The practice of midwifery has long been at home among Utah’s Mormon population (nearly 60 percent and 2.8 million residents), and has thrived within a regulatory environment that supports and respects the autonomy of nurse-midwives. This is great news for RNs in Utah looking to advance their careers and enter advanced practice as certified nurse-midwives (CNM).
Nurse-midwives in many other states continue to bear the burden of restrictive legislation that prevents them from practicing to the full extent of their training without physician oversight. However, Utah remains an independent practice state where nurse-midwives practice independently without being required to hold a collaborative practice agreement with a physician.
Recent statistics from the American College of Nurse-Midwives reflect Utah’s supportive atmosphere for nurse-midwives. In 2015, there were 142 certified nurse-midwives practicing in Utah. In 2013 alone, certified nurse-midwives attended more than 4,000 childbirths in Utah, representing more than 10 percent of all vaginal births in the State that year.
Utah’s certified nurse-midwives are licensed as advanced practice nurses, and provide a full range of services to women of all ages and stages of life. In addition to caring for expectant mothers and attending childbirth, these healthcare leaders provide:
- Family planning services
- Reproductive education
- Gynecological checkups
- Preconception planning and care
- Treatment of sexually transmitted diseases
- Care of the newborn during the first 28 days of life
Steps to Becoming a Nurse-Midwife in Utah
RNs in Utah looking to advance their education and scope of practice to become certified nurse midwives (CNM) must meet the requirements for natiaonl certification through the American Midwifery Certification Board and CNM licensure through the Utah Department of Commerce-Division of Occupational and Professional Licensing (DOPL). This guide explains how:
|Earn a Qualifying Graduate Degree in Nurse-Midwifery|
|Take and Pass the National Certification Examination|
|Apply for Advanced Practice Licensure in Nurse-Midwifery|
|Explore Career Option in Utah and Keeping Credentials Current|
Step 1. Earn a Qualifying Graduate Degree in Nurse-Midwifery
Earning an certified nurse-midwife license in Utah starts by completing a graduate degree in nurse-midwifery accredited by the American Commission for Midwifery Education (ACME).
Schools that offer graduate degrees in nurse-midwifery often provide students with a number of options, such as:
- Part-Time/Full-Time Programs: While full-time ACME-accredited master’s degrees in nurse-midwifery take about two years to complete, part-time programs take about three years to complete. The slower pace of part-time programs is often the ideal choice for practicing RNs juggling education and full-time employment.
- Partially/Fully Online Programs: Many institutions offering nurse-midwifery programs offer them as partially or fully online programs, thus allowing students to complete the didactic component of their degree program from the comfort of their home. Online nurse-midwifery programs have become quite commonplace, given the lack of programs throughout the U.S. For example, there is just one program in Utah, located in Salt Lake City.
In addition to master’s degrees in nurse-midwifery, many students choose to complete dual specialization programs so as to achieve a greater foundation of knowledge in women’s health and expand their practice options. One of the most popular programs today is the nurse-midwifery/women’s health master’s degree. Upon graduating from this dual focus program, RNs may seek national certification as both a certified nurse-midwife (CNM) and a Women’s Health Nurse Practitioner (WHNP) and apply for advanced practice licensure in both specialties.
Graduates of these programs are eligible to take the necessary exams to earn either one or both national certifications:
- Certified Nurse-Midwife (CNM)
- Women’s Health Nurse Practitioner (WHNP)
Choosing the Right Program Based on Current Education
RNs who already possess a Bachelor of Science in Nursing (BSN) will complete a program structured as either a Master of Science in Nursing (MSN) in nurse midwifery or a Master of Science (MS) in Nurse Midwifery.
Those with an associate’s degree in nursing may enroll in ACME accredited RN-to-MSN programs to earn both their bachelor’s and qualifying master’s degree in one accelerated dual-degree program.
RNs in Utah that possess a Master of Science in Nursing (MSN) often pursue post-graduate certificates in nurse-midwifery so as to earn initial CNM licensure. Currently licensed Advanced Practice Registered Nurses (APRNs) may also seek post-graduate certificates to achieve initial CNM licensure.
Program Features and Structure
Programs in nurse-midwifery or nurse-midwifery/women’s health consist of two components: a didactic component and a clinical component, both of which provide students with the knowledge and skills required to deliver healthcare to women of all ages, including primary, prenatal, birth, newborn, and gynecological care.
