Last Updated: May 2025 | Reviewed by Abbie Jacobs
Learning how to become a nurse-midwife in Pennsylvania involves completing specific education, certification, and licensing requirements that prepare you for this rewarding healthcare career. The demand for certified nurse-midwives (CNMs) continues to grow as more women throughout Pennsylvania choose them for personalized care during pregnancy and comprehensive women’s health services. According to the American College of Nurse-Midwives (ACNM), nurse-midwifery care is associated with numerous benefits, including decreased rates of low birth weight and fewer costly, unnecessary, and invasive procedures like episiotomies and C-sections.
According to the U.S. Bureau of Labor Statistics, Pennsylvania’s 450+ certified nurse-midwives earned an average annual salary of $112,840 as of 2024. The Pennsylvania Department of Health reports that over 16.2% of births in Pennsylvania were attended by midwives in 2023, reflecting a steady increase from previous years.
This growing trend demonstrates the increased preference for nurse-midwife care across the state. While most CNMs work in hospital obstetric departments, other nurse-midwifery practice models include freestanding birth centers, women’s health clinics, and home birthing services.
“Completing my nurse-midwifery education at the University of Pennsylvania was transformative. The program’s rigorous curriculum and clinical experiences throughout Philadelphia’s diverse healthcare settings prepared me to provide compassionate, evidence-based care to women across all stages of life. Since graduating in 2022, I’ve been practicing at a birth center in Lancaster County where I’ve attended over 150 births. The demand for midwifery services continues to grow as more families seek personalized, holistic care.”
— Melissa Thornton, CNM, MSN, Graduate of Penn Nursing’s Nurse-Midwifery Program
Since 1978, Lifecycle WomenCare in Bryn Mawr has provided women’s health services, including labor and delivery, gynecological care, contraception, breastfeeding services, menopausal care, and education on women’s health topics. At this facility, a team of certified nurse-midwives works alongside women’s health nurse practitioners, registered nurses, and additional qualified healthcare professionals to provide comprehensive care.
Steps to Becoming a Certified Nurse-Midwife in Pennsylvania
The Pennsylvania State Board of Nursing is responsible for licensing nurse-midwives. To earn a nurse-midwife license, candidates must hold an active Pennsylvania RN license and complete the following steps:
Step 1. Complete a Graduate Program in Nurse-Midwifery
The first step toward earning the certified nurse-midwife (CNM) credential through the American Midwifery Certification Board (AMCB) and qualifying for state licensure as a nurse-midwife through the Pennsylvania State Board of Nursing is to earn a master’s or higher degree in nurse-midwifery from a program approved by the Accreditation Commission for Midwifery Education (ACME).
There are two ACME-accredited schools with campus locations in Philadelphia. Several other ACME-accredited schools offer Pennsylvania residents the opportunity to enroll in online graduate degree programs in nurse-midwifery. Online programs provide the additional advantage of allowing nurses to maintain their current employment while completing their studies according to a flexible schedule.
Graduate programs in nurse-midwifery often offer students the option for a dual specialization in women’s health. Graduating from one of these Nurse Midwife/Women’s Health Nurse Practitioner (NM/WHNP) programs fulfills the education requirements for national certification and state licensure in both specialty areas.
Program Options for Pennsylvania Nurses
| Program Type | Designed For | Typical Duration |
|---|---|---|
| MSN/MS Programs | RNs with Bachelor of Science in Nursing (BSN) degrees | 2-3 years full-time |
| RN-to-MSN Programs | RNs with associate’s degrees in nursing | 3-4 years full-time |
| Post-Graduate Programs | RNs with an MSN wanting to add CNM certification | 1-2 years full-time |
| DNP Programs | RNs seeking the highest level of clinical preparation | 3-4 years full-time |
Graduate Admission Standards
Standard admission requirements for nurse-midwife graduate programs include:
- Active, unencumbered RN license
- Bachelor of Science in Nursing (BSN) or completion of nursing prerequisite courses
- Minimum GPA (typically 3.0 or higher)
- Letters of recommendation from professional references
- Personal essay or statement of purpose
- Resume documenting clinical experience (some programs require 1-2 years)
- GRE scores (required by some programs)
- Interview (for competitive programs)
Although most applicants to nurse-midwife graduate programs hold a BSN, ACME accredits RN-to-MSN bridge programs in midwifery for those with associate’s degrees in nursing. These RN-to-MSN bridge programs result in a bachelor’s and master’s degree in nurse-midwifery, all in one accelerated program that can usually be completed in about three years.
