Midwife vs. Nurse Midwife: Explaining the Difference in 2026

Co-Founder and Chief Data Scientist

Students often compare Midwives and Nurse Midwives due to their overlapping roles in maternal and newborn care. Both focus on supporting pregnancy, birth, and postpartum health, but their education, certification, and scope of practice differ significantly. For example, Certified Nurse Midwives (CNMs) are registered nurses with advanced clinical training, while midwives may have diverse educational backgrounds.

Understanding these distinctions is crucial as the number of CNMs in the US grows, reflecting a rising demand for highly trained maternity care providers. This article aims to clarify the differences to help students make informed career decisions in this evolving healthcare field.

Key Points About Pursuing a Career as a Midwife vs a Nurse Midwife

Midwives generally require less formal nursing education, offering quicker entry but typically lower average salaries around $60,000 compared to Nurse Midwives' $115,000 in 2024.
Nurse Midwives have stronger job growth projected at 11% through 2032, reflecting rising demand for advanced clinical skills in women's health care.
Both roles impact maternal care, but Nurse Midwives can prescribe medications and perform advanced procedures, enhancing their professional scope and workplace versatility.

What does a Midwife do?

A midwife specializes in supporting women throughout pregnancy, labor, and postpartum. They focus on natural childbirth methods while promoting healthy pregnancies. Daily responsibilities include prenatal exams, tracking fetal growth, counseling on nutrition and birth plans, and providing emotional care.

During delivery, midwives manage pain, monitor labor progress, and assist with birth, stepping in with medical interventions only when needed. Post-delivery, they offer newborn care and support mothers' recovery, including breastfeeding help and health monitoring.

Most midwives work in hospitals, birthing centers, clinics, or private practices. The demand for midwives is growing, especially in maternity and women's health fields, reflecting their vital role in comprehensive reproductive care.

What does a Nurse Midwife do?

A Nurse Midwife is a specialized advanced practice nurse focused on women's reproductive health, pregnancy, labor, delivery, and postpartum support. They perform prenatal exams, oversee labor and delivery, and provide postpartum care, including breastfeeding guidance and parental education. Additionally, they diagnose and manage gynecological issues, prescribe medications, and assist with family planning.

These professionals work in various settings such as hospitals, clinics, birthing centers, health departments, private offices, and occasionally attend home births. In the U.S., most Nurse Midwives are employed within hospitals and physician practices. According to the Bureau of Labor Statistics, the median yearly income for this role is estimated at $129,650 in 2025.

What skills do you need to become a Midwife vs. a Nurse Midwife?

Understanding the distinct skills required for Midwives and Nurse Midwives is crucial for anyone considering these professions. While both roles focus on maternal and newborn care, their training and responsibilities differ, leading to unique skill requirements. Below are the key skills needed for each profession to excel in their respective fields.

Skills a Midwife Needs

Empathy: Ability to provide emotional support and comfort to expecting mothers throughout pregnancy and childbirth.
Clinical Knowledge: Understanding of prenatal care, labor processes, and postpartum recovery without extensive medical intervention.
Communication: Clear explanation of childbirth options and effective listening to patient concerns and questions.
Physical Stamina: Capability to assist during potentially long and physically demanding labor situations.
Problem-Solving: Ability to recognize complications early and decide when to refer patients to higher medical care.

Skills a Nurse Midwife Needs

Advanced Clinical Expertise: Comprehensive knowledge of medical procedures, pharmacology, and diagnostics to manage more complex pregnancies.
Leadership: Ability to supervise healthcare teams and coordinate patient care across multiple settings.
Critical Thinking: Skill in assessing risks and making swift, informed decisions under pressure.
Patient Advocacy: Supporting patients' rights while integrating evidence-based medical practices into care plans.
Interpersonal Skills: Building trust with patients from diverse backgrounds and collaborating effectively with other healthcare professionals.

How much can you earn as a Midwife vs. a Nurse Midwife?

