As of 2014, the U.S. Bureau of Labor Statistics (BLS) reported that there were 100 certified nurse midwives practicing in Wisconsin, earning an average annual salary of $93,640. Although the number of CNMs is relatively low in comparison with Wisconsin’s population, the BLS expects the number of nurse-midwives to increase by 31% nationwide during the ten-year period leading up to 2022, a much faster rate than average. In 2010, 84% of women in Wisconsin received prenatal care in their first trimester, but the National Women’s Health Center expects this number to rise as the number of practicing nurse-midwives in Wisconsin increases.
In Wisconsin, CNMs have the opportunity to work in 150 hospitals throughout the state as well as numerous physician’s offices, independent birth centers, and women’s wellness centers. CNMs are required to complete traditional nurse training as well as extensive clinical hours working with mothers in all stages of pregnancy. CNMs in Wisconsin are required to obtain written collaborative agreements with supervising physicians and file them with the state board, although they do not have to obtain on-site supervision.
CNMs are qualified to provide many primary care needs as well as OB/GYN services because of their extensive education. In fact, 90% of visits to CNMS are for primary, preventive care, according to the Journal of Nurse-Midwifery. High-risk pregnancies under the care of CNMs are half as likely to result in low birth weight, and low birth weight is the primary reason for the high rate of infant mortality in the United States, according to the Wisconsin Program for Training Regionally Employed Care Providers.
Steps to Becoming a Nurse-Midwife in Wisconsin
In order to become a certified nurse-midwife in Wisconsin, RNs must meet all CNM licensing requirements through the Wisconsin State Board of Nursing, which includes earning a master’s degree or higher and gaining certification through the American Midwifery Certification Board.
Follow the guide below to become certified as a nurse-midwife:
|Earn a Qualifying Degree in Nurse Midwifery|
|Pass the National Certification Examination|
|Apply for Certified Nurse-Midwife Licensure in Wisconsin|
|Start Practicing as a CNM and Renew Certification on a Regular Cycle|
Step 1. Earn a Qualifying Degree in Nurse Midwifery
In order to sit for the national certification examination in midwifery, candidates must earn their master’s degree from a university accredited by the Accreditation Commission for Midwifery Education (ACME).
Master’s of Science in nursing programs are open to bachelor’s prepared RNs. Candidates who have not completed a BSN are eligible to enroll in RN-to-MSN programs which will confer both a BSN and MSN through a single accelerated dual-degree program.
MSN programs vary in requirements, but all programs are made up of two parts:
- 40-60 semester hours
- 700-1000 clock practicum hours
Currently, there are 39 nurse-midwifery programs accredited by ACME throughout the country, offered either on-campus or online.
In partial distance and fully online programs, coursework is completed online while clinical hours are completed in Wisconsin hospitals and clinics that are geographically accessible to the student. Six fully online, accredited options are offered, as well as 17 hybrid programs. Because there are so few nurse-midwife programs available at campus locations, online options are nationally accepted and preferred as flexible options for working RNs. Distance learning often requires students to complete online tutoring sessions, as well as attend intensive courses on campus for one to two weeks a semester.
In order to be accepted into these programs, most ACME accredited schools require:
- A BSN
- RN license and minimum one year practicing experience
- Minimum GPA
- Personal statement
- Letters of recommendation from previous instructors
CNMs are able to gain dual certification in Nurse Midwifery and Women’s Health (NM/WHP) through select dual-focus programs. A dual certification program allows students the option to take the WHNP exam and earn the NM/WHP credential along with taking the Certified Nurse Midwife exam. The NM/WHP title will allow the nurse to provide primary care to women across the life cycle rather than specifically focusing on the childbearing years.
Classroom study for an MSN often includes the following topics:
- Theoretical Foundations of Nursing
- Pathophysiological Concepts for Advanced Practice
- Roles and Issues in Advanced Practice
- Advanced Pharmacology and Therapeutics
- Nurse-Midwifery Care During Labor and Birth
Dual focus NM/WHP classes often include the following topics:
- Well Woman Health Care
- The Childbearing Family
- Primary Care for Women
- Health Promotion
For all nurse-midwifery graduate programs, clinical hours will be logged in a variety of settings within physician’s offices, hospitals, and independent birth clinics. Students will care for a variety of patients in all stages of pregnancy, labor and delivery.
