Of the 11,018 certified nurse midwives practicing in the United States, only 40 CNMs were licensed to practice in West Virginia as of 2012 according to the American Midwifery Certification Board. However, the Health Resources and Services Administration (HRSA) has reported that the number of nurses earning master’s degrees in the US has increased by about 60% from 2007 to 2011, leaving ample room for growth in the nurse-midwifery profession.
The rising number of RNs pursuing CNM recognition in West Virginia is recognized as key to making perinatal and gynecological care more accessible to women residing in the 53 medically underserved areas in the state designated as health professional shortage areas (HPSA) as of 2011.
More than half of West Virginia’s CNMS work for primary care physicians or in hospital obstetrics units, while nearly as many find employment in birth centers and women’s clinics, or establish independent practices of their own. As advanced practice registered nurses (APRN) licensed through the West Virginia Board of Examiners for Registered Professional Nurses, CNMs in the state are required to obtain written collaborative agreements with supervising physicians that must be kept on file with the board.
CNMs provide advanced care to women and newborns, embracing a holistic approach to antepartum, intrapartum and postpartum care, reproductive care and women’s health. The West Virginia Nurses’ Association recognizes CNMs as being key to providing comprehensive women’s healthcare services to lower income residents, who all too often have a higher risk of complications during pregnancy.
Steps to Becoming a Nurse-Midwife in West Virginia
RNs in West Virginia interested in becoming certified nurse midwives must meet all requirements for advanced practice registered nurse (APRN) licensure through the West Virginia Board of Examiners for Registered Professional Nurses. The steps in this guide provide detailed instructions on how to become a nurse-midwife in West Virginia:
Step 1. Earn a Master’s Degree or Higher in Nurse Midwifery
The first step to becoming a certified nurse midwife in West Virginia is to earn a master’s degree in nurse-midwifery through one of the online or campus-based schools accredited by the Accreditation Commission for Midwifery Education (ACME).
Bachelor’s prepared RNs are qualified to enroll into conventional master’s programs, while RNs holding an associate’s degree are eligible to enroll in bridge programs (RN-to-MSN), which offer students the opportunity to earn both a BSN and MSN at the same time.
Master’s programs in nurse-midwifery are divided into classroom study and clinical hours, and will usually involve 40-60 semester hours and 700-1000 clock hours for clinicals.
ACME provides a list of accredited nursing programs throughout the country, which are offered in three different formats:
- Traditional study on a physical campus
- Partial distance learning
- Fully online programs
For students enrolling in partial distance and fully online programs, coursework is completed online while clinical hours are completed in local hospitals and clinics that are geographically accessible to students in West Virginia.
In order to be accepted into these programs, most ACME accredited schools require:
- A BSN (not required for bridge programs)
- RN license
- Minimum 1 year of practicing experience as an RN
- Minimum GPA
- Personal statement
- Letters of recommendation
Some master’s programs offer additional areas of emphasis, which can include women’s health, family nurse practitioner, nursing administration, and psychiatric mental health. Master’s in nurse midwifery/women’s health nurse practitioner (NM/WHNP) are among the most popular dual emphasis programs for nurse midwives. A dual certification program allows students the option take the WHNP exam and gain certification as a women’s health nurse practitioner in addition to earning the CNM credential. WHNPs often serve as primary care providers in addition to providing general gynecological care and support through labor and delivery.
Classroom study for a master’s program in nurse-midwifery might include:
- Comprehensive Antepartum Care
- Comprehensive Perinatal Care
- Roles and Issues in Advanced Practice
- Advanced Pharmacology and Therapeutics
- Advanced Concepts in Physiology & Pathophysiology
Dual certification NM/WHNP classes might include:
- Well Woman Health Care
- The Childbearing Family
- Primary Care for Women
- Health Promotion
For all nurse-midwife and NM/WHNP programs, clinical hours will be logged in a variety of in-patient, out-patient settings by working with patients in antepartum, intrapartum, and postpartum stages of labor and delivery.
