Last Updated: May 2025 | Reviewed by Abbie Jacobs
According to the ACNM, Virginia is one of the top 20 states in the U.S. for nurse-midwifery practice. 258 state-licensed CNMs oversee one out of every 20 births in the state. If you’re interested in becoming a certified nurse-midwife in Virginia, this comprehensive guide will walk you through the entire process from education to career opportunities.
In 2023, approximately 14% of births in Virginia were attended by midwives, according to the U.S. Department of Health & Human Services, Centers for Disease Control and Prevention, and the National Center for Health Statistics, showing continued growth in this vital healthcare field.
“My journey to becoming a CNM in Virginia was both challenging and immensely rewarding. The rigorous education prepared me for a career where I can truly make a difference in women’s lives. The clinical training at Virginia Hospital Center gave me hands-on experience that was invaluable. Now, as a practicing CNM in Richmond, I’m grateful for Virginia’s supportive environment for nurse-midwives and the collaborative relationships I’ve built with physicians and other healthcare providers.” – Sarah Thompson, CNM, Class of 2022, Shenandoah University
Understanding the CNM Designation in Virginia
In Virginia, Certified Nurse-Midwives are classified as Advanced Practice Registered Nurses (APRNs) and licensed as nurse practitioners through the Virginia Board of Nursing. This classification distinguishes CNMs from other midwifery designations and grants them significant practice autonomy.
It’s essential to understand how Virginia distinguishes between different types of midwives:
- Certified Nurse-Midwives (CNMs) – Hold a master’s or higher degree, national certification through the American Midwifery Certification Board (AMCB), and are licensed as nurse practitioners through the Virginia Board of Nursing. CNMs are exempt from supervisory requirements imposed on other midwives.
- Direct Entry Midwives (DEMs) – Have less formal education and training, generally have no nursing credentials, and cannot practice as midwives in any capacity without a certified medical professional present to oversee their work.
This distinction reflects the advanced training and qualifications of CNMs, positioning them as experts in facilitating births and providing gynecological and obstetric care throughout a woman’s life.
Steps to Become a Certified Nurse-Midwife in Virginia
These steps offer a clear path for Virginia RNs interested in becoming certified nurse-midwives, from education and national certification in nurse-midwifery to nurse practitioner specialty licensing as an accredited nurse-midwife through the Virginia Board of Nursing:
Step 1. Earn a Qualifying Master’s Degree or Higher in Nurse-Midwifery
To meet the requirements for national certification through the American Midwifery Certification Board (AMCB) and nurse practitioner licensure as a nurse-midwife through the Virginia Board of Nursing, registered nurses with licenses in good standing must complete a master’s or higher degree through a program recognized by the Accreditation Commission for Midwifery Education (ACME). While several flexible online master’s degree programs are available to accommodate working RNs, Shenandoah University is currently the only school physically located in Virginia with a qualifying ACME-accredited program.
Program Options for Aspiring Nurse-Midwives
| 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 |
Admission Requirements
Typical entry requirements for graduate programs in nurse-midwifery are similar to those of most graduate-level nursing programs nationwide. These often include:
- Letters of recommendation
- Current RN license in good standing
- Personal essay, video essay, or statement of purpose
- BSN or completion of nursing prerequisite courses
- GRE General Test (some programs waive this requirement)
- Minimum 3.0 GPA
- 1-2 years of clinical nursing experience (often in labor and delivery or women’s health)
Program Structure and Components
All ACME-accredited programs meet the ACNM requirements for taking the CNM certification exam. These include:
- 40-60 credits of didactic curriculum
- Specialized Midwifery courses requiring a minimum of 600 clinical hours and as many as 720
- The hours vary due to the unpredictable nature of birth
- Completion of an Evidence-Based Practice Project or thesis
Midwifery programs cover a variety of topics that encompass the general knowledge that an advanced practice nurse requires:
- Advanced Pharmacology and Therapeutics
- Advanced Pathophysiology
- Advanced Health Assessment
- Health Promotion and Disease Prevention
