The education required to become a midwife in the United States depends on which of three credential paths you choose, and they vary significantly. A Certified Nurse-Midwife (CNM) needs a master’s degree at minimum, while a Certified Professional Midwife (CPM) can qualify through apprenticeship-based training without a graduate degree. A third option, the Certified Midwife (CM), requires a master’s degree but not a nursing background.
Three Credential Paths, Three Sets of Requirements
The U.S. has no single route into midwifery. Each credential carries different educational expectations, different scopes of practice, and different levels of state recognition.
Certified Nurse-Midwife (CNM): The most widely recognized credential. CNMs are Advanced Practice Nurses with a master’s or doctoral degree from a university-affiliated nurse-midwifery program. They are licensed in all 50 states and can practice in hospitals, birth centers, and home settings. Beyond delivering babies, CNMs provide well-woman care across the lifespan, including gynecological exams, contraception, and menopause management.
Certified Midwife (CM): This credential mirrors the CNM in educational rigor but does not require a nursing degree. CMs complete a graduate-level midwifery program and pass the same national certification exam as CNMs. The catch: CMs are only legally recognized in a handful of states, currently including Delaware, Hawaii, Maine, New Jersey, New York, Oklahoma, Rhode Island, and Virginia. Several other states are pursuing CM licensure.
Certified Professional Midwife (CPM): CPMs follow a different model entirely. This credential recognizes multiple routes of education, including accredited midwifery schools and apprenticeship-style training. CPMs must demonstrate clinical competency and pass both a skills evaluation and a written exam. The defining feature of the CPM is its requirement for out-of-hospital birth experience, making it the credential most closely tied to home birth and birth center practice.
The CNM Path: Nursing Degree First, Then Graduate School
Becoming a CNM is a two-stage process. You first become a registered nurse, then complete a graduate midwifery program. Most people spend six to eight years in school total, though the timeline varies depending on whether you study full-time or part-time.
Stage one is earning a Bachelor of Science in Nursing (BSN) and obtaining your RN license. Some midwifery programs accept applicants with a non-nursing bachelor’s degree if they’ve completed an accelerated nursing program, but a BSN from an accredited program is the standard expectation.
Stage two is a graduate midwifery program accredited by the Accreditation Commission for Midwifery Education (ACME). These programs award a Master of Science in Nursing (MSN) with a midwifery specialization, or in some cases a Doctor of Nursing Practice (DNP). Coursework covers advanced pharmacology, prenatal and intrapartum care, newborn assessment, and women’s health across the lifespan. Clinical hours are substantial: Georgetown University’s program, for example, requires over 1,000 clinical hours across 27 months of part-time study and 49 credits.
After finishing the program, you sit for the national certification exam administered by the American Midwifery Certification Board (AMCB). You have 24 months from program completion to pass the exam, with a maximum of four attempts allowed.
Undergraduate Prerequisites That Matter
Whether you’re heading into a nursing program or applying directly to a graduate midwifery program, a strong science foundation is essential. The American College of Nurse-Midwives recommends thorough grounding in biology, microbiology, chemistry, and human anatomy and physiology. These courses are prerequisites for virtually every midwifery program in the country.
Beyond the hard sciences, programs often require or recommend coursework in nutrition, statistics, lifespan development, English composition, sociology, and psychology. Women’s studies courses are also considered valuable preparation. A minimum cumulative GPA of 3.0 and a science GPA of 3.0 are common thresholds for competitive programs.
The CPM Path: Apprenticeship or Accredited Program
The CPM route looks fundamentally different from the CNM path. You do not need a nursing license or a graduate degree. Instead, CPM candidates qualify through one of two tracks.
The first is completing a program accredited by the Midwifery Education Accreditation Council (MEAC). These programs incorporate core competencies adopted by the Midwives Alliance of North America, along with the clinical experience requirements and essential skills identified by the North American Registry of Midwives (NARM). Programs range from direct-entry midwifery schools to distance-learning models combined with clinical placements.
The second track is the Portfolio Evaluation Process (PEP), administered by NARM. This is an apprenticeship-based route where students learn under experienced midwife preceptors. Qualified preceptors verify the student’s knowledge and skills throughout training. Once the PEP is complete, candidates sit for NARM’s written and skills examinations.
Both tracks require documented out-of-hospital birth experience, which is unique to the CPM credential. This means CPM training is inherently oriented toward home birth and freestanding birth center care rather than hospital-based practice. CPM legal recognition varies widely by state, so checking your state’s licensing laws before committing to this path is important.
The CM Path: Graduate-Level Without Nursing
The CM credential was created for people who want the same level of graduate midwifery education as a CNM but come from a non-nursing background. CM students might hold a bachelor’s degree in biology, public health, or another health-related field. They complete an ACME-accredited midwifery program and pass the same AMCB certification exam that CNMs take.
The education itself is rigorous and equivalent to CNM training in scope. The limitation is purely legal: only eight states currently recognize the CM credential, which significantly restricts where you can practice. If you’re considering this path, confirm that your state either already licenses CMs or has active legislation in progress.
Bridge Programs for Working Nurses
If you’re already a registered nurse, bridge programs offer a streamlined route to the CNM credential. These RN-to-MSN midwifery programs are designed for working nurses and are often available in part-time or online formats with required clinical intensives.
Typical admission requirements include a BSN from an accredited program, a current U.S. RN license, a minimum 3.0 GPA, and a completed statistics course. Most programs do not require GRE scores. You’ll submit transcripts, a personal statement, a professional resume, and letters of recommendation.
Part-time bridge programs generally take about 27 months to complete, though full-time options at some schools can be shorter. Clinical hours still need to be completed in person, so even online programs require travel to clinical sites or on-campus intensives.
Master’s vs. Doctorate: What’s Required Now
A master’s degree is currently the minimum for CNM and CM certification. There is no mandatory doctoral requirement, despite a push from the American Association of Colleges of Nursing that initially proposed making the Doctor of Nursing Practice (DNP) the entry-level degree for all advanced practice nurses by 2015. That deadline passed without the change being adopted for midwifery.
The Directors of Midwifery Education formally declined to endorse a mandatory doctorate for entry into practice, citing a lack of evidence that it would improve outcomes and concerns about increased costs to students and institutions. The American College of Nurse-Midwives supports doctoral education as an option for midwives who want to continue their education, but it remains voluntary. Many universities now offer DNP programs in midwifery alongside MSN programs, giving students a choice. A DNP may open doors to leadership, teaching, or policy roles, but it is not required to practice clinically as a midwife.