How to Work in the U.S. As a Foreign-Educated Midwife
If you’re a midwife trained outside the U.S. and planning to immigrate to the U.S., you’ll need a license to continue your career. Although you may be legally allowed to work, getting a midwife license can be a long process.
The journey to getting licensed can be challenging and may even tempt you to consider jobs outside the field of midwifery. However, it’s essential to know that validating your foreign credentials is possible. In the United States, there are three ways to practice midwifery and continue doing what you love while earning a good income.
To help make getting your midwifery license smoother, we’ll guide you through the steps to start your career as a midwife in the U.S.
The Importance of Midwifery Licensing in the U.S.
When you first became a midwife, it was probably because you wanted to help bring new life into the world and support women through one of life’s most profound experiences.
No matter what your motivations were, it turns out that midwives can make impressive salaries depending on what state they work in. According to Indeed.com, the national average salary for midwives is over $100,000 annually.
While working as a midwife often means directly assisting in births, there are plenty of other job opportunities your career path could open up in the U.S. Midwives can find jobs working in hospitals, birthing centers, clinics, or as educators.
So, even if you want to take your career in another direction, getting licensed to work in the U.S. will allow you to earn an above-average salary while you build the career you’ve already started.
Types of Midwife Credentials in the United States
There are three different credentials: Certified Nurse Midwife, abbreviated as “CNM”; Certified Midwife, or “CM”; and Certified Professional Midwife, or “CPM”. There are differences between each type of midwife regarding the education they require, what settings and states they can practice in, and which medical procedures they can perform.
For a detailed look at the differences between these three types of midwifery credentials, the American College of Nurse-Midwives, abbreviated “ACNM.” has created a side-by-side chart helpful for folks needing a visual aid. But let’s go over the main points.
Certified Nurse Midwife (CNM)
CNMs and CMs are the most alike in education requirements and scope of practice. Both are required to complete a graduate-level midwifery education program accredited by the Accreditation Commission for Midwifery Education, which is abbreviated as “ACME,” and must pass the national certification exam administered by the American Midwifery Certification Board, or the “AMCB.”
CMs and CNMs are trained to provide a full range of primary healthcare services to women from adolescence through menopause. This includes general health visits, gynecologic checkups, family planning services, treatment of STDs, and neonatal care. Both can work in various settings, such as hospitals, health clinics, OB/GYN practices, birth centers, and private homes.
However, there are some important differences between Certified Nurse-Midwives and Certified Midwives. Most importantly, CNMs must become registered nurses before completing a graduate-level nurse-midwifery program accredited by ACME. Additionally, CNMs are recognized and able to work in all 50 states.
Certified Midwife (CM)
In contrast, CMs do not require a nursing background and instead enter midwifery directly through an ACME-accredited program. However, a limited number of states recognize the credential of CM, those being:
- Arkansas
- Colorado
- Delaware
- Hawaii
- Maine
- Maryland
- New Jersey
- New York
- Oklahoma
- Rhode Island
- Virginia
- District of Columbia.
While CNMs and CMs provide a full range of primary healthcare services, CNMs have broader recognition and integration into the healthcare system.
Certified Professional Midwife (CPM)
Certified Professional Midwives are different from CMs and CNMs in many ways. Most significantly, CPMs are not required to be registered nurses and do not need a graduate-level education. However, CPMs will need to prove extensive clinical experience.
In terms of practice, CPMs focus almost exclusively on providing midwifery care in out-of-hospital settings, such as home births and private birthing centers.
CPMs are certified by a different organization known as the North American Registry of Midwives, or “NARM,” and after completing their apprenticeships, CPMs will take the NARM exam. CPMs are recognized in 36 states as of 2023. You can check out a map the National Association of Professional Midwives created for a list of those states.
Understanding the Title “Licensed Midwife” (LM)
It’s important to note that many states use the title “Licensed Midwife,” or “LM,” as a title for midwives who are legally authorized to practice. Depending on the state’s regulations, this title can apply to all three types of midwives. While each state may have its way of using this title, obtaining certification as a CNM, CM, or CPM is generally required before applying for state licensure.