- Research Methods and Evidence-Based Practice
- Healthcare Policy and Ethics
Coursework specific to the major would typically include:
- Antepartum Care and Complications
- Intrapartum and Postpartum Care
- Women’s Reproductive Health
- Newborn Care
- Advanced Integrated Midwifery
- Primary Care for Women
- Multicultural Midwifery
- Legal Issues and Ethics in Maternal Healthcare
- Professional Issues in Nurse-Midwifery
While the classroom will encompass most of the theoretical discussion needed to prepare someone for a career in nurse-midwifery, clinical experience is required to transition into full practice. The Virginia Board of Nursing requires at least 720 hours of supervised residency under a licensed practitioner or APRN to qualify for licensure. An advisor will assist students of online programs with finding an appropriate clinical environment. Participating facilities in Virginia include:
- The Virginia Hospital Center, Arlington
- Sentara Norfolk General Hospital, Norfolk
- Carilion Roanoke Memorial Hospital, Roanoke
- Winchester Medical Center, Winchester
- Augusta Health, Fishersville
- University of Virginia Medical Center, Charlottesville
- VCU Medical Center, Richmond
Clinical observations will put students in direct contact with pregnant women and provide students with a first-hand look at women’s needs during the birthing process, including:
- Comprehensive antepartal care
- Prenatal care
- Applied obstetrics
- Ambulatory care
- Labor and delivery management
- Postpartum care
- Well-woman gynecology
- Primary care for women across the lifespan
Step 2. Successfully Complete the Exam for National Certification in Nurse-Midwifery
A master’s degree in midwifery qualifies candidates to sit for the AMCB National Certification Examination. The AMCB’s qualifications are subject to change at any time, and an up-to-date copy can be found here. As of May 2025, a candidate must uphold all of the following requirements to be eligible to take the exam:
- Maintain licensure as a Registered Nurse in one of the 50 states, a U.S. territory, or the District of Columbia
- Proof consists of a copy of licensure that is valid on the date of the examination
- Satisfactory completion of a graduate degree program that has met the institutional requirements prescribed by ACME
- Verification by the director of a nurse-midwifery program confirming that institutional requirements are met
- Attestation by the director of the nurse-midwifery program that the candidate is performing at the level of a safe, beginning practitioner
Applicants to the exam must apply within 24 months of completing their program. The application is available here. It can be completed online, but applicants may request a hard copy of the form to be submitted alongside their required credentials. Those required credentials include:
- Proof of licensure
- $550 examination fee
- $125 processing fee
- This fee is forfeited if an applicant’s exam needs to be rescheduled or if an applicant is late to their examination. In either event, the applicant will need to be reassessed.
- Your application (if a hard copy is submitted)
All of these materials should be submitted to:
AMCB
849 International Drive, Suite 120
Linthicum, MD 21090
Applicants will schedule their examination online through PSI Testing. In Virginia, there are testing centers available in:
- Alexandria
- Fredericksburg
- Norfolk
- Richmond
- Roanoke
- Charlottesville
Addresses and specific directions to these testing centers are available here.
Studying for and Passing the Exam
Candidates can use the Candidate Handbook as a study guide leading up to the exam. It features an overview of the exam as well as an overview of the topics that will be covered. These include:
- Antepartum: 19-26 percent
- Intrapartum: 17-26 percent
- Postpartum: 15-18 percent
- Newborn: 7-16 percent
- Well Women/Gyn: 15-18 percent
- Women’s Health/Primary care: 8-16 percent
The exam consists of approximately 175 multiple-choice questions, and candidates have four hours to complete it. A score of approximately 75% is needed to pass, though this can vary slightly with each administration. Results are typically available immediately after the examination is completed.
Step 3. Apply for Nurse Practitioner Licensure in Virginia as a Certified Nurse-Midwife
Upon successfully completing the exam and becoming certified, CNMs will be eligible to seek licensure as nurse practitioners specializing in nurse-midwifery in Virginia. The Virginia Board of Nursing offers two pathways for APRN licensure: examination (for new graduates) and endorsement (for those already licensed in another state).
