Nurse Midwives

Career summary

Nurse midwives are registered nurses with a master’s degree in midwifery. Nurse midwives can order lab tests throughout the pregnancy. They may also write prescriptions and administer medication during labor. They may attend births in a hospital, medical clinic setting, or birthing center.

Prenatal care

Nurse midwives work closely with expectant mothers throughout their pregnancy. They get a complete medical history from the patient to be sure it is a low-risk pregnancy. They determine the due date.

Nurse midwives educate pregnant women about nutrition, exercise, and general well-being. They regularly monitor fetal growth and listen to the baby's heartbeat. If complications develop, such as an ectopic pregnancy or signs that the mother or baby is not doing well, nurse midwives refer patients to obstetricians or other specialists.

Nurse midwives help pregnant women plan for childbirth. This includes helping them determine how they will manage pain and what kind of birthing environment they would like.

Birth

Nurse midwives monitor the mother and baby’s condition during labor by checking vital signs. They also monitor contractions and perform physical examinations to establish how the labor is progressing. They make suggestions for positions that may facilitate childbirth. They may administer oxygen if required.

Postpartum care

After the birth, nurse midwives provide medical care for infants including emergency resuscitation. They also monitor the mother’s recovery. In addition, they help mothers and babies learn how to breastfeed.

Related careers

This career is part of the Health Science cluster of careers.

Related careers include:

• Family and General Practitioners
• Genetic Counselors
• Licensed Practical Nurses
• Naturopathic Physicians
• Nurse Practitioners
• Obstetricians and Gynecologists
• Physician Assistants
• Registered Nurses

Military careers

• Registered Nurses

Job duties

Task list

The following list of tasks is specific to nurse midwives.

• Stabilize patients in emergency situations.
• Monitor the development of fetuses by checking size, heartbeat, and position.
• Provide care to both mothers and newborns.
• Teach and explain procedures to patients, family members, and staff members.
• Develop individual health and delivery plans for each patient.
• Order diagnostic and laboratory tests.
• Keep records of patients' visits, exams, and overall health.
• Provide primary health care to women.
• Refer patients to specialists as needed.
• Prescribe medications and help patients plan their families.
• Perform physical examinations.
• Read medical literature, talk with colleagues, and attend conferences to stay up to date on the field.
• May conduct research.
• May train and supervise staff.

Common work activities

Nurse midwives perform the following tasks. These tasks are common to many careers.

• Assist and care for others
• Document and record information
• Get information needed to do the job
• Make decisions and solve problems
• Update and use job-related knowledge
• Establish and maintain relationships
• Communicate with supervisors, peers, or subordinates
• Perform for or work with the public
• Identify objects, actions, and events
• Explain the meaning of information to others
• Analyze data or information
• Use computers
• Monitor events, materials, and surroundings
• Teach others
• Process information
• Organize, plan, and prioritize work
• Develop and build teams
• Evaluate information against standards
• Coach others
• Resolve conflicts and negotiate with others
• Judge the value of objects, services, or people
• Communicate with people outside the organization
• Perform activities that use the whole body
• Provide advice and consultation to others
• Coordinate the work and activities of others
• Schedule work and activities
• Guide, direct, and motivate others
• Think creatively
• Estimate sizes, quantities, time, cost, or materials needed
• Handle and move objects
• Develop goals and strategies
• Inspect equipment, structures, or materials

Work requirements

Working conditions

In a typical work setting, nurse midwives:

Interpersonal relationships

• Have a very high degree of social interaction. They work with mothers, infants, family members, and other medical professionals throughout the day.
• Are responsible for the health and safety of their patients.
• Are somewhat responsible for the work done by other midwives assistants.
• Communicate via face-to-face discussions and telephone on a daily basis. They also write e-mail, letters, and memos, but less frequently.
• Usually work as part of a team.
• Sometimes are placed in conflict situations in which patients and family members may be stressed or angry.

Physical work conditions

• Almost always work indoors.
• Are exposed to the diseases and infections of their patients on a regular basis.
• Frequently wear safety attire, such as medical gloves and masks, in the course of their day.
• Sometimes are exposed to contaminants.
• Work very near and come into close physical contact with patients.
• Occasionally work in noisy environments.

Work performance

• Must be very exact in their work. Errors could seriously harm the health of patients, including newborn infants.
• Make decisions on a daily basis that substantially impact patients and their families.
• Make nearly all their decisions and set their daily tasks and goals independently.
• Work in a moderately competitive, stressful atmosphere where they must meet daily deadlines.

