California Occupational Guides

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Detailed Guide for

Nurse Midwives in Ventura County

May also be called: Advanced Practice Nurses (APN); Advanced Practice Registered Nurses (APRN); and Certified Nurse Midwives (CNM)

What Would I Do?

Nurse Midwives, often called Certified Nurse Midwives (CNM), are registered nurses (RN) who have been educated and certified to provide primary health care services to women. CNMs work in collaboration with a physician to provide care for a woman throughout pregnancy and childbirth. CNMs are prohibited from using any artificial, forcible, or mechanical means of assisting childbirth, such as vacuum extractions. They offer primary health care for women but refer any major issues to a physician, who is a phone call away. Services include basic gynecological care and ordering laboratory tests and medical imaging studies as needed. They also provide immediate care of newborns and sign birth certificates. CNMs may also prescribe medications including birth control and medications for routine health care.

The California Department of Consumer Affairs, Board of Registered Nursing (BRN) specifies nurse midwifery care. This includes attendance at normal childbirths and providing prenatal, labor, and postpartum care, as well as newborn care. Additional practices are defined through standardized procedures developed by physicians, a health care facility’s administration, and Nurse Midwives. Therefore, some practices usually reserved for physicians may be performed by CNMs if within the established standardized procedures. Standardized procedures may allow Nurse Midwives to give blood transfusions, perform and repair episiotomies, perform circumcisions, and order and provide particular drugs, following patient-specific protocols. CNMs may provide emergency care until the physician arrives. They also may assist the physician on cesarean section births.

Certified Nurse Midwives are licensed by the BRN and have advanced nursing education in women’s health and obstetrics. They can also obtain the required permits to prescribe medications.

Licensed midwives are licensed by the Medical Board of California. They receive training in midwifery but do not obtain a nursing license. Licensed midwives primarily practice in out-of-hospital settings.

Tools and Technology

Nurse Midwives may use fetal heart rate monitors, blood pressure cuffs, suturing kits, and lancets. They may also use medical aspiration or irrigation syringes, medical tape measures, oxygen concentrators, and infant scales. They also use medical software.

Important Tasks and Related Skills

Each task below is matched to a sample skill required to carry out the task.

View the skill definitions
TaskSkill Used in this Task
Provide prenatal, intrapartum, postpartum, or newborn care to patients.Medicine and Dentistry
Monitor fetal development by listening to fetal heartbeat, taking external uterine measurements, identifying fetal position, or estimating fetal size and weight.Science
Perform physical examinations by taking vital signs, checking neurological reflexes, examining breasts, or performing pelvic examinations.Finger Dexterity
Document patients' health histories, symptoms, physical conditions, or other diagnostic information.Active Listening
Document findings of physical examinations.Written Expression
Write information in medical records or provide narrative summaries to communicate patient information to other health care providers.Inductive Reasoning
Order and interpret diagnostic or laboratory tests.Problem Sensitivity
Consult with or refer patients to appropriate specialists when conditions exceed the scope of practice or expertise.Deductive Reasoning
Initiate emergency interventions to stabilize patients.Complex Problem Solving
Source: U.S. Department of Labor Occupational Information Network (O*NET)

Working Conditions

Nurse Midwives work in clean environments such as hospitals, primary care clinics, and physicians’ offices. They may also work in homes; specialty clinics, such as birthing centers; and community health and family planning centers. They are often on their feet for long periods of time, as shifts may last up to 24 hours. They may be scheduled to work on call. According to the California Board of Registered Nursing, 2010 Survey of Nurse Practitioners and Certified Nurse Midwives, CNMs work an average of 36 hours a week. The same survey indicated that CNMs work few hours of overtime.

The work of a CNM may be stressful due to emotional demands of the work, difficulty communicating with patients, inadequate time with patients, and the high risk of liability concerns. However, it can also be rewarding in giving care to their patients.

Nurse Midwives may join a union such as the California Nurses Association.