Structure of the Graduate Program
A nurse-midwifery graduate program can be broken into two primary components, which may be completed concurrently:
- Didactic education – approximately 40-60 semester credits
- Clinical education – between 600-1,000 hours (more for dual-focus programs)
Didactic Education
The didactic education component covers vital topics and theory that nurse-midwives will use to provide effective antepartum, intrapartum, and postpartum care:
- Advanced health assessment techniques
- Advanced physiology and pathophysiology
- Psychology for pregnancy and maternal health
- Female reproductive health across the lifespan
- Labor, birth, and newborn care procedures
- Management of complicated pregnancies and deliveries
- Advanced integrated midwifery
- Maternal and infant biostatistics and epidemiology
- Culturally-sensitive and inclusive midwifery practices
- Legal issues and ethics in maternal healthcare
- Advanced pharmacology – at least 45 hours of coursework is required for prescriptive authority in Pennsylvania
- Research methods and evidence-based practice
- Healthcare policy and advocacy
Clinical Education
Students apply their didactic knowledge during the clinical portion of their education. Online students work closely with faculty advisors from their nursing college to identify clinical sites at local facilities throughout Pennsylvania. Nursing schools offering online programs continue to develop clinical partnerships with hospitals and other healthcare providers nationwide to minimize commuting and relocation requirements.
Examples of potential clinical sites located in Pennsylvania include:
- Einstein Medical Center with locations in Philadelphia, Elkins Park, and East Norriton
- Saint Luke’s University Health Network in Bethlehem and Allentown
- University of Pennsylvania Medical Center in Erie
- Jefferson University Hospital in Philadelphia
- Pennsylvania Hospital in Philadelphia
- Lehigh Valley Hospital in Allentown
- Moses Taylor Hospital in Scranton
- Reading Hospital
- Penn Medicine Birth Centers
- The Birth Center at Lifecycle WomenCare in Bryn Mawr
- The Midwife Center for Birth and Women’s Health in Pittsburgh
Step 2. Pass the National Nurse-Midwife Certification Exam
With a master’s degree in nurse-midwifery or women’s health/nurse-midwifery, RNs can apply to take the national exams required to become certified nurse-midwives or dually certified as nurse-midwives/women’s health nurse practitioners through the respective organizations:
- American Midwifery Certification Board (AMCB), sponsor of the Certificate in Nurse-Midwifery (CNM)
- National Certification Corporation (NCC), sponsor of the Women’s Health Care Nurse Practitioner (WHNP-BC) credential
Certification candidates can register for national exams directly through the appropriate sponsoring agency. Exam candidates may then register with testing centers for a date, time, and location. The AMCB certification exam is now administered online through a remote proctoring system, allowing candidates to take the exam from home. The NCC continues to administer exams at testing centers throughout Pennsylvania, including locations in:
- Harrisburg
- Philadelphia (multiple locations)
- Pittsburgh
- Allentown
- Erie
- Scranton
Certified Nurse-Midwife Exam
Prospective nurse-midwives can prepare for this exam by reviewing the AMCB’s Candidate Handbook. The exam is comprised of 175 questions with four hours allowed for completion. The topics evaluated are:
| Exam Content Area | Percentage of Questions |
|---|---|
| Antepartum care | 19-26% |
| Intrapartum care | 17-26% |
| Postpartum care | 15-18% |
| Gynecology | 15-18% |
| Women’s health and primary care | 8-16% |
| Newborn care | 7-16% |
Successful examinees will receive a Certificate in Nurse-Midwifery (CNM) from the AMCB. The current examination fee is $500, and candidates can apply for the National Certification Examination in Nurse-Midwifery by applying to:
AMCB
849 International Drive, Suite 120
Linthicum, MD 21090
Women’s Health Care Nurse Practitioner (WHNP) Exam
Candidates can prepare for this exam by studying the NCC’s WHNP Candidate Guide. The exam comprises 150 scored test questions, plus up to 25 unscored pretest questions. Three hours are allowed for completion, and subjects covered on the test are:
| Exam Content Area | Percentage of Questions |
|---|---|
| Gynecology | 35-40% |
| Obstetrics | 25-30% |
| Primary Care | 10-15% |
| Diagnostic testing and physical assessment | 10-15% |
| Pharmacology | 5-10% |
Upon passing the exam, nurses will earn the NCC’s WHNP-BC credential. The current examination fee is $325, and candidates can register for this exam online through the NCC’s website.
Step 3. Apply for a Nurse-Midwife License with the Pennsylvania State Board of Nursing
Once the education and national certification requirements have been met, nurse-midwife licensure applicants may submit a Nurse-Midwife License Application to Pennsylvania’s State Board of Nursing. As of 2025, the initial application fee is $50.
Those who have earned the Women’s Health Care Nurse Practitioner-Board Certification credential may also apply for women’s health NP recognition with Pennsylvania’s State Board of Nursing by submitting the Certified Registered Nurse Practitioner License in Women’s Health Application.
Applications may be submitted to:
State Board of Medicine
PO Box 2649
Harrisburg, PA 17105-2649
Applicants for either one or both licenses can apply online through the Pennsylvania Board of Nursing Online Application Portal.
Pennsylvania also requires nurse-midwives to complete at least 3 hours of Board-approved continuing education in child abuse recognition and reporting as part of the initial licensure requirements.
All nurse-midwives and women’s health NPs must maintain medical professional liability insurance as Pennsylvania law requires.
Collaborative Agreement
Pennsylvania’s certified nurse-midwives must establish a collaborative agreement with a physician or physician group and register this agreement with the Board of Nursing. The physician or physician group must also specialize in midwifery and have hospital privileges. A collaborative agreement form is included in the nurse-midwife license application.
Nurse practitioners are not required to enter into a collaborative agreement.
Prescriptive Authority
Nurse-midwives and women’s health NPs can apply for prescriptive authority. To earn this, candidates must complete the following:
- Complete at least 45 hours of classes in advanced pharmacology
- Complete the appropriate application(s) with the State Board of Nursing:
- Register with the Drug Enforcement Agency (DEA)
Nurse-midwives and women’s health NPs must enter into a prescriptive collaborative practice agreement with a supervising physician who practices in their area of expertise (midwifery or women’s health). This agreement is contained within each professional’s respective application packet.
Step 4. Explore Career Opportunities and Maintain Credentials
Applicants can check the Pennsylvania Department of State’s online license verification portal to determine when their license has been approved.
Upon becoming licensed, nurse-midwives may be interested in pursuing advanced career opportunities at their current employment or where they completed their clinical education.
Examples of significant employers and clinic models in the field of nurse-midwifery from throughout Pennsylvania include:
| Practice Setting | Employer Examples |
|---|---|
| Hospital-Based Services |
|
| Birth Centers |
|
| Women’s Health Clinics |
|
| Private Practice |
|
The following job listings were taken from a March 2025 survey of job vacancy announcements in Pennsylvania. (These are provided as illustrative examples only and should not be interpreted as a job offer or assurance of employment):
- Certified Nurse-Midwife with WellSpan Health in Gettysburg
- Certified Nurse-Midwife with the Allegheny Health Network in Pittsburgh
- Women’s Health NP with WellSpan Health Services in Lancaster
- Nurse-Midwife with the Reading Health System in West Reading
- Women’s Health NP at the Saint Mary Medical Center in Langhorne
- Certified Nurse-Midwife with Conemaugh Health System in Johnstown
- Certified Nurse-Midwife with the Pocono Health System in East Stroudsburg
- Full-time CNM for Penn Medicine Women’s Health in Philadelphia
- CNM Faculty Position at the University of Pennsylvania School of Nursing
Maintaining Licensure with the State Board of Nursing
Pennsylvania’s State Board of Nursing has different license maintenance requirements for different medical professionals:
- Nurse-Midwives – licenses expire on December 31 of even-numbered years; must maintain national certification with the AMCB
- Women’s Health NPs – licenses expire every two years on October 31; 30 hours of board-approved continuing education required for renewal (the NCC is a board-approved provider of continuing education)
Renewing Prescriptive Authority with the State Board of Nursing
Nurse-midwives and women’s health NPs who choose to renew their prescriptive authority must do so before their license expires. To complete the renewal process, candidates must earn 16 hours of continuing education in advanced pharmacology.
Renewing National Certification with the American Midwifery Certification Board (AMCB)
CNMs need to enroll in the AMCB’s five-year Certificate Maintenance Program to maintain their certification. During each five-year renewal cycle, CNMs must complete one of the following:
- Certified Nurse-Midwife re-examination
- Completing 20 hours of continuing education and three certificate maintenance modules
All certificate holders must also maintain an active RN license and complete two modules on midwifery history and racial disparities in maternal care.
Renewing National Certification with the National Certification Corporation (NCC)
Those with the WHNP-BC credential can renew their certification by completing the NCC’s three-year maintenance program. This involves taking the Continuing Competency Assessment and, based on the results, completing between 10-50 hours of continuing education.
Pennsylvania’s State Board of Nursing also accepts continuing education sponsored by the NCC for state license renewal purposes.