The core of these programs includes study in:
- Advanced health assessment
- Advanced pharmacology
- Healthcare for women and primary care
- Antepartum care
- Intrapartum and postpartum care
- Newborn care
- Reproductive physiology
- Advanced pathophysiology
- Fetal evaluation
- Perspectives in nurse-midwifery
The clinical component of a nurse-midwifery program, which may consist of up to 1,000 hours of practice, includes placement in a full-continuum of nurse-midwifery practice sites, such as private practice, birth centers, hospitals, and community clinics, among others.
Clinical placements usually occur within a close proximity to the campus, with the exception of online programs. In this case, the institution usually partners with many clinical sites across the country, thereby allowing students to complete their clinical practicums in sites close to home.
Just a few of the sites in Utah where students may satisfy a portion of their clinical component include:
- McKay-Dee Hospital, Ogden
- MountainStar Maternal-Fetal Services of Utah, Millcreek
- Gardner Women’s Center, Salt Lake City
- Mark’s Women’s Health, Salt Lake City
Admission into a conventional master’s degree in nurse-midwifery requires a BSN and a valid and unencumbered RN license. Depending on the institution, students may also need to possess:
- Nursing experience
- Minimum undergraduate GPA
- Admissions essay
- Minimum GRE scores
Step 2. Take and Pass the National Certification Examination
Upon successfully graduating from a master’s degree in nurse-midwifery, RNs in Utah must take and pass the Certified Nurse-Midwife (CNM) examination through the American Midwifery Certification Board.
Graduates of a master’s degree in nurse-midwifery/women’s health may also choose to take and pass the Women’s Health Care Nurse Practitioner (WHNP) examination through the National Certification Corporation.
Before scheduling to take the exam(s), candidates must apply through the appropriate certifying board and receive approval to test. Once they receive the approval, they can schedule to take the exam(s) at any of the Applied Measurement Professionals (AMP) testing centers in the U.S. In Utah, there is an AMP testing center located in Salt Lake City.
Step 3. Apply for Advanced Practice Licensure in Nurse-Midwifery
RN candidates who have achieved the CNM designation may apply for initial CNM licensure with the Utah Department of Commerce-Division of Occupational and Professional Licensing (DOPL).
Candidates must complete the Certified Nurse Midwife application and return it to the DOPL, along with:
- A $100 application processing fee
- Official transcripts documenting the completion of an accredited nurse-midwife program (must be sent directly from the school to the DOPL)
- Proof of CNM designation
Note: Candidates seeking APRN licensure as a WHNP must complete a separate APRN Application and pay the $140 application fee.
Controlled Substance License
Candidates planning to administer, possess, or prescribe controlled substances must complete Page 3 of the application and submit an additional $100 application processing fee.
In addition to receiving the Utah Controlled Substance License, CNMs prescribing controlled substances must also register with the DEA.
Step 4. Explore Career Option in Utah and Keeping Credentials Current
CNMs in Utah must always ensure their CNM designation and CNM license in Utah are in good standing.
CNM License Renewal
All CNM licenses in Utah expire on January 31of even-numbered years. The cost of renewal for a CNM license in Utah is $63. CNMs may renew their license using a paper renewal form or the online renewal form.
CNMs with Controlled Substance licenses must complete the Certified Nurse Midwife Controlled Substance renewal form and pay a $141 renewal fee ($63 CNM renewal fee and $78 Controlled Substance renewal fee).
CNMs in Utah must maintain their CNM certification as a condition of renewal. CNMs in Utah with a controlled substance license must also complete at least 4 continuing education hours per licensing period, with at least 3.5 of these hours in one or more controlled substance prescribing classes and .5 hour for the completion of the online DOPL tutorial.
CNM Certification Renewal
CNMs complete their continuing education requirements by following The American Midwifery Certification Board’s Certification Maintenance Program, which requires completing one of the following options:
- Option 1: Complete at least 3 AMCB Certificate Maintenance Modules during each five-year certification cycle and at least 20 contact hours of approved continuing education units; pay annual fees
- Option 2: Retake the AMCB Certification Examination and pay the $500 examination fee in lieu of annual fees
WHNP Certification Renewal
The National Certification Corporation requires WHNPs to take a continuing competency assessment at the beginning of each three-year maintenance cycle and complete a specific number of continuing education credits hours based on their performance.