Who Grants Midwifery Licenses?
As mentioned before, CNMs and CMs must both take a national exam administered by the American Midwifery Certification Board. Similarly, CPMs are required to take a national exam administered by the North American Registry of Midwives. Though midwives are supported by national organizations, they will ultimately receive their licenses from a state board.
State-Specific Licensing Boards
As we said earlier, each state has particular rules regarding what certification you’ll need to practice midwifery. So, the best thing you can do is thoroughly research the state you want to practice in to find that state’s licensing board.
Let’s look at New Jersey as an example because it’s one of the few states that allows all three types of midwives to practice. The New Jersey Division of Consumer Affairs is the organization that grants licenses to all three types of midwives. On their webpage, you’ll see a tab called “Applications and Forms,” when you click on it, you will see a separate application for CNMs, CMs, and CPMs.
In contrast, let’s look at Virginia, which recognizes all three types of midwives. If you’re a Certified Midwife or Certified Professional Midwife, you’ll seek licensing from the Virginia Board of Medicine. Meanwhile, Certified Nurse Midwives are technically nurses, so they’ll apply for a license through the Virginia Board of Nursing. Both organizations are subsections of the Virginia Department of Health Professions but have different board members and contact information.
As you can see, New Jersey and Virginia handle their licensing differently, and you’ll probably see many variations across each state. So, the most important thing is to be thorough in your research. If you’re in doubt, email or call your state licensing board.
How to Contact Your State’s Midwifery Licensing Board
Best Practices for Communication
A brief Google search should give you the phone number, mailing address, and email of the midwifery licensing board in the state where you want to work. However, pay close attention as some states have separate licensing boards for different types of midwives, while others have a combined board.
Here are some tips for emailing your state’s midwifery licensing board.
- Include your full name, phone number, address, and email.
- If English is not your first language, consider having your message professionally translated.
- Be mindful of time zone differences when calling.
Now, let’s dive into more specific information you’ll need before you can become a midwife.
Educational Requirements for Midwifery Licensing
Becoming a Certified Nurse Midwife (CNM)
There are a few educational steps that you must take to become a Certified Nurse-Midwife (CNM).
The journey begins with obtaining a Bachelor of Science in Nursing, often abbreviated as “BSN.” After earning a BSN, you’ll have to take the National Council Licensure Examination for Registered Nurses, which is typically called the “NCLEX.” At this point, you’ll be a Registered Nurse. For more information, you can check out our guide on how to work as a foreign-trained nurse in the United States.
Following this, an aspiring CNM must complete a graduate-level program in nurse-midwifery. This degree can be either a Master of Science in Nursing or a Doctor of Nursing Practice. No matter what, your degree must be accredited by the Accreditation Commission for Midwifery Education. Luckily, ACME provides a comprehensive list of programs that they accept on their website.
Finally, to practice as a CNM, the candidate must pass the national certification exam administered by the American Midwifery Certification Board and obtain state licensure, which may require additional state-specific exams or criteria.
Becoming a Certified Midwife (CM)
To become a Certified Midwife (CM), you’ll basically follow the same steps as a CNM, but without the nursing requirements.
So, you’ll need either a Master of Science in Nursing or a Doctor of Nursing Practice accredited by ACME. Then, you must pass the AMCB exam and any state-specific exams.
Becoming a Certified Professional Midwife (CPM)
Finally, to become a Certified Professional Midwife, there are multiple avenues of education and experience.
Portfolio Evaluation Process (PEP)
The first avenue could be particularly appealing if you’re a midwife from abroad. That is NARM’s Portfolio Evaluation Process, abbreviated as “PEP.” The PEP is an alternative pathway for becoming a CPM. This program allows aspiring midwives to demonstrate competency through a portfolio-based evaluation instead of completing a formal midwifery education program.
To begin the PEP, you must have a high school diploma or the equivalent before starting. Then, you’ll need to partner with a “preceptor,” which is a mentor and teacher. The preceptor oversees a midwife in training, ensuring they gain the necessary knowledge by being present during care and signing the required NARM forms.
