Nurse midwives were already making headlines in South Carolina by 1951. It was then that Life magazine featured nurse midwife Maude Callen in a photo essay, detailing her work as a primary care provider for women before, during, and after labor; and often over the course of their lifetimes. Life’s feature story helped bring attention to this dedicated specialist, and eventually a women’s clinic was opened in Callen’s name.
Since then more clinics have opened throughout the state as nurse midwifery has grown in popularity. In fact, the South Carolina Department of Employment and Workforce projects that the number of nurse-midwives in the state will increase by 36 percent over the ten-year period leading up to 2022 – significantly faster the national average growth rate for the nurse-midwifery profession.
With a growing preference for the more individualized, whole-person care that nurse midwives offer, more than four percent of expectant mothers in South Carolina choose to have nurse-midwives attend the birth of their children in 2013, and the proportions are continuing to shift towards CNM-attended births.
In 2014, South Carolina’s certified nurse-midwives, who are licensed as advanced practice registered nurses (APRN), earned an average annual salary of $80,440 compared to just $59,670 for RNs in the state (US Department of Labor).
Steps to Becoming a Certified Nurse-Midwife in South Carolina
The South Carolina Board of Nursing is responsible for issuing advanced practice registered nurse (APRN) licensure to qualified nurse-midwives.
In South Carolina, RNs with unencumbered licenses in good standing can complete these steps to become a certified nurse-midwife:
|Complete a Qualifying Graduate Program in Nurse-Midwifery|
|Pass the National Nurse-Midwife Certification Examination|
|Apply for an APRN License with the South Carolina Board of Nursing|
|Explore New Career Opportunities and Keep Credentials Current|
Step 1. Complete a Qualifying Graduate Program in Nurse-Midwifery
The South Carolina Board of Nursing requires its certified nurse-midwives (CNMs) to earn a master’s or higher degree in nurse-midwifery through a program that has been approved by the Accreditation Commission for Midwifery Education (ACME).
South Carolina residents have access to a number of ACME-accredited graduate programs in nurse midwifery throughout the country. Those who prefer not to relocate to other states can complete these programs online and maintain their work schedule while earning their degree.
Accredited graduate programs in nurse midwifery are increasingly offering students the option to pursue dual-specialization in women’s health. Graduating from an approved Nurse Midwife/Women’s Health Nurse Practitioner (NM/WHNP) program will fulfill the education requirements for candidates interested in earning dual certification and APRN licensure with recognition in both specialty areas.
Graduate Program Admission Requirements
Prospective graduate students will find admission standards for nurse-midwife graduate programs typically include:
- GRE General Test
- Personal essay, video essay, or statement of purpose
- Letters of recommendation
- Current RN license
- BSN or completion of nursing prerequisite courses
- Minimum GPA of 3.0
- Related work experience
While most applicants for nurse-midwife graduate programs hold a BSN, ACME also accredits RN-to-MSN bridge programs in midwifery for those who are enrolling with an associate’s degree in nursing.
Structure of a Graduate Program in Nurse Midwifery
Master’s programs in nurse-midwifery consist of two components:
- Didactic education – between 40-60 semester credits
- Clinical education – around 1,000 hours
Throughout didactic studies in nurse-midwifery, students will explore and master critical topics in the field:
- Complicated pregnancies and deliveries
- Integrated midwifery
- Nurse midwifery for the antepartum, intrapartum, and postpartum woman
- Advanced health assessments
- Legal issues and ethics in women’s health
- Pathophysiology and physiology
- Women’s reproductive health
- Midwifery in a multi-cultural environment
- Research methods for APRNs
- Pharmacotherapeutics – at least 45 hours required for prescriptive authority
Taking place within a hospital, university module lab, or other healthcare setting, students implement what they have learned in their didactic studies during their supervised clinical education. From an early stage, students completing their graduate degree online work with faculty advisors to identify locations throughout South Carolina where they can complete their clinical education. Colleges and universities are constantly striving to increase their clinical partnerships across the nation to maximize convenience and eliminate the need for students to relocate.
Examples of potential clinical locations in South Carolina can include:
- Lexington Medical Center in West Columbia
- Palmetto Health Baptist in Columbia
- Palmetto Health Baptist Parkridge in Columbia
- Palmetto Health Richland in Columbia
- Roper Saint Francis in Charleston
- Medical University of South Carolina (MUSC) in Charleston
- East Cooper Medical Center in Mount Pleasant
- Piedmont Medical Center in Rock Hill
Upon obtaining a master’s degree in nurse-midwifery or women’s health/nurse-midwifery, graduates can apply to take the national exams required to become certified nurse midwives or dually certified as nurse midwives/women’s health nurse practitioners.
