A midwife is not a nurse practitioner, but the two roles are closely related. In the United States, certified nurse-midwives (CNMs) and certified nurse practitioners (CNPs) are both classified as Advanced Practice Registered Nurses (APRNs). They share the same level of graduate-level training and similar legal authority, but they are officially recognized as separate roles with distinct scopes of practice.
How the APRN System Works
The national regulatory framework for advanced nursing recognizes exactly four APRN roles: certified registered nurse anesthetist, certified nurse-midwife, clinical nurse specialist, and certified nurse practitioner. All four require graduate-level education, national certification, and state licensure. So while a certified nurse-midwife and a nurse practitioner sit at the same professional level, they hold different titles, pass different certification exams, and are trained in different clinical specialties.
Think of it like comparing a cardiologist and a dermatologist. Both are physicians, both completed medical school and residency, but nobody would call one the other. The APRN umbrella works the same way: midwives and nurse practitioners are peers, not interchangeable titles.
What Each Role Actually Does
Certified nurse-midwives are primary care providers for women across the lifespan. Their training covers two disciplines: nursing and midwifery. The clinical focus includes gynecologic care, family planning, preconception counseling, pregnancy management, childbirth, postpartum recovery, and newborn care. Beyond pregnancy, CNMs also conduct annual exams, write prescriptions, and provide basic nutrition counseling. The key distinction is that midwives are trained and authorized to manage labor and deliver babies, something most nurse practitioners are not prepared to do.
Nurse practitioners, by contrast, come in several specialty tracks. A family nurse practitioner (FNP) provides primary care to patients of all ages and genders. A women’s health nurse practitioner (WHNP) focuses on gynecologic and reproductive care but typically does not manage labor and delivery. Other NP specialties include pediatrics, psychiatry, acute care, and adult-gerontology. The scope is broader in some ways and narrower in others, depending on the specialty.
Education and Certification
Both CNMs and NPs must hold a graduate degree, either a master’s or a doctorate. Both start as registered nurses before entering their advanced programs. The paths diverge from there. Nurse-midwifery students complete programs accredited by the Accreditation Commission for Midwifery Education (ACME) and then sit for the certification exam administered by the American Midwifery Certification Board. Nurse practitioners complete programs specific to their chosen specialty and take a separate board exam through organizations like the American Academy of Nurse Practitioners or the American Nurses Credentialing Center.
The coursework overlaps in areas like pharmacology, health assessment, and pathophysiology. But midwifery programs include extensive training in intrapartum care (managing active labor), newborn assessment, and the physiology of normal birth, topics that NP programs outside of women’s health rarely cover in depth.
Prescribing and Practice Authority
Both CNMs and NPs can prescribe medications, but the rules vary by state. Some states grant certified nurse-midwives full independent practice and prescriptive authority with no physician oversight. Others require a physician relationship for prescribing, a transition-to-practice period before independent work, or some combination of restrictions. The patchwork is similar to what nurse practitioners face, and in many states, the regulations for CNMs and NPs are nearly identical.
The range of state-level authority breaks down into several tiers: full independence for both practice and prescribing, full practice independence with a required transition period for prescribing, full practice independence but a physician relationship needed for prescribing, and mandatory physician oversight for both. Where you practice matters as much as which credential you hold.
Salary and Job Growth
Compensation for the two roles is remarkably similar. As of May 2024, the median annual wage for nurse practitioners was $129,210, while nurse-midwives earned $128,790. For context, nurse anesthetists (the highest-paid APRN role) earned a median of $223,210.
The job outlook differs more noticeably. Nurse practitioner positions are projected to grow 40% between 2024 and 2034, driven largely by primary care shortages and expanding scope-of-practice laws. Nurse-midwife positions are expected to grow 11% over the same period. Both rates are well above average, but the NP market is significantly larger in sheer volume of openings.
Types of Midwives Outside the APRN Framework
One important nuance: the term “midwife” does not always mean “certified nurse-midwife.” In the U.S., you may also encounter certified midwives (CMs) and certified professional midwives (CPMs). Certified midwives hold the same midwifery certification as CNMs but entered through a non-nursing graduate pathway. Certified professional midwives are credentialed through a different organization and focus almost exclusively on out-of-hospital births. Neither CMs nor CPMs are APRNs, and their scope of practice, prescriptive authority, and legal recognition vary widely by state.
When people ask whether “a midwife” is a nurse practitioner, the answer depends on which type of midwife they mean. A certified nurse-midwife is an APRN with a nursing background, graduate education, and broad clinical authority. Other midwife credentials exist entirely outside the nursing profession. If you’re comparing providers or choosing care, the specific credential matters more than the word “midwife” alone.