A preceptor must be registered with NARM, have at least 3 years of experience, and have attended 50 births after receiving their CPM credential. Additionally, 10 of those births must have been out-of-hospital births and have happened in the past 3 years.
Once you’ve found your preceptor, you can begin your PEP journey, which spans at least 2 years and must be completed within 10 years. The process unfolds in four phases:
Phase | Requirements |
Phase 1: Observation | – Attend 10 births in any capacity. |
Phase 2: Assistant Under Supervision | – Document 20 births.- Document 25 prenatal exams.- Document 20 newborn exams.- Document 10 postpartum visits. |
Phase 3: Primary Midwife Under Supervision | – Document 20 births.- Document 75 prenatal exams.- Document 20 newborn exams.- Document 40 postpartum exams.- Attend 5 births with full continuity of care (same midwife/midwifery team provides care throughout pregnancy, childbirth, and postpartum).- Attend 10 births where prenatal care was provided.- Completing this phase allows you to register for the NARM Examination. |
Phase 4: Additional Primary Midwife Experience | – Document 5 additional births as the primary midwife under supervision.- This phase can be completed before or after the NARM exam. |
Graduation From a MEAC Accredited Program
The second avenue to becoming a CPM is graduating from a program accredited by the Midwifery Education Accreditation Council (MEAC). The requirements are the following:
- Education Requirement: High school diploma or equivalent.
- Birth Attendance Requirements:
- Attend 2 hospital births.
- Attend 5 home births.
- Clinical Experience:
- Work as a primary midwife or primary midwife under supervision for at least 10 out-of-hospital births in the past 3 years within the U.S.
- Documentation Submission:
- Provide a notarized document such as:
- Final transcript, graduation certificate, or letter from your MEAC program confirming you’ve met all graduation requirements.
- If the school sends official documents directly to NARM, notarization is not required.
- Exam Requirement: Pass the NARM Exam.
Previous Certification as CNM or CM
The third avenue to becoming a CPM is if you’re already certified by the AMCB as a CNM or CM. The following table provides you with a breakdown of the steps in this process:
Pathway to Becoming a CPM for CNMs and CMs | Requirements |
Eligibility | Must be certified by AMCB as a Certified Nurse Midwife (CNM) or Certified Midwife (CM) |
Documentation Requirements | – Submit a copy of CNM or CM certificate– Provide proof of experience as a primary midwife or primary midwife under supervision for at least 10 out-of-hospital births– Document at least 5 births with continuity of care, including: – 5 prenatal visits – Attending the birth – Conducting a newborn exam – Performing 2 postpartum exams |
Exam Requirement | – Application approval by NARM– Must pass the NARM Examination |
Final Certification | – After passing the exam and meeting all requirements, CPM certification is granted– Can officially use the CPM title only after certification by NARM |
Credential Evaluation for Foreign-Trained Midwives
What is a Credential Evaluation?
Credential evaluation services assess the academic and professional qualifications of individuals from other countries, converting them into a format recognized and understood within the U.S. educational and employment sectors. They then produce a report that details how your foreign grades, degrees, and qualifications compare to those in the U.S.
This helps universities, state midwifery boards, and nursing boards understand your qualifications.
For example, suppose you already have a biology, nursing, or midwifery degree from another country. In that case, you might be able to have some academic credits transferred to a college or university in the U.S.
Becoming a CNM or a CM requires a degree from an ACME-accredited university in the United States. However, some colleges or universities might recognize basic coursework such as microbiology, nutrition, or other courses.
Similarly, if you’re pursuing a CNM license and already a registered nurse in a foreign country, you could potentially have your credentials verified in the U.S. The Commission on Graduates of Foreign Nursing Schools is the preferred credential evaluation service for nurses in the United States. By the way, if you’re a nurse working abroad, you might want to check out our guide for foreign nurses who want to start working in the U.S.