The certified nurse midwife salary in united states 2025 shows a significant pay gap compared to midwives without nursing credentials. Understanding the midwife vs nurse midwife pay comparison is crucial for those considering these professions, as salaries vary widely depending on education, location, and experience.

A midwife without a nursing license, often known as a Certified Professional Midwife (CPM) or direct-entry midwife, earns a median annual salary between $50,000 and $60,000. Entry-level midwives may start earning around $40,000, while the highest earners, typically experienced midwives working in private practice or birthing centers, can reach $90,000 or more. This difference reflects the varied work settings and scope of practice, with CPMs often working independently in less traditional environments.

In contrast, a certified nurse midwife (CNM) generally commands higher salaries due to advanced clinical training and greater responsibilities. Median salaries for CNMs range from $130,000 to $140,000 as of 2025, with entry-level professionals earning between $105,000 and $112,000. Those working in high-demand states such as California and Arizona can earn over $180,000, and the top 10% of CNMs make more than $225,000 annually. These figures highlight the financial advantages of pursuing a nursing degree and midwifery certification. For those interested in advancing quickly in healthcare fields, exploring fast-track associate degree programs online may be beneficial.

What is the job outlook for a Midwife vs. a Nurse Midwife?

Employment prospects for midwives and nurse midwives in the United States are very positive, with nurse midwives experiencing especially rapid growth. Both roles are becoming increasingly vital due to a rising need for maternal healthcare services and shifting industry dynamics. However, nurse midwives tend to have clearer career pathways and greater consistency in job regulations.

The demand for midwives is affected by regional regulations, which can vary widely by state, influencing the scope of their practice and workplace opportunities. Despite these challenges, midwives are recognized for providing personalized, holistic care, which is gaining traction among expectant mothers and healthcare providers alike. Technological advances and evolving healthcare policies also shape the employment environment for midwives, particularly in communities with high birth rates.

On the other hand, nurse midwives benefit from more standardized education and licensure requirements, contributing to a projected workforce growth of 38% between 2022 and 2032, according to the Bureau of Labor Statistics. This rate surpasses average job growth significantly. The increased reliance on nurse midwives reflects their essential role in delivering skilled maternal care within established healthcare systems, where they often have broader responsibilities and acceptance. This trend is further supported by ongoing healthcare reforms and an emphasis on integrated patient care models.

What is the career progression like for a Midwife vs. a Nurse Midwife?

The career progression for midwives and nurse midwives differs significantly based on their credentials and training. Understanding these distinctions clarifies the midwife career path and promotion options available in clinical and leadership roles.

Typical Career Progression for a Midwife

Entry-Level Midwife: Certified Midwives (CMs) and Certified Professional Midwives (CPMs) often begin working in birth centers or home birth settings, focusing on direct patient care.
Experienced Clinician: With growing expertise, midwives expand their clinical skills and develop a strong community reputation, leading to increased responsibilities.
Lead Midwife or Educator: Many take on leadership roles within their practice, such as lead midwife or clinical educator, mentoring junior staff or students.
Advocate or Consultant: Senior midwives may work as supervisors, consultants for birth centers, or advocate for midwifery policy at state or national levels, although opportunities in hospitals are limited.

Typical Career Progression for a Nurse Midwife

Entry-Level CNM: Certified Nurse Midwives start with a BSN, RN licensure, and graduate education (MSN or DNP), then typically work in hospitals, clinics, or group practices.
Clinical Leadership: With experience, nurse midwives can become lead CNMs or clinical managers, overseeing teams and patient care operations.
Advanced Leadership Roles: Those with advanced degrees like a DNP may advance to director of midwifery services or executive roles such as chief nursing officers or policy leaders.
Academic and Independent Practice: CNMs often take academic roles as professors or launch independent practices and birth centers, benefiting from broader career advancement opportunities within healthcare systems.

