
- Choices Women’s Medical Center
A survey of job vacancy announcements for certified nurse-midwives in New York performed in December 2015 provides insight into the types of opportunities available to newly licensed CNMs in the state. (These job listings are provided as illustrative examples only and do not represent a job offer or the assurance of employment.):
- Women’s Health Nurse Practitioner or Certified Nurse Midwife at SUNY Downstate Medical Center in Brooklyn
- Certified Nurse Midwife at Women’s Health Center in Mount Kisco
- Nurse Practitioner OB/GYN at Focus Staff in New York City
- Advanced Practice Clinician OB/GYN at Planned Parenthood in New York City
- Nurse Practitioner OB/GYN at Garden OB/GYN in Queens and Manhattan
License Renewal Through the New York State Education Department
Nurse-midwife, NP and RN registration certificates must be renewed every three years.
Certificate in Nurse Midwifery (CNM) Renewal Through the American Midwifery Certification Board (AMCB)
CNMs must complete the AMCB’s Certificate Maintenance Program every five years. This process requires CNMs to choose one of the following certificate renewal options:
- Re-take the exam
- Complete three Certificate Maintenance Modules throughout the five-year cycle and 20 hours of continuing education
Women’s Health Care Nurse Practitioner (WHMP-BC) renewal through the National Certification Corporation
- Certificate must be renewed every three years
- Current Women’s Health NPs must take the Continuing Competency Assessment, then 10-50 hours of continuing education will be assigned according to the assessment results
Salaries for Certified Nurse-Midwives in New York
As of 2015, certified nurse-midwives in New York State earned an average salary of $98,820 according to the New York Department of Labor. Experience continues to be the biggest factor contributing to higher CNM salaries, as is evident in the fact that the state’s most experienced certified nurse-midwives received salaries that fell within the 90th percentile, earning an average of $108,680. In comparison, certified nurse-midwives who were new to the field earned an average of $79,100 that year.
The Growing Demand for Certified Nurse-Midwives in New York
New York State was home to the highest number of certified nurse-midwives of any state in the nation as of 2014 (US Bureau of Labor Statistics). Still, the New York State Department of Labor expects the number of jobs for CNMs in the state to increase by 18.5% between 2012 and 2022. Even with such a strong job growth projection, 2015 trends suggest the possibility of an even faster rate of growth.
The New York State Department of Labor reported that 540 nurse midwives were licensed to practice in the state as of 2012, but by 2015 this number had increased more than two fold to 1,153.
The growing number of opportunities is reflected in the number of jobs advertised for certified nurse-midwives throughout New York State as of December 2015. A short list of examples included (This list is shown for informational purposes only and is not meant to imply an assurance of employment):
- Neighborhood Health Center – Buffalo
- Mount Kisco Medical Group – Mount Kisco, Rhinebeck
- Community Care Physicians, P.C. – New York
- Lim H. Tse, M.D. P.C. – Brooklyn
- Physician Affiliate Group of New York – Brooklyn
- Cortland Regional Medical Center – Cortland
- Lake Champlain Ob/Gyn, P.C. – Plattsburgh
- Peter’s Health Partners – Albany
- Saratoga Hospital – Saratoga Springs
- LI Healthcare – Auburn
New York’s certified nurse-midwives enjoy the ability to practice independently after meeting requirements for obtaining prescriptive authority. This level of autonomy allows the state’s CNMs to provide high-quality obstetric and gynecological care to the full extent of their training and education, which is particularly important in rural parts of the state with a recognized shortage of OB-GYN physicians.
While New York State has a high ratio of OB-GYN physicians on a population basis, these physicians are not evenly distributed in the state. In its 2014 workforce fact sheet for New York, the American Congress of Obstetricians and Gynecologists identified nine counties in New York with no OB-GYN specialists:
- Delaware County
- Essex County
- Hamilton County
- Livingston County
- Schoharie County
- Seneca County
- Tioga County
- Yates County
- Washington County
Salaries of Certified Nurse-Midwives in New York’s Major Metropolitan Areas
Certified nurse-midwives in New York City had a higher average salary than CNMs in New York state overall as of 2015 according to the state’s Department of Labor:
- Experienced – $109,150
- Average – $100,190
- Entry-level – $82,250
The US Bureau of Labor Statistics provides a detailed analysis of the salaries of nurse midwives in New York State’s major metropolitan areas as of 2014 (Nurse-midwives in the New York-White Plains-Wayne metropolitan area enjoyed the ninth highest average salary of any metropolitan area in the country as of 2014):