Even midwives who want to become a CPM in the U.S. may potentially use a credential evaluation service to show they have the equivalent of a high school diploma.
Credential Evaluation Services
Costs and Processing Time
Credential evaluation services offer different levels of evaluations. A basic service, often called a “general evaluation” or “course by course evaluation,” might cost between $70 and $200. A more comprehensive evaluation, which gathers additional information, could cost between $150 and $500.
The processing time for credential evaluations can range from a few days to 4 weeks. However, most evaluation companies offer expedited services for an added fee.
Necessary Documents
These companies will need your transcripts, mark sheets, certificates or diplomas, and other relevant material to perform the credential evaluation.
To process your credentials, evaluation services will need certified English translations of any foreign documents you include. The best way to make sure these translations are accurate is to have them completed by a professional translation service.
Proving English Proficiency
Why English Skills Are Important for Midwives
If you’re aspiring to start a career as a midwife in the U.S., strong English skills are essential for both your education and work. First, you most likely need to take some university courses and then pass your NARM exam.
After you’ve started working, you will regularly communicate with expectant mothers to explain prenatal care, guide them through the birthing process, and follow up with them and their newborns. Proficient English will allow you to communicate with colleagues, continue your education, and maintain your license.
English Proficiency Exams
Two of the most widely recognized exams to demonstrate English abilities are the Test of English as a Foreign Language, which is abbreviated as “TOEFL,” and the International English Language Testing System, or the “IELTS.” Both exams can help you prove your English skills and assist in getting hired at a hospital or birth center after you obtain your license.
Now, let’s talk about the two different national exams for midwives. First, we’ll cover the AMCB exam for CNMs and CMs, and then we’ll review the NARM exam for CPMs.
National Midwifery Exams
To be eligible to take this exam, you must have a master’s or doctoral degree from a U.S. midwifery program accredited by the Accreditation Commission for Midwifery Education.
The AMCB Exam for CNMs and CMs
AMCB Exam Structure and Content
The American Midwifery Certification Board exam has 175 multiple-choice questions, each with four possible answers. Candidates will be given 4 hours to complete the exam, and during that time, test-takers will be allowed to review or change any questions they’ve already answered. No points are deducted from your score for incorrect answers, so candidates are encouraged to answer every question, even if unsure.
The exam content is divided into six parts, each representing a percentage of the total exam.
Exam Content Area | Percentage of Total Exam |
Antepartum | 21% |
Intrapartum | 21% |
Postpartum | 18% |
Newborn | 10% |
Gynecology | 19% |
Primary Care | 11% |
Note: The exam questions are administered in a random order rather than being grouped by content area.
The content areas and percentages covered by the exam are based on a comprehensive survey given to practicing midwives to determine what their hands-on work is like. So you can be sure the testing material is relevant to real-life experience.
AMCB Exam Scoring
When you finish your exam, you’ll get an official score report at the testing center on the same day. If you pass the exam, your report will include a message letting you know you’ve passed. If you don’t pass, you’ll get a scaled score showing your overall performance on the exam. You’ll also receive raw scores, which tell you the number of questions you answered correctly in each of the six content areas of the exam and which areas you need to improve.
To pass the exam, candidates will need a score of 75 or higher out of 100. It’s important to note that each candidate’s score will be calculated as a scaled score rather than a raw percentage of correct answers. The raw score is converted to a scaled score because each person taking the exam gets a slightly different set of questions. Since there are differences between the exams, the conversion ensures everyone’s score is fair. The critical thing to remember is that you need at least a score of 75 to pass.
AMCB Exam Fees
The exam fee is $500, including a $121 processing fee, which you’ll lose if you reschedule less than two business days before your appointment. Candidates who are more than 15 minutes late, miss their appointments or lack the proper ID will also lose the processing fee and need to reschedule.
If a candidate does not pass the exam on their first attempt, the fee to retake it is $350. Candidates can retake the exam a maximum of 3 times after their first attempt.
If you apply online, the exam fees can be paid using a credit card. To do so, you’ll need to create an account with the AMCB using their online portal by following the provided link and clicking “New Applicant.”