Application by Examination
First-time APRN applicants in Virginia must apply through the examination pathway, which requires:
- Proof of licensure as a registered nurse in Virginia or proof of multistate licensure privilege
- A graduate degree in nursing with specialization as a nurse-midwife
- Submit evidence of current specialty certification (CNM certification)
- Submit a registration fee of $130
- Completion of an online application through the Virginia Board of Nursing website
Application by Endorsement
For CNMs already licensed in another state, Virginia offers an endorsement pathway, which requires:
- Verification of current licensure and good standing in another jurisdiction
- Proof of current AMCB certification
- Documentation of meeting Virginia’s practice requirements
- Payment of applicable fees
As nurse practitioners, CNMs can also pursue Authorization to prescribe to gain prescriptive authority. The application for Authorization to Prescribe is available through the Virginia Board of Nursing website. Requirements include:
- Completion of educational courses in pharmacology or pharmacotherapeutics equivalent to at least 30 contact hours
- Submission of a practice agreement that identifies the practice of the nurse practitioner
- Additional fee for prescriptive authority application
Financial Considerations and Fees
Becoming a CNM involves various financial investments beyond educational costs. According to the Virginia Board of Nursing fee schedule, prospective APRNs should anticipate:
- APRN application fee: $130
- Biennial APRN license renewal: $80 (plus $25 if late)
- License reinstatement (if needed): $150 ($200 after suspension or revocation)
- Duplicate license: $15
- Duplicate wall certificate: $25
- Transcript of application (if required): $35
- Returned check fee: $50
All fees must be paid by check or money order to the Treasurer of Virginia if submitted by mail or by credit/debit card for online payments. It’s important to note that all fees are nonrefundable, emphasizing the importance of ensuring application correctness and completeness.
Once the Virginia Board of Nursing grants nurse practitioner licensure, CNMs may begin practicing nurse-midwifery in the state. The process typically takes 30-45 days to receive a complete application package.
Step 4. Begin a Career as a Certified Nurse-Midwife in Virginia and Keep Credentials Current
Once licensed, CNMs in Virginia practice under the framework of advanced practice nursing. The Virginia Board of Nursing specifies:
- Minimum clinical practice requirements (720 supervised hours during education)
- Authorization to provide comprehensive women’s health care
- Practice agreement requirements with a licensed physician
- Ability to practice with greater autonomy than other midwife classifications
Virginia is home to several certified birth centers recognized by the Commission for the Accreditation of Birth Centers (CABC). These include New Life Birth Center in Rocky Mount and BirthCare & Women’s Health in Alexandria. It’s important to note that Virginia has specific regulations for facilities using the title “Birth Center,” and only CABC-accredited centers meet the national standards for quality and safety.
Hospitals, medical centers, and clinics that employ CNMs in Virginia include:
- Carilion Clinic, Blacksburg
- Mary Washington Healthcare, Stafford
- Planned Parenthood South Atlantic, Multiple locations
- University of Virginia Health System, Charlottesville
- Virginia Hospital Center, Arlington
- Sentara Norfolk General Hospital, Norfolk
- Carilion Roanoke Memorial Hospital, Roanoke
- Winchester Medical Center, Winchester
- Augusta Health, Fishersville
- Bon Secours Health System, Multiple locations
- Inova Health System, Northern Virginia
- VCU Health, Richmond
Keeping Nurse Practitioner Licensure Current through the Virginia Board of Nursing
Licensees will be required to renew their license every two years during the month of their birth, along with:
- $80 renewal fee
- Proof of continued CNM certification through AMCB
- Attestation of having met continuing competency requirements
Virginia requires that nurse practitioners complete at least 40 hours of continuing education during each two-year renewal period. For CNMs with prescriptive authority, at least 8 hours must be in pharmacology or pharmacotherapeutics.
If a license lapses, one of the following will be required for reinstatement:
- Completion of a minimum of three credit hours of post-licensure academic education relevant to nursing practice
- A board-approved refresher course in nursing
- Completion of a related, evidence-based research study
- Completion of publication as the author or co-author
- Teaching or developing a nursing-related course resulting in no less than three semester hours of college credit
- Teaching or developing nursing-related continuing education courses for up to 30 contact hours
- 15 contact hours of workshops, seminars, or conferences alongside 640 hours of active practice as a nurse
- 30 contact hours of workshops, seminars, conferences, or courses relevant to the practice of nursing
Keeping the CNM Credential Current through the American Midwifery Certification Board (AMCB)
All those who hold the CNM credential through the American Midwifery Certification Board (AMCB) must enroll in the AMCB’s five-year Certificate Maintenance Program. During each five-year renewal cycle, CNMs must complete one of the following:
- Re-take and pass the Certified Nurse-Midwife Examination
- Complete 20 hours of continuing education and three certificate maintenance modules
The AMCB certificate maintenance program ensures that CNMs stay current with best practices and advances in midwifery care. The AMCB website provides more information about specific requirements and acceptable continuing education activities.