Because of their structured education and credentials, nurse midwives generally have stronger career advancement opportunities for nurse midwives compared to non-nurse midwives. Demand for nurse midwife jobs is projected to grow 38% through 2032, highlighting the promising future in this field. For those interested in related educational paths, exploring top college courses for older adults online can provide valuable insights into continuing education options.

Can you transition from being a Midwife vs. a Nurse Midwife (and vice versa)?

Can you transition from being a midwife to a nurse midwife, and vice versa? The answer depends mainly on education and licensure requirements, which vary significantly between the two roles. While some skills are transferable, the pathways to switch between certified midwife (CM) and certified nurse midwife (CNM) are complex and typically require additional schooling.

Transitioning from midwife to nurse midwife involves earning nursing credentials first. A CM must obtain a nursing degree, either an ADN or BSN, and pass the NCLEX-RN exam to become a licensed registered nurse. Only after this step can they enroll in a graduate nurse-midwifery program accredited by ACME and later pass the AMCB certification exam to become a CNM. Although midwifery skills like prenatal care and postpartum management apply, the new nursing fundamentals and clinical hours represent significant additional training. For those looking for the cheapest way to get an associate's degree, pursuing a nursing pathway is often the initial step toward becoming a nurse midwife.

Regarding the requirements to become a nurse midwife after being a midwife, this additional education and licensing process means the transition can take several years. However, CNMs benefit from broader licensure and greater prescriptive authority compared to CMs.

Conversely, transitioning from nurse midwife to midwife is less common and may offer limited professional advantages. CMs are licensed in just over a dozen states, restricting career mobility. While a CNM could meet the graduate education requirements for CM licensure, the reverse transition typically does not leverage the CNM's nursing background and is therefore uncommon.

What are the common challenges that you can face as a Midwife vs. a Nurse Midwife?

Midwives and nurse midwives face several common challenges related to demanding workloads and emotional stress, which impact their professional and personal lives. Issues unique to each career further complicate their roles, as outlined below.

Challenges for a Midwife

Limited access to medical resources: Often work outside hospitals with fewer resources, complicating patient care.
Reduced professional recognition: Direct-entry or certified professional midwives may struggle for acceptance within the healthcare system.
Serving vulnerable populations: Frequently care for underserved groups, increasing stress and barriers to quality care.

Challenges for a Nurse Midwife

State regulation complexities: Navigating varying laws that affect their scope of practice can be difficult.
Physician collaboration: Must advocate for patient-centered care in settings that emphasize medical intervention.
Malpractice and insurance concerns: Higher clinical responsibilities increase risk and associated costs.

Both groups often experience work-life balance difficulties due to unpredictable schedules, night shifts, and on-call demands, common stressors in the midwife career challenges in the United States. Despite this, nurse midwives report high job satisfaction, with 87% willing to choose their career path again.

Salary satisfaction varies, as nurse midwives typically earn more than non-nurse midwives, reflecting educational and clinical differences. However, many report that compensation does not fully match workload demands, fueling ongoing debates about pay equity and retention in nurse midwife job difficulties and burnout.

Students or professionals considering this field might explore affordability options, including the cheapest per credit hour online college programs, to manage education costs while pursuing these rewarding yet challenging careers.

Is it more stressful to be a Midwife vs. a Nurse Midwife?

Stress impacts both Midwives and Nurse Midwives significantly, but no clear evidence shows one role is universally more stressful than the other in the US. Instead, stress levels are influenced largely by factors such as work environment, caseload, and the level of organizational support.

Midwives, especially those without nursing backgrounds, often deal with unique challenges including limited professional recognition, restricted resources, and less autonomy within healthcare settings. These issues can increase emotional strain and contribute to burnout, as well as intentions to leave the field. Unpredictable schedules, emotional intensity of childbirth care, and high patient acuity are common stressors that affect midwives broadly.

Certified Nurse Midwives (CNMs) face stress linked to managing complex patient cases, advocating for their patients, and navigating sometimes challenging interprofessional dynamics-particularly where midwifery philosophies are undervalued. Both Midwives and CNMs report burnout rates around 40%, with the culture and climate of their workplace playing a more decisive role in stress levels than individual traits. Ultimately, the impact of stress varies depending on factors like whether one works in a hospital or community setting, the strength of leadership support, and years of experience in the profession.