You can also pay by check if you send in a paper application by including the check in the same envelope as your application. You can find the printable versions of the CNM application here and the CM application here. When you complete the application, you can mail it to the American Midwifery Certification Board. If you’re applying to take the CNM exam, you must include a copy of your Registered Nurse license along with your exam application.
Eligibility for the AMCB Exam
After receiving and processing your application, the AMCB will notify you by email if you are eligible to take the exam. If you prefer to be notified in writing or by phone, please inform the AMCB office when submitting your application.
Results of your AMCB Exam
The AMCB posts an updated, public list of people who have passed the exam on their website. New names are added within 30 days after score reports are emailed or mailed. Please note that this online list is not considered a primary source verification.
However, the AMCB will provide an extra verified copy of your certificate. By default, the AMCB will mail your certification and your one free verification to the address indicated on the examination application form within 8 weeks.
But, if you prefer to have your copy sent to a different organization, such as a state licensing board, you’ll need to indicate on your examination application which address you would like the verification sent to.
If you need any additional copies of your certificate, you can request them using the AMCB website. You’ll need to log into the website’s user portal and click the link “purchase verification letters.” There’s a fee of $50 for this service, which is payable by personal check or credit card.
Study Resources and Preparation Tips
As you prepare for the AMCB exam, you might look online for a study group or guide. Unfortunately, there aren’t many resources available, and this is probably because the AMCB’s website explicitly says they do not endorse any review courses or books.
The AMCB exam handbook goes further to say that the questions on the exam are not based on one specific reference. Pages 18 and 19 of the handbook list 24 resources that the AMCB specifically suggests as study materials for the exam.
As mentioned earlier, the questions on the exam are based on a survey given to practicing midwives. The survey results are quantified and published every few years in what they call a “task analysis report.” So, a great way to study for the exam is by carefully reviewing the AMCB’s most recent task analysis report. Beginning on page 33 of the 2022 copy of the task analysis report, you can see detailed percentages, charts, and explanations of medical conditions and practices experienced by midwives in the field. Because this survey is used to create the exam, it’s a great place to begin if you’re wondering precisely what material to freshen up on.
Although the AMCB does not endorse any study materials, there is a book called Midwifery & Women’s Health Nurse Practitioner Certification Review Guide, which has a 4.8 out of 5 stars on Amazon. The book claims to be based on the AMCB exam, and the most recent edition was published in 2021. However, the authors plan to release an updated version in December 2024. You can find both used and new copies of the book online and a Kindle version if you want to start studying right away.
If you’re searching for a structured, online study guide, you can check out Boardvitals.com. The website offers access to more than 350 practice questions, which they claim were written by certified midwives who’ve already passed the exam. Boardvitals.com provides access to their study materials based on periods. Access for 6 months costs $159, 3 months costs $109, and 1 month costs $89. There are no specific reviews regarding the AMCB exam study resources. However, the website generally has a good reputation for helping other medical professionals like nurses and psychologists pass their national exams so it could be a valuable resource. BoardVitals also offers an Android and Apple mobile app, allowing you to access your study materials from your phone anytime.
A similar online resource called PocketPrep offers study materials for a monthly subscription of $15 to $20. It’s difficult to find reviews specifically regarding PocketPrep’s AMCB exam resources, but in general, the website has thousands of 5-star reviews from medical professionals across various fields. PocketPrep also offers Android and Apple mobile apps and claims to be designed for busy people. The app offers multiple types of quizzes like the “Weakest Subject Quiz” and the “Question of the Day,” so it could be great for folks with limited time.
Another possible resource could be the subreddit r/Midwives, which has more than 17,000 members. Though the group isn’t focused specifically on the AMCB exam, people post in the group every day and receive multiple responses. There’s most likely a large number of people in that group who’ve taken the AMCB exam, so that might be a great starting point.
The NARM Exam for CPMs
Testing Locations and Online Exam Options
NARM has partnered with a company called ProvExam to administer the exam. So, after NARM has approved you, you’ll communicate with ProvExam to schedule where and when you take the exam. One possible option is to take the exam on a computer at one of ProvExam’s testing centers.