Resources for Nurse-Midwives in Utah
CNMs in Utah exploring opportunities in nurse-midwifery may look to large hospitals, small birth centers, or private practices, among others. Just a few Utah sites where nurse-midwives may find a number of professional prospects include:
- Utah Valley Women’s Center, Provo
- Avenue Women’s Center, Salt Lake City
- Jordan River Women’s Health, West Jordan
- Madsen Health Center – University of Utah Health Care, Salt Lake City
- American Fork Hospital Women’s Center, American Fork
- Salt Lake Regional Women’s Clinic, Salt Lake City
- Rocky Mountain Women’s Health Center, West Valley City
Recent job posts (sourced in December 2015) reveal that Utah is rich in professional opportunities for nurse-midwives. Although the following list is for illustrative purposes only, it does provide job seekers with an idea of the types of jobs they may find in Utah:
- Certified Nurse Midwife: University of Utah, Maternal-Fetal Medicine Division, Salt Lake City
- Certified Nurse Midwife: St. Mark’s Hospital, Salt Lake City
- Certified Nurse Midwife: Intermountain Healthcare, Salt Lake City
- Certified Nurse Midwife: U.S. Army Medical Recruiting Brigade
Nurse-midwives in Utah looking to open a birth center or start a private midwifery practice may find a wealth of information and assistance through state professional associations, such as:
- Utah Midwives Organization
- Utah Midwives Association
- Utah Nurses Association
- Utah Small Business Development Centers
- Utah Small Business Administration
Salaries for Certified Nurse-Midwives in Utah
In May of 2014, the United States Department of Labor, Bureau of Labor Statistics, published salary data that revealed the average midwife salary in Utah to be $81,870. The median salary was just 2.4% less at $79,910. It was noted that there was an approximate 56% difference in salaries among nurse-midwives just entering the field as compared to those with the most experience. The starting salary for nurse-midwives in Utah ranged between $42,370 and $46,790 that year, while the salary for experienced nurse-midwives ranged between $89,550 and $95,360.
Studies Reveal a Growing Interest in Nurse-Midwifery Among Women in Utah
In January of 2012, the National Center for Health Statistics (NCHS) Data Brief was published detailing the findings of a 19-year-long study (1990-2009) on home birthing trends in the United States. In the brief, it was revealed that Utah had the 4th highest percentage of at-home births in the United States with more than 1.5% of all births annually taking place in the home. In a separate publication, the National Vital Statistics Report from March of 2010, it was reported that the total percentage of out-of-hospital births in Utah between 2005 and 2006 was 1.73%, most of which were home births (1.25%). The remaining 0.46% of out-of-hospital births took place in freestanding birthing centers. The report also revealed that the occurrence of home births in Utah between 2003 and 2006 increased by 3.3%, which was just shy of the national increase of 3.5%.
Though most births still occur in traditional hospital settings, it’s important to recognize that within hospital systems midwives are equally involved in women’s healthcare. One study conducted and published by the Utah Department of Health in January of 2015 reported that certified nurse-midwives attended and delivered a total of 12,421 babies between 2010 and 2012. Approximately 95% of those births were attended in hospitals with the balance being home births (1.3%) and birth center births (3.7%). Here is a look at the percentage of out-of-hospital births to take place in Utah between 2010 and 2012 by county and/or region:
- Salt Lake County (including Salt Lake City, West Valley, West Jordan): 2.1%
- Utah County (including Provo): 3%
- Central Utah: 4.5%
- Southwest Utah: 6%
The prevalence of nurse-midwives in women’s healthcare in Utah, both in-hospital and out-of-hospital, is a good indicator of career potential for midwives in the state.
Career Outlook for Nurse-Midwives in Utah
The United States Department of Labor, Bureau of Labor Statistics, projects that the demand for nurse-midwives nationwide will increase by 31% in the 10-year period between 2012 and 2022. This national projection is expected to correlate to a positive employment outlook for nurse-midwives in Utah as well.
Another way to examine salary is to look specifically at job opportunities available for nurse-midwives in Utah. One salary site known as SimplyHired offers additional information on starting salary offers for job openings in December 2015 (shown for illustrative purposes only; not meant to suggest the availability of jobs or the assurance of employment):
- Intermountain Healthcare, Salt Lake City: $82,909
- University of Utah, Salt Lake City: $77,358 to $93,000