How to choose between becoming a Midwife vs. a Nurse Midwife?

Deciding between a career as a Certified Midwife (CM) or a Certified Nurse-Midwife (CNM) involves evaluating important factors such as education, scope of practice, and professional goals. Understanding these differences helps students align their choices with their strengths and career aspirations.

Here are key considerations when deciding how to choose midwife or nurse midwife career paths:

Educational Background: CNMs must be registered nurses with a graduate degree in nurse-midwifery, while CMs complete midwifery programs without nursing prerequisites, highlighting differences in education for midwife vs nurse midwife.
Scope of Practice: CNMs are licensed nationwide with prescriptive authority and broad healthcare roles; CMs have restricted state licenses and often limited prescribing rights.
Work Settings and Lifestyle: CNMs typically work in hospitals offering more structured hours; CMs may find roles in birth centers or community settings with varied schedules.
Professional Interests: CNMs provide comprehensive women's health care across the lifespan, whereas CMs focus more on pregnancy and birth care, appealing to those valuing holistic models.
Career Advancement and Salary: CNMs generally have higher earning potential and leadership opportunities due to wider practice recognition compared to CMs, whose field is expanding as licensure grows.

For those committed to nursing and seeking maximum clinical flexibility, the CNM path is ideal. Alternatively, aspiring midwives uninterested in nursing but passionate about birth-centered care may prefer the CM route. Prospective students should explore programs at the top accredited universities in the us to find options that best fit their interests and goals.

What Professionals Say About Being a Midwife vs. a Nurse Midwife

Callie: "Choosing a career as a Midwife has offered me incredible job stability and a rewarding salary potential. The demand for skilled midwives continues to grow, which provides a strong sense of security and a fulfilling professional life. I'm grateful for the ability to support mothers throughout their unique journeys."

Sheena: "The challenges of being a Nurse Midwife are what make this career so unique and impactful. You're not just delivering babies; you're empowering women with knowledge and care during some of the most significant moments of their lives. This role has deepened my appreciation for holistic health and community support."

Lynette: "Professional development is a major benefit of pursuing nursing midwifery. Between ongoing training programs and numerous opportunities for specialization, I've been able to advance my skills and career steadily. The combination of clinical practice and continual learning keeps the work dynamic and satisfying."

Other Things You Should Know About a Midwife & a Nurse Midwife

What certifications are required to become a Midwife or Nurse Midwife?

To become a certified professional midwife (CPM) in the U.S., candidates typically complete accredited midwifery education and pass the North American Registry of Midwives (NARM) exam. Certified Nurse-Midwives (CNMs) must hold a registered nurse (RN) license, complete a graduate-level nurse-midwifery program accredited by the Accreditation Commission for Midwifery Education (ACME), and pass the American Midwifery Certification Board (AMCB) exam.

Do Midwives and Nurse Midwives work in the same healthcare settings?

Midwives often practice in community-based settings, including birth centers and home births, focusing on natural and low-intervention births. Nurse Midwives generally work in hospitals, clinics, and private practices where they can collaborate with physicians and provide comprehensive women's health services beyond childbirth.

What is the scope of practice difference between Midwives and Nurse Midwives?

Midwives primarily focus on pregnancy, childbirth, and postpartum care, often emphasizing holistic and natural approaches. Nurse Midwives provide a broader spectrum of healthcare, including gynecological exams, family planning, and primary care for women across the lifespan in addition to maternity care.

Are there differences in legal recognition and licensure between Midwives and Nurse Midwives?

Legal recognition of midwives varies widely by state, with some states licensing only nurse midwives and others allowing certified professional midwives to practice legally. Nurse Midwives have standardized licensure across states due to their nursing credentials, which generally allows for more consistent legal and professional recognition nationwide.