Or, for a more convenient option, candidates can take the test from their computer. You’ll need a WiFi connection and a computer with a functioning camera and microphone. On the day of your exam, you’ll log into ProvExam’s online portal, where a live, remote proctor will monitor you as you take the exam.
Exam Structure and Content Areas
The exam consists of 300 multiple-choice questions, each with four possible answers. The exam is divided into two parts, and candidates will have 3 hours to complete each part. The contents of the exam are divided into seven areas. Those are:
- Professional Issues, Knowledge, and Skills
- General Healthcare Skills
- Maternal Health Assessment
- Prenatal
- Labor, Birth, and Immediate Postpartum
- Postpartum
- Well-baby care.
Scoring and Passing Requirements
The raw score needed to pass the exam can vary slightly depending on the version of the exam. Typically, the minimum raw score required to pass ranges between 79% and 81%. However, everyone’s results are reported as a scaled score where 75 or above is needed to pass.
All exam results will be reported as either pass or fail. Candidates will get an email with their unofficial scores from ProvExam within three business days. If you pass, you won’t see a detailed breakdown of your scores. If you don’t pass, you’ll get a report showing how you did in the main areas of the exam. Official scores will usually be sent by NARM within two to three weeks after the exam date.
Exam Registration and Fees
The exam costs $200, and you can pay using a money order or cashier’s check payable to the “North American Registry of Midwives.” Or, if you prefer to pay with a card, you’ll receive an invoice by email with a direct link for credit or debit card payment after your application has been received. Candidates who cancel or reschedule with a notice period of 5 to 29 days must pay a $55 rescheduling fee. If a candidate reschedules, cancels within 5 days, or fails to show up at the testing site, they must pay a $210 rescheduling fee.
Study Resources and Preparation Tips
One of the best places to begin studying is the CPM Candidate Information Booklet, a 75-page online PDF. Pages 35 through 46 provide an in-depth outline of the seven content areas mentioned earlier. There, you’ll find a detailed breakdown of medical conditions and terminology you must study before taking the exam.
Another excellent study resource is a deck of 600 free practice questions on Brainscape.com. The questions are organized into the seven content areas of the NARM exam and are designed to reflect the style of the exam questions. Each question has four possible answers, with the correct answer indicated in a column to the right.
You can check out the NARM Exam Prep at gomidwife.com for a more structured review course. The website and exam prep was created by a CPM named Amy Kirbow, and one of the most incredible things about the site is that you can email her directly. The exam prep is also quite affordable at $50 for 1 month or $75 for 3 months of access to online study materials. The review includes over 1,000 questions, scenarios, definitions, tips, and tricks designed to help candidates pass the exam on their first attempt.
If you’re looking for other aspiring midwives to talk to, you can check out some online groups. For starters, a Facebook group called NARM CPM Exam Study Group has over 2,000 members and regular monthly activity.
Now that we’ve covered national exams let’s focus on some popular states for people moving to the United States.
State-Specific Licensing Requirements
Midwifery Licensing in California
In California, CPMs and CNMs are allowed to practice midwifery.
CPMs must only pass the NARM exam and apply through the Medical Board of California. On the other hand, CNMs in California will obtain their license through the California Board of Registered Nursing and need to pass the NCLEX.
Midwifery Licensing in Florida
In Florida, CNMs are allowed to practice as advanced practice nurses, meaning they must pass the NCLEX.
For CPMs, the situation is unclear because the National Association of Certified Professional Midwives website lists Florida as a state where they can practice. However, the Florida Health Department website says the CPM credential is insufficient to practice in Florida. As always, the best thing to do if you’re unsure is to contact the Florida Health Department for current information.
Midwifery Licensing in Illinois
As for Illinois, CNMs must pass the NCLEX to become registered nurses and practice midwifery.
