Last Updated: June 2025 | Reviewed by Abbie Jacobs
North Dakota offers exceptional opportunities for certified nurse-midwives (CNMs), with independent practice authority and no physician supervision requirements. As an Advanced Practice Registered Nurse (APRN) specializing in nurse-midwifery, you’ll provide comprehensive healthcare services to women throughout their lifespan while enjoying one of the most autonomous practice environments in the nation.
The demand for nurse-midwifery services continues to grow in North Dakota, where women increasingly seek the personalized, holistic approach that CNMs provide. Despite this growing demand, the state maintains a limited workforce of certified nurse-midwives, creating substantial career opportunities for qualified professionals ready to advance women’s healthcare through the midwifery model of care.
Steps to Becoming a Certified Nurse-Midwife in North Dakota
The path to becoming a Certified Nurse Midwife (CNM) in North Dakota involves completing rigorous educational requirements, passing national certification exams, and obtaining state licensure. Follow these essential steps as outlined by the North Dakota Board of Nursing:
Step 1. Earn a Qualifying Master’s Degree or Higher in Nurse-Midwifery
All prospective nurse-midwives in North Dakota must complete a graduate or post-graduate program in nurse-midwifery accredited by the American Commission for Midwifery Education (ACME). While North Dakota doesn’t currently have any accredited nurse-midwife programs within the state, numerous online programs allow students to complete didactic coursework remotely while arranging local clinical experiences.
Types of Nurse-Midwifery Degree Programs
Educational pathways to becoming a CNM accommodate nurses at various stages of their careers:
Master of Science in Nursing (MSN) with Nurse-Midwifery Focus
Traditional MSN programs designed for RNs with a Bachelor of Science in Nursing (BSN) typically require two years of full-time study. These programs provide comprehensive preparation for advanced practice roles in midwifery.
RN-to-MSN Bridge Programs
For RNs holding associate degrees, accelerated RN-to-MSN programs incorporate BSN requirements alongside graduate midwifery coursework. These programs typically span three years and provide a streamlined pathway to advanced practice.
Post-Graduate Certificates
Designed for RNs already holding an MSN, post-graduate certificates enable nurses to add nurse-midwifery specialization to their credentials. These focused programs concentrate solely on midwifery-specific content.
Dual Specialization Programs
Increasingly popular dual specialization programs combine nurse-midwifery with training as a women’s health nurse practitioner (WHNP). Graduates qualify for dual certification as both CNM and WHNP-BC, expanding their scope to include treatment of chronic and acute illnesses affecting women.
Program Structure and Clinical Requirements
Nurse-midwifery programs consist of two essential components:
| Component | Description |
|---|---|
| Didactic Component | Coursework, seminars, and lectures covering advanced health assessment, pathophysiology, pharmacology, and midwifery-specific content |
| Clinical Component | Supervised clinical rotations under AMCB-certified CNMs or qualified APRNs at approved healthcare facilities |
Core Curriculum Areas:
- Advanced Health and Physical Assessment
- Advanced Physiology and Pathophysiology
- Advanced Pharmacology for Primary Care
- Primary Care of Women Across the Lifespan
- Antepartum and Intrapartum Care
- Postpartum and Newborn Care
- Advanced Midwifery Role Development
Clinical Sites in North Dakota
Students pursuing online CNM programs can complete clinical requirements at various North Dakota healthcare facilities, including:
- CHI St. Alexius Health, Bismarck
- CHI St. Joseph’s Health Clinic, Dickinson
- Mid Dakota Clinic Center for Women, Bismarck
- Mercy Medical Center, Williston
- Sanford Birth Center, Bismarck
- Trinity Health System facilities throughout the state
Admission Requirements
Typical admission requirements for nurse-midwifery programs include:
- Current, unencumbered RN license
- Bachelor of Science in Nursing (BSN) for MSN programs
- Minimum undergraduate GPA (usually 3.0 or higher)
- GRE scores (varies by program)
- Professional letters of recommendation
- Personal statement or essay
- Clinical experience in women’s health or obstetrics (preferred)
“Choosing to pursue my CNM through an online program while living in North Dakota was the best decision I made. I completed my clinical rotations at Sanford in Bismarck, where I now practice as an independent CNM. The flexibility of online learning combined with hands-on experience in my community prepared me perfectly for serving North Dakota families.” – Lisa K., CNM, Bismarck
When researching accredited nurse-midwifery programs in North Dakota and surrounding states, prospective students should consider both traditional on-campus and online CNM programs. Many nationally recognized institutions offer distance learning options for MSN, DNP, and post-master’s CNM degrees, making advanced midwifery education accessible to North Dakota residents without relocating. These ACME-accredited programs maintain the same rigorous standards whether delivered online or in person, ensuring graduates are well-prepared for certification and practice.