Step 2. Pass the National Nurse-Midwife Certification Examination
The South Carolina Board of Nursing requires all CNMs to become nationally certified through the American Midwifery Certification Board (AMCB).
Graduates of dual-focus nurse midwife/women’s health nurse practitioner programs may opt to become nationally certified through the National Certification Corporation (NCC) to earn the Women’s Health Nurse Practitioner-Board Certified (WHNP-BC) credential. Choosing to do this will also qualify nurse-midwives to apply for an additional women’s health nurse practitioner license with the South Carolina Board of Nursing.
To become certified by one or both of these organizations, candidates must pass the appropriate exam after registering with the respective certifying body. Both exams are multiple-choice and computer-based. The AMCB and NCC require exam applicants to hold a current RN license.
After registering with the sponsoring organizations, candidates can sign up for a date, time, and location to take their exams with Applied Measurement Professional (APM). This company proctors both exams at H&R Block Centers in the cities of:
Certified Nurse Midwife Exam
Prospective nurse midwives can start preparing for this exam by reviewing the AMCB’s Candidate Handbook. The test itself is comprised of 175 questions that must be completed within four hours. The topics evaluated are:
- 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
Candidates can apply for the National Certification Examination in Nurse-Midwifery by sending an application to:
849 International Drive, Suite 120
Linthicum, MD 21090
Successful examinees will receive a Certificate in Nurse Midwifery (CNM) from the AMCB.
Women’s Health Care Nurse Practitioner (WHNP) Exam
Candidates who opt to take this exam can prepare by studying the NCC’s WHNP Candidate Guide. The exam is scheduled for three hours, comprised of 150 scored test questions, may contain up to 25 unscored pretest questions. The topics evaluated are:
- Gynecology – 35-40 percent
- Obstetrics – 25-30 percent
- Primary Care – 10-15 percent
- Diagnostic testing and physical assessment – 10-15 percent
- Pharmacology – 5-10 percent
Upon passing the exam candidates will earn the NCC’s WHNP-BC credential. Candidates can register for this exam online through the NCC’s website.
Step 3. Apply for an APRN License with the South Carolina Board of Nursing
With a specialized graduate education and national certification, candidates are ready to complete an APRN Application for Licensure as a nurse midwife with the South Carolina Board of Nursing (this can also be done online).
Nurse midwives who have completed a dual focus program in women’s health and earned the WHNP-BC credential through the NCC can complete an additional APRN application for licensure as a women’s health nurse practitioner.
Prospective nurse-midwives can check the progress of their application by looking themselves up on the South Carolina Department of Labor, Licensing, and Regulation’s license verification portal.
Supervising Physician Agreement
Included in the APRN application packet is a place to indicate the names of a supervising physician and a backup supervising physician. South Carolina law mandates that all APRNs must practice under the approximate supervision of a physician who specializes in the same area of practice, in this case an OB/GYN.
Nurse midwives and women’s health NPs in South Carolina can gain full prescriptive authority by completing these tasks:
- At least 45 hours of graduate education in pharmacotherapeutics
- A South Carolina Application for Prescriptive Authority – this includes a section that must be completed by a supervising physician
- Register with the DEA (Drug Enforcement Agency)
Step 4. Explore New Career Opportunities and Keep Credentials Current
The South Carolina Board of Nursing can issue an APRN license in as little as ten days after a complete application has been received. Once the license is active, CNMs can begin pursuing their career goals in nurse-midwifery.