Regarding CPMs, state licensure in Illinois is still in the process of changing. In 2021, the state passed the “Licensed Certified Professional Midwifery Practice Act.” However, CPMs are still not permitted to begin practicing. The Illinois Council of Certified Professional Midwives estimates that sometime between 2024 and 2025, CPMs will be allowed to practice. So, CPMs may want to contact them for updated information.
Midwifery Licensing in Massachusetts
Massachusetts remains relatively strict about who can be licensed. As of 2024, only CNMs are legally allowed to practice midwifery, meaning hopeful midwives will have to pass the NCLEX.
Midwifery Licensing in New Jersey
Unlike Massachusetts, New Jersey grants licenses for all three types of midwives. For CMs and CPMs, there are no additional state exams. But, if you want to practice as a CNM, you must pass the NCLEX to become a registered nurse.
New York State grants licenses to CNMs and CMs, and there are no additional state exams. However, CNMs must pass the NCLEX to become registered nurses.
Midwifery Licensing in Texas
Lastly, Texas allows CNMs and CPMs to obtain licenses, and CPMs will be required to take the Texas Midwives Jurisprudence Exam, which costs $34.
Like all the states we’ve mentioned, CNMs in Texas will need to pass the NCLEX to become a registered nurse. They will also need to pass the Texas Nursing Jurisprudence Exam, which costs $25. Luckily, the exam has only 50 questions, and the Texas Board of Nursing has created an online prep course.
Midwife Credentialing by State | |||
States | CNM | CM | CPM |
California | ✓ | ✓ | |
Florida | ✓ | ||
Illinois | ✓ | In Process | |
Massachusetts | ✓ | ||
New Jersey | ✓ | ✓ | ✓ |
New York | ✓ | ✓ | |
Texas | ✓ | ✓ |
Maintaining Your Midwifery License
License Renewal Fees and Requirements by State
After receiving your license, you’ll need to maintain it to continue working as a midwife.
California
- CPMs: $300 renewal fee, 36 hours of approved continuing education every 2 years.
- CNMs: $150 renewal fee, 30 hours of continuing education every 2 years.
Florida
Illinois
Massachusetts
New Jersey
- CNMs: $160 renewal fee, 30 hours of continuing education every 2 years.
- CMs and CPMs: $270 renewal fee, 30 hours of continuing education every 2 years.
New York
It’s worth noting that according to the New York State Office of Professions, Certified Midwives and Certified Nurse Midwives are identical in their ability to practice. Likewise, Registered Nurses who become midwives are not obligated to maintain their status as registered nurses. Plus, midwives will not be required to complete continuing education in New York to keep their licenses. This could be an exciting opportunity, considering New York is one of the most popular states for immigrants.
However, it’s good to remember that a nursing background might increase your chances of gaining employment.
- Midwifery License: Valid for life, initial cost of $322, no continuing education required.
- Registered Nurse License (if maintained separately): At least $73 renewal fee every 3 years, with varying fees depending on the specific nursing license.
- Continuing Education for Nurses: Courses such as infection control, child abuse reporting, or pain management are required every 3 years.
Texas
- CPMs: $390 renewal fee, 20 hours of continuing education every 2 years.
- CNMs: $129 renewal fee, 20 hours of continuing education every 2 years.
Key Takeaways for Foreign-Trained Midwives
That covers some of the most popular states for people relocating to the U.S. from abroad. But these are just a few examples of the requirements you might encounter. While each state has its unique regulations, you now have a solid starting point to navigate your journey, whether you’re aiming to become a CNM, CM, or CPM.
As you embark on this journey, remember that you’re not just moving to a new country; you’re bringing your valuable skills to a place where they are increasingly needed. The landscape for midwives is changing rapidly, with new laws and legislation increasingly recognizing the vital role of different types of midwives in healthcare. And this means there are growing opportunities for you to make a difference.
Regardless of your chosen path, one thing is certain: relocating to the United States often requires official English translations of your important documents. Whether for a visa application, submitting your marriage license, or providing college transcripts to a licensing board, having certified translations is crucial. Just reach out to us, and we’ll be sure to get you the translations you need!
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