Step 2. Take and Pass the National Certification Examination to Become a CNM
After graduating from an ACME-accredited program, candidates must pass the national certification examination administered by the American Midwifery Certification Board (AMCB). State licensure in North Dakota requires successful completion of this comprehensive examination.
Examination Details
| Exam Component | Details |
|---|---|
| Format | Computer-based examination |
| Number of Questions | 175 multiple-choice questions |
| Time Allowed | 4 hours |
| Testing Centers in ND | Bismarck and Fargo (PSI Services) |
| Results | Immediate official results at the testing site |
Examination Content Areas
The CNM certification examination assesses knowledge across multiple domains:
- Antepartum care and complications
- Intrapartum care and labor management
- Postpartum and newborn care
- Primary care and gynecology
- Professional issues and healthcare systems
- Pharmacology and clinical decision-making
Retake Policy
Candidates who don’t pass initially may retake the examination under these conditions:
- First retake: No sooner than 30 days after initial attempt
- Subsequent retakes: Minimum 90-day intervals required
- Maximum attempts: 4 times within 24 months of program completion
- After 4 attempts or 24 months: Must complete another ACME-accredited program
Dual Certification Option
Graduates of dual specialization programs may also pursue Women’s Health Care Nurse Practitioner (WHNP) certification through the National Certification Corporation (NCC), expanding their practice scope.
Step 3. Apply for APRN Licensure as a Nurse-Midwife through the North Dakota Board of Nursing
Following successful certification, candidates must obtain APRN licensure through the North Dakota Board of Nursing. The comprehensive application process ensures all nurse-midwives meet state standards for independent practice.
Application Requirements
Submit the Initial Practice License Application with the following documentation:
- Evidence of current CNM certification from AMCB
- Official transcripts showing nurse-midwifery degree completion
- Criminal History Record Check ($20 processing fee)
- Current RN license in North Dakota or a compact state
- Application fee: $100 (base) + $50 (prescriptive authority) = $150 total
Prescriptive Authority Requirements
North Dakota CNMs seeking prescriptive authority must additionally provide:
- Evidence of 30 contact hours of pharmacotherapy education within the past 3 years
- Transcripts showing completion of advanced pharmacology coursework
- An additional $75 processing fee for the prescriptive authority application
| License Type | Initial Fee | Renewal Fee (Biennial) |
|---|---|---|
| APRN License Only | $100 | $160 |
| APRN with Prescriptive Authority | $225 | $210 |
Step 4. Explore Nurse-Midwife Career Options in North Dakota and Maintain Credentials
North Dakota’s certified nurse-midwives enjoy exceptional professional autonomy with independent practice authority. CNMs provide comprehensive healthcare services across diverse settings without physician supervision requirements.
Scope of Practice
As Advanced Practice Registered Nurses, North Dakota CNMs provide:
- Primary healthcare services from adolescence through menopause
- Gynecologic and reproductive health care
- Family planning and preconception counseling
- Complete pregnancy, labor, and delivery care
- Postpartum care for mothers
- Newborn care within the first 28 days of life
- Health promotion and disease prevention services
Practice Settings and Employers
North Dakota CNMs work in various healthcare environments:
| Healthcare System | Locations |
|---|---|
| Trinity Health | Minot, Williston, Kenmare |
| CHI Health System | Bismarck, Dickinson |
| Sanford Health | Bismarck, Fargo |
| Private Practices | Great Plains Women’s Health, Mid Dakota Clinic |
Continuing Education Requirements
State License Renewal (Biennial)
- 12 contact hours of approved continuing education
- 15 contact hours of pharmacology CE (for prescriptive authority)
- 400 hours of nursing practice within the preceding 4 years
- Online renewal through the NDBON portal
National Certification Maintenance (5-year cycle)
AMCB offers two maintenance options:
- Option 1: Complete 3 AMCB Certificate Maintenance Modules + 20 CE hours
- Option 2: Retake certification examination ($500 fee)
CNM Salary Information and Job Outlook in North Dakota
While specific North Dakota salary data for nurse-midwives is limited due to the small workforce, national trends and regional healthcare compensation patterns provide valuable insights for career planning.