Salaries for Certified Nurse-Midwives in Virginia
According to the U.S. Bureau of Labor Statistics, certified nurse-midwives in Virginia enjoy competitive salaries that reflect their advanced education and specialized skills. The median annual wage for CNMs in Virginia is $108,350 as of May 2023, above the national median for this profession.
The demand for nurse-midwives continues to grow in Virginia, with an expected occupational growth rate of 26% between 2022 and 2032. This growth rate is significantly higher than the average for all occupations in the state, just 15%. This positive job outlook reflects the increasing recognition of CNMs’ value to maternal and women’s healthcare.
Here is an overview of the salary data for nurse-midwives in Virginia by location:
| Location | Average | Entry-Level | Experienced |
|---|---|---|---|
| Statewide | $112,840 | $88,730 | $143,280 |
| Richmond Metropolitan Area | $118,230 | $92,150 | $149,640 |
| Virginia Beach-Norfolk-Newport News | $109,780 | $85,420 | $138,760 |
| Washington-Arlington-Alexandria | $120,940 | $95,320 | $152,870 |
| Charlottesville | $106,420 | $83,960 | $134,580 |
(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 CNM in Virginia
What is the difference between a Certified Nurse-Midwife (CNM) and a Certified Professional Midwife (CPM) in Virginia?
In Virginia, a Certified Nurse-Midwife (CNM) is an advanced practice registered nurse with graduate-level education in midwifery who is licensed through the Virginia Board of Nursing. CNMs can practice independently, prescribe medications with proper authorization, and work in various healthcare settings. A Certified Professional Midwife (CPM) is a direct-entry midwife with specialized training in out-of-hospital births but without nursing education. CPMs in Virginia have more restricted practice scopes and cannot work without physician supervision.
Can I complete a nurse-midwifery program online while living in Virginia?
Yes, there are several ACME-accredited nurse-midwifery programs that offer online didactic coursework with arranged clinical placements in your local area. While Shenandoah University is the only physical school in Virginia with an ACME-accredited program, Virginia residents can attend programs like Frontier Nursing University, Georgetown University, or Thomas Jefferson University online while completing clinical requirements at approved sites in Virginia.
What is the scope of practice for Certified Nurse-Midwives in Virginia?
CNMs in Virginia have a broad scope of practice that includes providing primary healthcare to women throughout their lifespan, with a special emphasis on pregnancy, childbirth, and gynecologic care. They can provide prenatal care, attend births in hospitals, birth centers, or homes, offer postpartum care, conduct well-woman exams, provide family planning services, treat common gynecological conditions, and prescribe medications with proper authorization from the Virginia Board of Nursing.
Do Certified Nurse-Midwives in Virginia need a collaborative agreement with a physician?
Yes, CNMs in Virginia currently need to establish a practice agreement with a licensed physician. However, this does not mean they work under direct supervision. The practice agreement outlines practice, consultation, and referral process parameters. Some restrictions on CNM practice have been relaxed in recent years as Virginia has moved toward more autonomous practice for advanced practice registered nurses.
How long does it take to become a Certified Nurse-Midwife in Virginia?
Becoming a CNM in Virginia typically takes 6-8 years of education and experience. This includes 2-4 years for a BSN, 1-2 years of nursing experience (recommended or required by most programs), and 2-3 years in a graduate nurse-midwifery program. The process may be shorter for those pursuing accelerated or bridge programs, or longer for those attending part-time while working.
If you’re interested in midwifery but want additional specialization options, consider exploring dual-focus nurse-midwife/women’s health NP programs. These programs prepare you for two APRN certifications and expand your career opportunities.
For a comprehensive list of all available programs nationwide, visit our guide to accredited nurse-midwife programs. These programs meet the national standards for midwifery education and prepare you for certification.
For more information about midwifery education and career paths, visit MidwifeSchooling.com, your comprehensive resource for becoming a certified nurse-midwife.