Becoming a midwife involves specializing in the care of people during pregnancy, childbirth, and the postpartum period. The exact time required depends entirely on the specific credential chosen, as training ranges from multi-step academic routes to direct, apprenticeship-focused models. Understanding the distinctions between the three primary types of recognized midwives in the United States is the first step in estimating the commitment.
Understanding the Types of Midwives
The three main categories of certified midwives in the US are differentiated by their educational requirements and practice settings. These distinctions determine the length of study and the scope of practice. Certified Nurse-Midwives (CNMs) and Certified Midwives (CMs) generally practice in all settings, while Certified Professional Midwives (CPMs) focus on out-of-hospital care.
Certified Nurse Midwife (CNM)
The Certified Nurse-Midwife designation represents the most academically rigorous and widely recognized path, requiring an existing background in nursing. CNMs are advanced practice registered nurses (APRNs) who complete a graduate degree in nurse-midwifery. Due to their dual licensure, CNMs provide comprehensive care across the lifespan, including gynecological and primary care, primarily practicing in hospital systems, clinics, and birth centers.
Certified Professional Midwife (CPM)
The Certified Professional Midwife is the only credential that specifically requires competency in out-of-hospital settings, such as homes and freestanding birth centers. This path is non-nursing, often referred to as direct-entry, and focuses on the Midwives Model of Care for low-risk pregnancies. CPMs are certified through the North American Registry of Midwives (NARM), and their training often involves a combination of didactic study and extensive clinical apprenticeship.
Certified Midwife (CM)
The Certified Midwife credential is academically similar to the CNM path but does not require the prerequisite nursing degree. CMs follow the same specialized graduate-level educational path and pass the same certification exam as CNMs. This makes their clinical scope of practice largely identical to that of a CNM, though their legal recognition and ability to practice is limited to a small number of states.
The Timeline for Certified Nurse Midwives
The path to becoming a Certified Nurse-Midwife is the most standardized, typically requiring a total time commitment of six to eight years. The first mandatory step is earning a Bachelor of Science in Nursing (BSN) degree, which involves four years of full-time study. After graduating, the candidate must pass the national licensure exam to become a Registered Nurse (RN), a prerequisite for entry into a graduate program.
Following RN licensure, the aspiring CNM must complete an accredited graduate program in nurse-midwifery. These programs are accredited by the Accreditation Commission for Midwifery Education (ACME) and typically result in a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP). A full-time MSN program usually takes two to three years to complete, including didactic coursework and clinical rotations.
Most graduate programs recommend or require one to two years of clinical experience as an RN, often in labor and delivery, before admission. Including this recommended work experience, the total time commitment reaches the upper end of the six- to eight-year range.
The Timeline for Certified Midwives
The timeline for a Certified Midwife (CM) is shorter than the CNM track because it bypasses the requirement for a nursing degree. This path begins with a bachelor’s degree in a health-related field, which generally takes four years of study. After securing the undergraduate degree, the candidate enters a specialized, ACME-accredited graduate program in midwifery.
This graduate phase is identical to the one required for CNMs, typically lasting two to three years for a master’s degree. The total time for the CM path is generally six to seven years. Although the educational standard is the same as the CNM, the CM credential is legally recognized and regulated in only a few states.
The Timeline for Certified Professional Midwives
The path to becoming a Certified Professional Midwife (CPM) is highly variable, typically requiring three to five years. The two primary educational routes are graduation from a program accredited by the Midwifery Education Accreditation Council (MEAC) or completion of the Portfolio Evaluation Process (PEP) supervised by the North American Registry of Midwives (NARM). MEAC-accredited programs are direct-entry, do not require a prior degree, and usually take three to four years to complete.
The Portfolio Evaluation Process (PEP) is an apprenticeship model where the candidate gains knowledge and clinical skills under the supervision of a qualified preceptor. This route is less standardized, requiring a minimum of two years and 1,350 clinical contact hours for the apprenticeship component. The entire PEP process, including didactic study, often takes three to five years or longer, depending on the availability of preceptors and the student’s pace.
All CPM candidates must document the required hands-on experience, including a specific number of supervised births, to meet competency requirements. This clinical training must span at least two years, making the acquisition of these required experiences a significant factor in the overall length.
Post-Education Requirements: Certification and Licensing
Completion of the educational or apprenticeship phase leads to the mandatory steps of national certification and state licensure. CNMs and CMs must pass the national certification examination administered by the American Midwifery Certification Board (AMCB). Passing this exam validates the candidate’s knowledge and is a prerequisite for state licensing.
CPMs must pass the national certification exam administered by the North American Registry of Midwives (NARM) to earn their credential. Once certified, the midwife must apply for state licensure or registration within their intended state of practice. State requirements are highly diverse; while CNMs are licensed in all 50 states, the legal recognition and scope of practice for CMs and CPMs vary significantly.
Factors That Can Lengthen the Journey
Several practical realities can extend the total time beyond the minimum academic years required for any midwifery path. Attending a program part-time is a common factor, which can add one to three years to a graduate degree or MEAC program. Many CNM candidates also work as an RN for a period before beginning graduate studies, adding two or more years to gain experience and save funds.
Difficulty securing clinical sites or preceptors can create significant delays, particularly for those pursuing the CPM path through the apprenticeship model. Even after graduation, the time required to prepare for and pass the board certification exam, along with administrative processing time for state licensure, can add several months.