| Experience Level | National Average Annual Salary |
|---|---|
| Entry Level (10th percentile) | $63,450 |
| Median (50th percentile) | $120,880 |
| Experienced (75th percentile) | $146,020 |
| Top Earners (90th percentile) | $171,230 |
Job Outlook and Growth Projections
The employment outlook for nurse-midwives remains exceptionally positive:
- National growth projection: 45% increase through 2032
- Much faster than average for all occupations
- Driven by increased demand for women’s healthcare services
- Enhanced by growing preference for the midwifery care model
North Dakota Market Factors
Several factors contribute to strong CNM employment prospects in North Dakota:
- Limited Competition: Small existing workforce creates opportunities
- Rural Healthcare Needs: High demand in underserved areas
- Independent Practice: Ability to establish private practices
- Growing Awareness: Increasing consumer demand for midwifery services
(Salary data for nurse-midwives reported by the U.S. Bureau of Labor Statistics in May 2023. Figures represent state data, not school-specific information. Job growth data provided by Projections Central, a resource funded by the U.S. Department of Labor’s Employment and Training Administration. Conditions in your area may vary. Information accessed June 2025.)
Frequently Asked Questions About Becoming a CNM in North Dakota
Do I need to relocate to attend a nurse-midwifery program since North Dakota has no in-state schools?
No, relocation isn’t necessary. Many ACME-accredited programs offer online or hybrid formats that allow you to complete didactic coursework remotely. You’ll arrange clinical rotations at approved facilities within North Dakota, enabling you to gain hands-on experience in your local community while earning your degree.
What’s the difference between a CNM and a CPM in North Dakota?
Certified Nurse-Midwives (CNMs) are Advanced Practice Registered Nurses with graduate degrees who can prescribe medications and practice independently in hospitals and clinical settings. Certified Professional Midwives (CPMs) typically attend out-of-hospital births and have different educational pathways. North Dakota licenses CNMs as APRNs but has different regulations for CPMs.
How long does the entire process take to become a CNM in North Dakota?
The timeline varies based on your starting point: RNs with a BSN typically need 2-3 years for the MSN degree, plus 3-6 months for certification and licensing. RNs with associate degrees may need 3-4 years for RN-to-MSN programs. Post-graduate certificates for nurses with existing MSNs can be completed in 12-18 months.
Can I specialize in both nurse-midwifery and women’s health as a nurse practitioner?
Yes! Dual specialization programs, which prepare graduates for both CNM and WHNP-BC certification, are increasingly popular. These programs typically add 6-12 months to standard CNM programs but significantly expand your scope of practice to include treatment of acute and chronic women’s health conditions.
What clinical sites are available for CNM students in North Dakota?
North Dakota offers diverse clinical training opportunities at facilities including CHI St. Alexius Health, Trinity Health System, Sanford Health, and various private practices. Online programs often have established relationships with these facilities, or you may arrange your preceptorships with program approval.
Do North Dakota CNMs need collaborative agreements with physicians?
No, North Dakota grants full independent practice authority to certified nurse-midwives (CNMs). You can diagnose, treat, prescribe medications, and manage patient care without physician supervision or collaborative agreements, making North Dakota one of the most autonomous practice states for nurse-midwives.
What’s the job market like for new CNM graduates in North Dakota?
The job market is exceptionally favorable due to the limited number of practicing certified nurse-midwives (CNMs) statewide, combined with a growing demand for midwifery services. New graduates often receive multiple job offers, particularly in rural and underserved areas where the need for women’s healthcare providers is greatest.
How much continuing education do I need to maintain my CNM license in North Dakota?
North Dakota requires 12 contact hours of continuing education every two years for APRN renewal. If you hold prescriptive authority, you’ll need 15 contact hours specifically in pharmacology. Additionally, you must maintain your national certification through AMCB, which requires either ongoing education modules or re-examination every five years.