Will This Job Fit Me?

Those who like to work with, communicate with, and teach people may enjoy the job of Nurse Midwife. An interest in providing service to others is helpful in this occupation.

What Wages and Benefits Can I Expect?

Wages

The median wage in 2020 for Nurse Midwives in California is $163,054 annually, or $78.39 hourly. The median is the point at which half of the workers earn more and half earn less.

Change to Hourly Wages
Annual Wages for 2020Low
(25th percentile)
Median
(50th percentile)
High
(75th percentile)
California$132,370$163,054>$145,600
Source: EDD/LMID Occupational Employment Statistics Survey, 2020 Wages do not reflect self-employment.
View Wages for All Areas

Benefits

Typical benefits for CNMs include medical, dental, life, and vision insurance as well as vacation, sick leave, and retirement plans. Large employers may also offer tuition reimbursement and time off for training.

What is the Job Outlook?

Demand for Nurse Midwives is expected to be high, especially in low-risk patient populations, to provide obstetrics and gynecology services. Other factors, including healthcare legislation and the resulting newly insured as well as the increased emphasis on preventative care also contribute to this demand.

As this is an emerging occupation, the number of Nurse Midwives in California is unknown at this time. However, the BRN reported that, in October 2012, there were 1,237 actively licensed Nurse Midwives in California, plus an additional 787 Nurse Midwives actively licensed to prescribe drugs. According to the 2010 BRN survey, CNMs had a higher rate of employment if they were dual certified as nurse practitioners. Additionally, almost three-quarters of those surveyed work in advanced practice, whether as a CNM or as a nurse practitioner. Of those not working in advanced practice, 57.8 percent worked as RNs.

The trend toward managed care and the desire for more cost-effective practices is anticipated to drive demand for CNMs. According to the 2010 BRN survey, in the next five years, many CNMs are expected to retire, decrease their work hours, work outside of their practice, or leave the profession. However, the survey concluded that it is still difficult to predict the future of the CNM workforce due to issues such as the high cost of malpractice insurance.

Projections of Employment

How Do I Qualify?

Education, Training, and Other Requirements

An individual must be a licensed registered nurse before specializing as a Certified Nurse Midwife. California requires Certified Nurse Midwives to obtain a minimum of a master’s degree in a Board-approved nurse-midwifery program, as well as certification from the Board of Registered Nursing. This requires passing a background check.

In order to furnish drugs or devices, Nurse Midwives must complete a Board-approved pharmacology course and have a minimum of 520 hours of physician-supervised experience furnishing drugs or devices.

Early Career Planning

Those interested in becoming Nurse Midwives should take college preparatory courses in biology, chemistry, health science, and computer literacy to help prepare for the rigorous college training required. English, math, social studies, and foreign language classes are also helpful. Volunteer work in a health care setting provides exposure and skills to help prepare for a health care career. Some Regional Occupational Programs (ROP) offer introductory health care courses for those wanting to explore the field. To find an ROP program near you, go to the California Association of Regional Occupational Centers and Programs Web site.

Work Study Programs

Supervised clinical experience is an integral part of the education to become a registered nurse. Additional clinical experience is part of the Nurse Midwife education program.

Continuing Education

To renew the RN license, nurses must obtain 30 hours of continuing education every two years. While the BRN does not require continuing education to maintain certification as a Nurse Midwife, the American Midwifery Certification Board requires 50 hours of approved continuing education every five years.

Licensing and Certification

The BRN issues two-year licenses to nurses and two-year advanced practice certificates to Nurse Midwives. To obtain the RN license, applicants must pass the National Council Licensure Examination (NCLEX-RN), pass a background check, and pay the appropriate fees. Additional information is available at www.rn.ca.gov/applicants/lic-exam.

Click on the license title below for details.