Step 2. Pass the National Certification Examination
After earning a qualifying degree, master’s or higher, candidates become eligible to sit for the Certification Examination in Midwifery. Candidates that have completed a dual focus program with an emphasis in women’s health are also eligible to sit for the Women’s Health Nurse Practitioner Exam. Both exams qualify the candidate to apply for licensure as an APRN through the Wisconsin RN board.
Applicants can apply online through Applied Measurement Professionals (AMP) and will receive a date and time to take the exam at a testing center in either Green Bay or Milwaukee.
Certified Nurse Midwife (CNM) Certification
The American Midwifery Certification Board (AMCB) offers CNM certification to all students who have taken the exam within 24 months of completing a midwifery program.
Candidates are encouraged to prepare by using the AMCB candidate handbook. The test is four hours long, administered on a computer, and is divided into six categories of questions:
- Well Woman/Gynecology
- Women’s Health/Primary Care
Applicants can apply online or send a hard copy application directly to the following address:
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
Candidates can schedule a test date and time through AMP online.
After successfully passing this exam, nurses will earn the Certified Nurse Midwife (CNM) credential.
Women’s Healthcare Nurse Practitioner (WHNP) Certification
The WHNP certification is intended for those students who have completed an MSN with a dual emphasis in nurse-midwifery and women’s health. It is offered by the National Certification Corporation.
Students must apply online through the NCC and pay an examination fee of $325 at the time of registration. The test is three hours long, administered on a computer, and divided into five categories of questions:
- Primary Care
- Diagnostic testing and physical assessment
Candidates can schedule a test date and time through AMP online.
After successfully passing this exam, nurses will earn the Women’s Health Nurse Practitioner (WHNP) credential.
Step 3. Apply for Certified Nurse-Midwife Licensure in Wisconsin
The Wisconsin RN Board offers Nurse Midwife Licensure, which must be renewed every two years.
To gain licensure, candidates must print the application and mail it along with:
- Transcripts from an ACME approved CNM program
- Verification of Education, completed by the applicant and sent by the university
- $75 license fee
Mail the application and included documents to:
Wisconsin Board of Nursing, Department of Safety and Professional Services
P.O. Box 8935
Madison, WI 53708-8935
Step 4. Start Practicing as a CNM and Renew Certification on a Regular Cycle
Certified Nurse Midwives and NM/WHPs are qualified to begin practice in the state after receiving licensure from the Wisconsin State Board of Nursing. However, CNM and WHNP certifications must be maintained on a regular cycle.
CNM License Maintenance – Wisconsin State Board of Nursing
The Wisconsin State RN board requires CNMs to renew their license on 2/28 or 2/29 of even years for a fee of $86. The renewal process is offered online through the state board. Candidates can also request a paper renewal form by calling the board at 888‑506‑4239 or 608‑261‑4460.
CNMs are required to complete eight contact hours per renewal period. When renewing, candidates will be required to submit the following:
- Certificate of legal status
- Signature attesting to completion of continuing education (eight contact hours)
- Current liability insurance
- Current national certification or continuous competence assessment cycle
In Wisconsin, renewing the CNM license automatically renews the RN license.
CNM Certification Renewal Requirements – American Midwifery Certification Board
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; and pay annual fees
- Option 2: Retake the AMCB Certification Examination and pay the $500 examination fee in lieu of annual fees
WHNP Certification Maintenance – National Certification Corporation
The WHNP certification requires renewal every three years. The National Certification Corporation offers modules of continuing education with topics including maternal newborn, obstetrical, pharmacology, women’s health care, high risk neonatal, and electronic fetal monitoring and assessment.
For a fee of $100, NM/WHPs create a continuing education plan through the NCC. The plan will allow nurses to track their progress in completing continuing education units, which can vary individually based on plan.