CNMs who have just earned their APRN license will be excited to pursue a new career path with their current employer, the place where they completed their clinical education, or branch out to consider other employment options in smaller practices and birthing centers. Significant employers in South Carolina – and potential models for those who want to start their own practice – include the following:
- Lexington Medical Center’s Birth Center in West Columbia
- Palmetto Health’s Women’s Services and Birth Places in Columbia
- Roper Saint Francis’ Pregnancy and Newborn Care unit in Charleston
- Medical University of South Carolina (MUSC) pregnancy services in Charleston, Mount Pleasant, and North Charleston
- Piedmont Medical Center’s Women’s Tower in Rock Hill
- Charleston Birth Place in North Charleston
- Grand Stand Health’s Maternity Center in Charleston
Prospective CNMs and women’s health NPs can find examples of career paths by examining the following list of vacancies sourced from a statewide survey completed in December 2015. (Listings are provided here as illustrative examples only and do not constitute a job offer or assurance of employment):
- Certified Nurse Midwife with the Piedmont Gyn/Ob clinic in Rock Hill
- Certified Nurse Midwife Clinician with Planned Parenthood in Columbia
- Certified Nurse Midwife with Beaufort Memorial Hospital
- Nurse Practitoner at Riverside Women’s Care in Bluffton
- Nurse Midwife or Women’s Health NP at Palmetto Health Baptist Parkridge in Columbia
- Director of Nursing in Women’s Services at the East Cooper Medical Center in Mount Pleasant
Renewing the APRN License with the South Carolina Board of Nursing
All APRN licenses in South Carolina must be renewed by April 30th of even-numbered years. To renew, nurse-midwives will need to do one of the following:
- Maintain national certification with the AMCB (and maintain national certification with the NCC if also renewing a women’s health nurse practitioner APRN license)
- Complete 30 hours of board-approved continuing education (and an additional 30 hours if also renewing a women’s health nurse practitioner APRN license)
Prescriptive authority can be renewed if the nurse-midwife has completed twenty hours of board-approved continuing education in pharmacotherapeutics.
Maintaining National Certification with the American Midwifery Certification Board (AMCB)
Nurse midwives can maintain their certification with the AMCB by enrolling in its Certificate Maintenance Program. This program is completed on a five-year cycle through one of the following options:
- Retaking the National Certification Examination in Nurse-Midwifery
- Completion of three certificate maintenance modules and 20 hours of continuing education
Maintaining National Certification with the National Certification Corporation (NCC)
Women’s health NPs can maintain their WHNP-BC credential with the NCC by enrolling in its maintenance program. This is completed on a three-year cycle and requires attaining between 10 to 50 hours of continuing education. The amount of required hours depends on a candidate’s score on the requisite Continuing Competency Assessment.
Salaries for Certified Nurse-Midwives in South Carolina
Data published by the South Carolina Department of Employment and Workforce found that the median salary among nurse-midwives in South Carolina was $80,970 as of 2014. The starting salary among nurse-midwives was 34% less than the median that year at $53,370. Experienced nurse-midwives were reported to earn an average of $93,970, which was 43% more than the average starting salary and 13.8% more than the median in 2014.
Factors Contributing to Job Growth for Certified Nurse-Midwives in South Carolina
In 2012, the South Carolina Department of Employment and Workforce published projections showing that the number of nurse-midwives licensed in the state would likely increase by 32% between 2012 and 2022. The average 10-year growth rate of most other occupations throughout the state is just 11%, revealing an expected demand for certified nurse-midwives that is nearly three times greater than what is expected for most other occupations.
In 2012, the Greenville Health System opened the Greenville Midwifery Care & Birth Center. The recent addition of in-hospital nurse-midwifery services offers women more choice and control over their gynecologic and obstetric needs. This also offers nurse-midwives even more opportunities to practice under the umbrella of a larger healthcare system.
According to a 2015 article in The Post and Courier, approximately 50,000 babies are born in South Carolina each year, and about 2% of those births are either home births or take place in independent birthing centers. Though the vast majority of nurse-midwives work in hospital obstetric centers, a number also work in birthing centers and attend home births. Though there are very few out-of-hospital births in South Carolina when compared to in-hospital births, nurse-midwives attend virtually all deliveries that take place outside of the conventional hospital setting.
An Analysis of Nurse-Midwife Salaries in South Carolina According to Location
The average salary for nurse-midwives in South Carolina in 2013, according to the American College of Nurse-Midwives, was $82,010. Data reported by the South Carolina Department of Employment and Workforce in 2014 indicated that the median salary among nurse-midwives in South Carolina was $80,970.
In the Charlotte-Gastonia-Concord area, the median salary was reported to be $65,890, nearly 19% less than the statewide median. However, the starting salary for CNMs in this area was slightly higher than the statewide average starting salary for this profession.
- Starting: $53,370
- Median: $80,970
- Experienced: $93,970
- Starting: $54,020
- Median: $65,890
- Experienced: $75,500
A survey of job openings for certified nurse-midwives in South Carolina performed in December 2015 also reveals some insight into starting salary offers for CNMs in different parts of the state. SimplyHired’s salary aggregation methodology relies on current job opportunities rather than a continuous averaging of salaries, as the South Carolina Department of Employment and Workforce does. The figures shown here represent the average starting salary offers for CNMs as published by SimplyHired in December 2015:
- Columbia: $71,000
- Charleston: $70,000
- Greenville: $70,000