Online programs are the preferred format for working RNs in West Virginia and other states where no campus-based programs are available. Online and hybrid distance learning programs accredited by ACME are available through six schools throughout the country.
Through distance learning, students will complete courses online while logging clinical hours in West Virginia. Students of hybrid programs are required to physically visit the school two weeks out of the semester for intensive courses.
Step 2. Register for and Pass the National Certification Examinations
After earning a qualifying master’s degree or higher, candidates would be eligible to sit for the Certification Examination in Nurse-Midwifery through the American Midwifery Certification Board and earn the CNM credential. Graduates of dual focus NM/WHNP programs can also take the Women’s Health Nurse Practitioner Certification Exam through the National Certification Corporation. Both exams allow candidates to apply for Advanced Practice Registered Nurse (APRN) licensure through the West Virginia RN Board.
Candidates register for either one or both exams online through Applied Measurement Professionals (AMP) and will receive a date and time to take the exam at an AMP testing center in Dunbar, West Virginia.
Certified Nurse Midwife Certification
The CNM certification is offered through the American Midwifery Certification Board (AMCB). The AMCB provides a candidate handbook to clarify eligibility requirements, additional information on applying for certification, tips on computer-based testing, and information on keeping certification current. Applicants are required to take the exam within 24 months of completing a nurse-midwifery program.
Students take the exam on a computer with a four-hour time limit. The test is divided into six categories of questions:
- Well Woman/Gynecology
- Women’s Health/Primary Care
American Midwifery Certification Board (AMCB)
849 International Drive, Suite 120
Linthicum, Maryland 21090
With the application, candidates must include:
- A $500.00 examination fee
- A copy of the candidates’ RN certification
- A signed letter from the program director confirming completion of midwife program
Nurses who pass this exam will earn certification as a Certified Nurse Midwife.
Women’s Healthcare Nurse Practitioner Certification
The WHNP certification is offered through the National Certification Corporation and is intended for those students who have completed an MSN with a dual emphasis in nurse-midwifery and women’s health.
The test is divided into five categories of questions:
- Primary Care
- Diagnostic testing and physical assessment
Nurses who pass this exam will earn certification as a Women’s Health Nurse Practitioner.
Step 3. Apply for Advanced Practice RN Licensure through the West Virginia RN Board
Candidates can apply for their APRN license as a certified nurse midwife and/or women’s health nurse practitioner online through the West Virginia Board of Examiners for Registered Professional Nurses.
After submitting the initial information online, candidates must print the application and send it along with:
- Transcripts from an ACME approved APRN program
- Verification of certification
- $35 Application fee
Mail the application and included documents to:
West Virginia West Virginia Board of Examiners for Registered Professional Nurses
101 Dee Drive, Suite 102
Charleston, WV 25311-1620
Step 4. Start Practicing as a Certified Nurse Midwife and Keep Credentials Current
Once CNMS and WHNPs have received their certification from the West Virginia RN Board, they are qualified to begin practice in the state. However, APRN licensure as well as CNM and WHNP certifications must be maintained on a regular cycle to ensure compliance with West Virginia statutes.
APRN Certification Maintenance
APRN certification must be renewed every two years. The renewal application is available online between May 1st and June 30th.
In order to renew, applicants must have completed 24 contact hours, with 12 hours in pharmacotherapeutics and 12 hours in the clinical management of patients.