Job Opportunities in Wisconsin for CNM/WHNPs
Nurse-midwives are qualified to serve the community in Wisconsin hospitals, physician’s offices, women’s health clinics and birthing centers.
A few examples of hospitals and clinics in Wisconsin are located below:
(Please note that there is no guarantee that these entities will currently be hiring CNMs)
- Arboretum Obstetrics and Gynecology (Madison, WI)
- UW Hospital and Clinics- Gynecology (Madison, WI)
- Women’s Care of Wisconsin (Appleton, WI)
- First Choice Women’s Health (Janesville, WI)
Examples of positions offered in Wisconsin as of 2015 are shown here below as illustrative examples only and should not be interpreted as an assurance of employment:
- Certified Nurse Midwife at Gundersen Health System (Tomah, WI)
- Certified Nurse Midwife at ThedaCare (Berlin, WI)
- Certified Nurse Midwife at Planned Parenthood of WI (Racine, WI)
- Certified Nurse Midwife at Medical College of Wisconsin (Milwaukee, WI)
Salaries for Certified Nurse-Midwives in Wisconsin
The 60 certified nurse-midwives that practiced in the Milwaukee area enjoyed the unique distinction of having the 10th highest average salary among CNMs across all metropolitan areas of the country in 2014 (US Bureau of Labor Statistics).
The Wisconsin Department of Workforce Development conducted an analysis of certified nurse-midwife salaries in the state as of 2014, and found the average among them to be $93,644 that year. Certified nurse-midwives in the state with the most experience earned an average of $103,392. In contrast, nurse midwives who were new to this profession earned an average of just $74,146.
The number of jobs for nurse midwives in Wisconsin is expected to increase dramatically between 2012 and 2022. The Wisconsin Department of Workforce Development expects a job growth rate of 23.08% for nurse midwives during the ten-year period between 2012 and 2022.
Increasing the Utilization of Certified Nurse-Midwives Could Mitigate the Impending Physician Shortage in Wisconsin
The Wisconsin Nursing Workforce: Status and Recommendations produced by the Wisconsin Center for Nursing in 2013 stated that increasing the utilization of APRNs such as certified nurse-midwives could help to mitigate Wisconsin’s impending physician shortage.
OB-GYN physicians are in short supply in much of Wisconsin according to a 2014 fact sheet published by the American Congress of Obstetricians and Gynecologists. On a population basis, the number of OB-GYN physicians was 10% less than the national average. In fact, 26 counties did not have any of these specialists at the time of this report. Legislation allowing CNMs to practice independently to the full extent of their training as is being implemented in much of the rest of the country would further mitigate this shortage.
Healthcare practices in Wyking that were offering jobs for certified nurse-midwives as of December 2015 included:
- U.S. Army Healthcare Team – Milwaukee
- Gundersen Health System – Tomah
- Planned Parenthood of Wisconsin, Inc. – Racine, Milwaukee
Additionally, the Wisconsin Guild of Midwives provided a list of a number of practices that employed certified nurse-midwives as of 2015:
- Community Midwives, LLC – Madison
- Open Door Midwifery – Viroqua
- Footprints in Time Midwifery Services – Black River Falls
- Strongwork Homebirth – Madison
- Authentic Birth Center – Wauwatosa
This information is provided to demonstrate the types of jobs available for midwives in Wisconsin and is not a guarantee of employment.
Salaries for Certified Nurse-Midwives in the Milwaukee Area
The Wisconsin Department of Workforce Development analyzed the salaries of nurse midwives in Milwaukee-Waukesha-West Allis as of 2014. Their findings revealed that certified nurse-midwives in this metropolitan area at all levels of experience earned a higher salary than the average for the rest of the state. This difference was particularly striking for entry-level nurse midwives in the Milwaukee area:
- Experienced – $105,811
- Average – $99,823
- Entry-level – $87,848
For comparison, the US Bureau of Labor Statistics provides an expanded analysis of salaries for CNMs working in the Milwaukee area as of 2014: