2020 Year of the Nurse: Midwives

Suzan Miller-Hoover DNP, RN, CCNS, CCRN-K

The World Health Assembly, the governing body of the World Health Organization (WHO), has designated 2020 as the Year of the Nurse and Midwife. The purpose of this designation is to advance nurses’ vital position in transforming healthcare around the world. It also is in honor of the 200th anniversary of Florence Nightingale’s birth.

In the US, nurses engage in a wide range of roles and specialties, which is why the American Nurses Association (ANA) chose to promote 2020 as the “Year of the Nurse.” ANAs goal is to encourage inclusivity and participation of all nurses, including nurse midwives, in this landmark year of activities. (ANA, 2019)

The advanced practice nurse, in this case a midwife, is a growing field. Midwives attended 351,968 or 9.1% of the births in the country (American College of Nurse-Midwives (ACNM), 2019).

In 2019 there were 12,218 practicing Certified Nurse-Midwives (CNM). In addition to nurse midwives, there were:
  •   102 Certified Midwife (CM)
  •   9000 Doulas
(ACNM, 2019)

Certified Nurse-Midwives (CNM) are licensed, independent healthcare practitioners with prescriptive privileges and recognized as primary caregivers under federal law.
  •   CNM specialize in low-risk pregnancies, labor and birth, examinations, and basic gynecological health concerns.
  •   Recognized in all 50 states and District of Columbia, American Samoa, Guam, Puerto Rico and US Virgin Islands
  •   Medicaid reimburse mandated and private insurance may be mandated
(ACNM, 2019)

Certified Midwife (CM) are licensed, independent healthcare practitioners who complete the same training as CNM.
  •   CM specialize in low-risk pregnancies, labor and birth, examinations, and basic gynecological health concerns.
  •   Recognized in Delaware, Maine, Hawaii, New Jersey, New York, and Rhode Island
  •   CMs have prescriptive authority in New York, Rhode Island and Maine
  •   Medicaid reimburse mandated and private insurance may be mandated
(ACNM, 2019)

Doulas: Non-clinical professionals who provide physical and emotional support for the parents during the pregnancy, labor, and postpartum.
  •   Cannot deliver babies
  •   Work in partnership with healthcare providers
  •   Liaison and consistent presence of support
(Cleveland Clinic, 2018; March of Dimes, 2018)

The major difference between CNM and CM is the CM is not a nurse. However, the educational and certification requirements are the same for CNM and CM.

Certified Nurse-Midwife (CNM): Graduate (Master’s or Doctorate degree)
  •   Prerequisites: RN licensure, Bachelor’s degree or higher
  •   National certification (American Midwifery Certification Board, AMCB) and state licensure
  •   Recertification every 5 years
(ACNM, 2017)

Doulas: Completion of an approved doula workshop, online training for breast feeding, auditing a childbirth class, hands-on support for several clients
  •   Certification by DONA International or The International Childbirth Education Association (ICEA)
  •   Recertification every 3 years
(Doula.com, 2017; The International Childbirth Education Association (ICEA), 2017)

CNM salaries vary among the states, areas of employment, and type of degree; however, the average salaries across the nation are listed below:
  •   Annual salary $102,390 or $46-$57 per hour
  •   Outpatient care centers: $55.32
  •   Hospitals: $50.82
  •   Physician offices; $46.69
(Registerednursing.org., ND)

Doulas’ income varies as each doula can set their own fee within a suggested fee schedule.
A doula can expect to earn $15,000 to $35,000 in full time employment (Payscale.com, 2018).

Being a CNM can be very fulfilling, especially if you pair your services with a certified doula. These two roles make a big difference in the type of experience a birthing couple has. In conjunction with WHO and ANA, we celebrate nurses and midwives for their continued contributions to providing safe patient care.

American College of Nurse-Midwives (ACNM). (2017). Comparison of Comparison of Certified Nurse-Midwives, Certified Midwives, Certified Professional Midwives Clarifying the Distinctions Among Professional Midwifery Credentials in the U.S. Retrieved from: https://www.midwife.org/acnm/files/ccLibraryFiles/FILENAME/000000006807/FINAL-ComparisonChart-Oct2017.pdf

ACNM. (2019). Essential facts about midwives. Retrieved from: https://www.midwife.org/acnm/files/cclibraryfiles/filename/000000007531/EssentialFactsAboutMidwives-UPDATED.pdf

Cleveland Clinic. (2018). Nurse midwife vs. doula: what’s the difference, and which one do I need? Retrieved from: https://health.clevelandclinic.org/nurse-midwife-vs-doula-whats-the-difference-and-which-one-do-i-need/

DONA.com. (2020). Become a Doula. Retrieved from: https://www.dona.org/become-a-doula/

The International Childbirth Education Association (ICEA). (2017). Birth doula certification. Retrieved from: https://icea.org/certification/birth-doula/

March of Dimes. (2018). March of Dimes Position Statement: Doulas and Birth outcomes. Retrieved from: https://www.marchofdimes.org/materials/Doulas%20and%20birth%20outcomes%20position%20statement%20final%20January%2030%20PM.pdf

Payscale.com. (2018). Salary for Certification: Certified birth doula. Retrieved from: https://www.payscale.com/research/US/Certification=Certified_Birth_Doula/Salary

Registerednursing.org. (ND). Nurse midwife salary. Retrieved from: https://www.registerednursing.org/nurse-midwife/salary/

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