Applicants will submit an application online and send hard copies of required documents to the WV RN board. To renew, applicants must send:
- Copies of continuing education requirement certificates
- Renewal fee of $35
- Completed verification of collaborative relationship form
- Official verification of national certification sent directly to the WV RN Board from your certifying body
Mail required documents to:
West Virginia Board of Examiners for Registered Professional Nurses
101 Dee Drive, Suite 102
Charleston, WV 25311-1620
CNM Certification Maintenance
CNMs have two options involving certification maintenance:
- Complete continuing education credits over a five year certification cycle
- Retake the AMCB certification exam on the fourth year of the cycle
If CNMs choose to complete continuing education credits rather than retaking the certification exam, the credits are offered by the AMCB in three modules: the IP, AP and GYN modules. Over the five year cycle, CNMs will complete all three modules online as evidence of certification maintenance. Modules are graded and documented at the time of completion.
WHNP Certification Maintenance
The WHNP certification must be maintained every three years or it will expire. WHNP certified nurses are required to obtain specific hours of continuing education every three years as outlined by the National Certification Corporation.
Core certification maintenance costs $100. The NCC allows holders of the WHNP certification to create a continuing education plan through their website. By using the NCC tools, CNMs will be able to track their progress in completing continuing education units. The educational requirements vary individually based on plan.
Job Opportunities in West Virginia for CNM/WHNPs
Newly certified CNMs and WHNPs can find employment in many different settings in West Virginia, from large hospitals to OB/GYN offices to independent women’s health clinics and birthing centers.
A few examples of hospitals and clinics in West Virginia are located below (examples shown for illustrative purposes only):
- CAMC Women and Children’s Hospital (Charleston, WV)
- Camden Clark Medical Center (Parkersburg, WV)
- Women’s Health Center of West Virginia (Charleston, WV)
- WomenCare Birth Center (Hurricane, WV)
- Greenbrier Birthing Center (Hillsboro, WV)
- FamilyCare Health Center (Scott Depot, WV)
Examples of positions offered in West Virginia in December 2015 include:
- RN OB/GYN at WVU Healthcare (Morgantown, WV)
- Advanced Nurse Practitioner at Med Express (Beckley, WV)
- Advanced Nurse Practitioner at Med Express (Vienna, WV)
Salaries for Certified Nurse-Midwives in West Virginia
The West Virginia Department of Commerce reported that nurse midwives earned an average salary of $97,492 as of 2015. Nurse midwives in West Virginia with the greatest amount of experience earned an average of $104,048. In contrast, nurse midwives in West Virginia new to the field earned an average starting salary of $84,380.
As of 2013, there were 136 certified nurse-midwives licensed to practice in West Virginia according to the American Association of Colleges of Nursing. Demand for certified nurse-midwives is such that the West Virginia Department of Commerce predicts that the number of jobs for CNMs will increase by 13.6% between 2012 and 2022.
West Virginia’s Shortage of OB-GYN Physicians Should Increase Demand for Certified Nurse-Midwives
As stakeholders increasingly recognize the role that APRNs such as certified nurse-midwives play in providing high-quality healthcare, the demand for APRNs has been increasing. CNMs in West Virginia can prescribe contraceptives and perinatal medications without any limitations, so they are seen as critical to filling gaps in OB-GYN care in areas that lack adequate numbers of gynecological and obstetric physicians.
Much of West Virginia suffers from a shortage of OB-GYN physicians according to the 2014 fact sheet on the state by the American Congress of Obstetricians and Gynecologists. Its analysis revealed that the number of OB-GYN physicians in West Virginia that year was just 81% of the national average on a population basis.
More alarmingly, more than half of West Virginia’s counties did not have a single OB-GYN physician. Counties in West Virginia that had a high ratio of OB-GYNs per female population included:
- Cabell County
- Kanawha County
- Lewis County
- Monongalia County
- Ohio County
- Raleigh County
Average Salaries of Certified Nurse-Midwives in West Virginia’s Largest Cities
The employment site Indeed.com tracks the salaries of professions and provides an average salary from job postings advertised the previous year. Shown below is the average salary of certified nurse-midwives in West Virginia’s largest cities during the year preceding December 2015:
- Huntington – $88,000
- Parkersburg – $86,000
- Charleston – $84,000
- Morgantown – $72,000