  • Nurse Midwife at www.labormarketinfo.edd.ca.gov/OccGuides/LicenseDetail.aspx?LicID=776

  • Nurse Midwife Furnishing Certificate (NMF) at www.labormarketinfo.edd.ca.gov/OccGuides/LicenseDetail.aspx?LicID=76948

  • Nurse, Registered at www.labormarketinfo.edd.ca.gov/OccGuides/LicenseDetail.aspx?LicID=778%20
Contact the agency that issues the license for additional information. Click on the license title below for details.

To obtain a Nurse Midwife (NM) certificate from the BRN, an applicant must complete a BRN-approved nurse midwifery education program. If the applicant completed a program not approved by the BRN, completion of additional courses may be required. The BRN also accepts Nurse Midwife certification from the American Midwifery Certification Board (AMCB) as an alternate method.

The AMCB issues a national, five-year certificate for CNMs. Nurses must be educated through an approved master’s degree program, pass an exam and background check, and pay the fees.

Several Nurse Midwives also obtain their nurse practitioner certification from the BRN. Many are certified by the American Nurses Credentialing Center (ANCC). Others are certified by the American Academy of Nurse Practitioners (AANP), the National Certification Corporation (NCC), or the Pediatric Nursing Certification Board (PNCB). Contact the agency that issues the certificate or license for additional information.

Employers typically require that CNMs have Cardiopulmonary Resuscitation (CPR) or Basic Life Support (BLS) certification. Some may require Advanced Cardiovascular Life Support (ACLS) certification. For more information, go to the U.S. Department of Labor's Career InfoNet Web site and scroll down to "Career Tools." Click on "Certification Finder" and follow the instructions to locate certification programs.

Where Can I Find Training?

There are two ways to search for training information:

Contact the schools you are interested in to learn about the classes available, tuition and fees, and any prerequisite course work.

Where Would I Work?

The largest industries employing Nurse Midwives are as follows:

Industry TitlePercent of Total Employment for Occupation in California
Outpatient Care Centers56.8%
Offices of Physicians17.6%
General Medical and Surgical Hospitals15.1%
Local Government6.9%
Source: EDD/LMID Staffing Patterns

Finding a Job

Direct application to employers remains an effective job search method. The Internet, medical recruiters, health care staffing agencies, and professional associations are sources for job listings. In addition, clinical experience during schooling provides networking opportunities. Online job opening systems include JobCentral at www.jobcentral.com and CalJOBSSM at www.caljobs.ca.gov.

To find your nearest One-Stop Career Center, go to Service Locator. View the helpful job search tips for more resources. (requires Adobe Reader).

Yellow Page Headings

You can focus your local job search by checking employers listed online or in your local telephone directory. Below are some suggested headings where you might find employers of Nurse Midwives.

  • Birth Centers
  • Community Health
  • Family Planning
  • Hospitals
  • Medical Clinics
  • Nurse Midwives
  • Obstetrics
  • Physicians

Find Possible Employers

To locate a list of employers in your area, go to "Find Employers" on the Labor Market Information Web site:

  • Select one of the top industries that employ the occupation. This will give you a list of employers in that industry in your area.
  • Click on "View Filter Selections" to limit your list to specific cities or employer size.
  • Click on an employer for the street address, telephone number, size of business, Web site, etc.
  • Contact the employer for possible employment.

Where Could This Job Lead?

Some CNMs move into supervisory positions. With additional education, some may become midwife program educators.

Related Occupations

Below is a list of occupations related to Nurse Midwives with links to more information.

OccupationOccupational
Guide
Industry
Report
Occupational
Profile
Nurse PractitionersGuide
Physician AssistantsGuide
Registered NursesGuide

Other Sources

These links are provided for your convenience and do not constitute an endorsement by EDD.

For the Career Professional

The following codes are provided to assist counselors, job placement workers, or other career professionals.

SystemCode
SOC - Standard Occupational Classification29-1161
O*NET - Occupational Information Network
   Nurse Midwives29-1161.00
   Interest Codes (RIASEC)SIR