Hours/travel

• Often work over 40 hours per week.
• Usually are on-call and may work weekends and nights.
• Sometimes work in a stressful atmosphere, often during complicated births.

Physical demands

Nurse midwives frequently:

• Use their hands to handle, control, or feel objects, tools, or controls.
• Stand for long periods of time.

It is important for nurse midwives to be able to:

• Speak clearly so listeners can understand.
• Understand the speech of another person.
• See details of objects that are less than a few feet away.
• Hold the arm and hand in one position or hold the hand steady while moving the arm.
• Use fingers to grasp, move, or assemble very small objects.

It is not as important, but still necessary, for nurse midwives to be able to:

• See details of objects that are more than a few feet away.
• See differences between colors, shades, and brightness.
• Use one or two hands to grasp, move, or assemble objects.
• Move two or more limbs together (for example, two arms, two legs, or one leg and one arm) while remaining in place.
• Use muscles to lift, push, pull, or carry heavy objects.
• Use stomach and lower back muscles to support the body for long periods without getting tired.
• Make quick, precise adjustments to machine controls.
• Determine the distance between objects.
• Hear sounds and recognize the difference between them.
• Focus on one source of sound and ignore others.
• Bend, stretch, twist, or reach out.
• Coordinate movement of several parts of the body, such as arms and legs, while the body is moving.
• Be physically active for long periods without getting tired or out of breath.
• Use muscles for extended periods without getting tired.

Skills and abilities

Nurse midwives need to:

Communicate

• Speak clearly so listeners can understand.
• Understand written information.
• Listen to others and ask questions.
• Understand spoken information.
• Write clearly so other people can understand.
• Read and understand work-related materials.

Reason and problem solve

• Use reasoning to discover answers to problems.
• Analyze ideas and use logic to determine their strengths and weaknesses.
• Notice when something is wrong or is likely to go wrong.
• Understand new information or materials by studying and working with them.
• Combine several pieces of information and draw conclusions.
• Judge the costs and benefits of a possible action.
• Recognize the nature of a problem.
• Follow guidelines to arrange objects or actions in a certain order.
• Concentrate and not be distracted while performing a task.
• Develop rules that group items in various ways.
• Think of new ideas about a topic.
• Recognize when important changes happen or are likely to happen in a system.
• Think of original, unusual, or creative ways to solve problems.

Use math and science

• Use scientific methods to solve problems.

Manage oneself, people, time, and things

• Check how well one is learning or doing something.
• Manage the time of self and others.
• Go back and forth between two or more activities or sources of information without becoming confused.

Work with people

• Be aware of others' reactions and understand the possible causes.
• Look for ways to help people.
• Change behavior in relation to others' actions.
• Use several methods to learn or teach new things.
• Teach others how to do something.

Perceive and visualize

• Quickly and accurately compare letters, numbers, objects, pictures, or patterns.
• Identify a pattern (a figure, object, word, or sound) that is hidden in distracting material.

Education and training

Educational programs

The programs of study listed below will help you prepare for the occupation or career cluster you are exploring.

Programs of study directly related to this occupation

• Midwifery
• Nurse Midwifery

Other programs of study to consider

• Advanced Nursing
• Anatomy
• Licensed Practical Nursing
• Nursing Assisting
• Nursing Education
• Physiology
• Pre-Nursing
• Registered Nursing

Training

To work as a nurse midwife, you typically need to:

• have a high school diploma or equivalent;
• complete a bachelor's degree in nursing;
• complete supervised clinical work experience;
• complete an accredited nurse-midwifery program; and
• obtain a midwifery license.

Education after high school

Nurse midwives are both nurses and midwives. Some become midwives after completing a nursing degree; others study both simultaneously. In general, as a nursing student, you study anatomy, physiology, and chemistry. You also take courses in medications and patient care. Near the end of training you complete a supervised work experience in a hospital. During your clinical work experience you observe and assist during childbirths.

On-the-job training

You'll spend a considerable amount of time observing and assisting with childbirths. You'll be supervised by experienced nurse midwives. Depending on the type of program, you may do this in a hospital, clinic, or birthing center.

Military training

Some branches of the military offer training in nursing specialties to people who are already licensed as a registered nurse. Training lasts 14 to 27 weeks, depending on your specialty. Additional training occurs on the job.

Helpful high school courses

In high school, take classes that prepare you for college. A college preparatory curriculum  may be different from your state's graduation requirements . You need a strong background in math and science to become a nurse midwife. Take as many math and science courses as you can.

You should also consider taking some advanced courses in high school. This includes Advanced Placement (AP) and International Baccalaureate (IB) courses if they are available in your school. If you do well in these courses, you may receive college credit for them. Advanced courses can also strengthen your college application.