Salaries for Certified Nurse-Midwives in Pennsylvania
In 2024, the U.S. Bureau of Labor Statistics reported that Pennsylvania’s average salary for nurse-midwives was $112,840. The average starting salary for those new to the field was approximately $85,210, while the most experienced nurse-midwives earned an average of $146,370 annually.
Positive Growth Trends in Nurse-Midwifery
The Centers for Disease Control and Prevention’s National Vital Statistics System reported that Pennsylvania has consistently ranked among the top states for out-of-hospital births. As of 2023, approximately 2.1% of all deliveries in the state occurred at home or in birthing centers, steadily increasing from the 1.61% recorded in earlier years.
Statistics show a positive trend toward less invasive midwife-attended births, and career opportunities for nurse-midwives in hospital obstetric departments, birthing centers, and independent private practices are expected to remain strong throughout Pennsylvania.
The Bureau of Labor Statistics estimates that the demand for nurse-midwives will increase by 11.2% nationally during the 10 years between 2022 and 2032. According to the Pennsylvania Department of Labor & Industry, the projected growth for nurse-midwives in Pennsylvania from 2022 to 2032 is 10.3%, slightly lower than the national average but still representing strong professional growth.
Nurse-Midwife Salaries in Pennsylvania by Metropolitan Area
According to 2024 BLS data, Reading is the highest-paying area for nurse-midwives at the entry level in Pennsylvania, while Lancaster offers the highest compensation for experienced nurse-midwives.
| Metropolitan Area | Entry-Level | Average | Experienced |
|---|---|---|---|
| Lancaster | $82,950 | $116,490 | $151,620 |
| Philadelphia-Camden-Wilmington | $81,370 | $113,580 | $148,340 |
| Pittsburgh | $88,930 | $107,460 | $127,810 |
| Reading | $91,670 | $121,530 | $147,280 |
| Allentown-Bethlehem-Easton | $84,310 | $109,780 | $142,660 |
(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 May 2025.)
Frequently Asked Questions about Becoming a Nurse-Midwife in Pennsylvania
How long does it take to become a certified nurse-midwife in Pennsylvania?
The total time to become a CNM in Pennsylvania typically takes 6–8 years of education and training. This includes: 2–4 years to earn a BSN (or ADN plus RN-to-BSN program), 0–2 years of clinical nursing experience (required by some graduate programs), and 2–3 years to complete a graduate nurse-midwifery program. After completing educational requirements, candidates must pass the national certification exam and apply for Pennsylvania state licensure, which typically takes 2–3 months.
Do nurse-midwives in Pennsylvania need a collaborative agreement with a physician?
Yes, Pennsylvania law requires certified nurse-midwives to establish a collaborative agreement with a physician or physician group specializing in midwifery with hospital privileges. This agreement must be registered with the State Board of Nursing as part of the licensure process. Additionally, CNMs seeking prescriptive authority must enter into a separate prescriptive collaborative practice agreement with a supervising physician who practices midwifery.
What is the average salary for a nurse-midwife in Pennsylvania?
According to the U.S. Bureau of Labor Statistics, the average annual salary for certified nurse-midwives in Pennsylvania is $112,840 as of 2024. Entry-level CNMs earn approximately $85,210, while experienced nurse-midwives can earn up to $146,370. Salaries vary by location, with metropolitan areas like Reading ($121,530) and Lancaster ($116,490) offering higher average compensation than other regions in the state.
Can I complete my nurse-midwifery education online while living in Pennsylvania?
Pennsylvania residents can complete the didactic portion of their nurse-midwifery education through online ACME-accredited programs. However, clinical requirements must still be completed in person at approved healthcare facilities. Many online programs help students arrange clinical placements at locations throughout Pennsylvania, including hospitals, birth centers, and women’s health clinics. This hybrid approach allows students to maintain their current employment while pursuing their education. Several ACME-accredited schools offer distance learning options accessible to Pennsylvania residents.
What continuing education requirements must nurse-midwives meet in Pennsylvania?
Nurse-midwives in Pennsylvania must maintain their national certification with the AMCB, which requires completing the five-year Certificate Maintenance Program. This involves taking the recertification exam or completing 20 hours of continuing education plus three certificate maintenance modules. For Pennsylvania license renewal, which occurs biennially (every two years) on December 31 of even-numbered years, CNMs must also maintain their RN license. Those with prescriptive authority must complete 16 hours of continuing education in advanced pharmacology during each renewal cycle. Additionally, all healthcare providers must complete at least 2 hours of continuing education in child abuse recognition and reporting for license renewal.