Helpful electives to take in high school that prepare you for this career include:

• Anatomy and Physiology
• Child Development
• Computer Applications
• Food and Nutrition
• Foreign Language
• Introduction to Health Care
• Nursing
• Safety and First Aid

The courses listed above are meant to help you create your high school plan. If you have not already done so, talk to a school counselor or parent about the courses you are considering taking.

You should also check with a teacher or counselor to see if work-based learning opportunities are available in your school and community. These might include field trips, job shadowing, internships, and actual work experience. The goal of these activities is to help you connect your school experiences with real-life work.

Join some groups, try some hobbies, or volunteer with an organization that interests you. By participating in activities you can have fun, make new friends, and learn about yourself. Maybe one of them will help direct you to a future career. Here are examples of activities and groups  that may be available in your high school or community.

Things to know

Employers of look for licensed registered nurses (RNs) who have completed an additional program in midwifery at an accredited school and obtained their midwifery license. 

In addition, employers look for nurse midwives that have a caring and compassionate attitude toward others. Good judgment and the ability to make quick decisions are also important.

Costs to workers

Some workers may wish to join a professional association, which may have annual dues. Workers may have to pay for continuing education classes to keep up with changes in the field.

Licensing/certification

Direct entry midwives must be licensed to practice in Washington. Requirements for licensed midwives generally include:

• a high school diploma or equivalent;
• a certificate or diploma from a legally incorporated, state-approved midwifery program or equivalent education and experience;
• two letters of recommendation;
• submission of personal data related to working in this occupation;
• passing state midwifery jurisprudence exam;
• passing state and national written examinations; and
• completion of seven hours of HIV/AIDS education.

Licensed midwives may also purchase and administer certain legend drugs, including those prescribed by a physician.

For more information, contact:

Washington State Department of Health
Midwifery Program 
PO Box 47877
Olympia, WA 98504
360.236.4700

Certified nurse midwives must be licensed as Advanced Registered Nurse Practitioners by the State Board of Nursing. For licensing information, see the Hiring Practices section in the description for nurse practitioners.

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Wages

Pay varies by employer, area of the country, and the worker's level of experience.

Nurse midwives who work full time may receive benefits. Typical benefits include health insurance, sick leave, and paid vacation.

Employment and outlook

Washington outlook

The table below provides information about the number of workers in this career in various regions. It also provides information about the expected growth rate and future job openings.

National employment

Major employers:

• Doctors' offices
• Hospitals
• Outpatient care centers

National outlook

Job opportunities for nurse midwives are expected to be excellent. As the population grows, there will be more women having babies. Many women are deciding to use a nurse midwife to provide care during, before, and after childbirth. This will increase the need for nurse midwives. Job opportunities are expected to be especially good in medically underserved areas such as inner cities and rural areas. 

Other resources

About Midwifery 

American College of Nurse-Midwives 
8403 Colesville Road, Suite 1550
Silver Spring, MD 20910
240.485.1800

American Midwifery Certification Board 
849 International Drive, Suite 120
Linthicum, MD 21090
866.366.9632
410.694.9424

American Nurses Association 
8515 Georgia Avenue, Suite 400
Silver Spring, MD 20910
800.274.4262
301.628.5000

Explore Health Careers: Nurse Midwife 

Midwifery Education Accreditation Council (MEAC) 
850 Mt Pleasant Avenue
Ann Arbor, MI 48103

Midwives Alliance of North America 
PO Box 373
Montvale, NJ 07645
844.626.2674

Midwives' Association of Washington State 
16830 NE 9th Place
Bellevue, WA 98008
888.422.4784

North American Registry of Midwives 
5257 Rosestone Drive
Lilburn, GA 30047
888.842.4784
770.381.9051

Nursing 
From Johnson & Johnson

What is a Midwife? 

References

Career cluster

• Health Science

Career path

• Social

O*Net  occupations

• Midwives (29-9099.01) 
• Nurse Midwives (29-1161.00) 

O*Net job zones 

• Job Zone 4 - Considerable preparation needed. A minimum of two to four years of work-related skill, knowledge, or experience is needed for these occupations.

• Job Zone 5 - Extensive preparation needed. Extensive skill, knowledge, and experience are needed for these occupations. Many require more than five years of experience.

DOT occupation

• Nurse-midwife (075.264-014) 

Strong Interest Inventory

• Registered Nurse

Holland occupational clusters

• Social/Investigative/Realistic
• Social/Realistic/Enterprising
• Social/Realistic/Investigative

COPSystem

• Service Professional