On this page11 sections
- Key takeaways
- How much do midwives make?
- Midwife salary by state
- Top-paying states and metro areas for midwives
- Where nurse midwives work, and what each setting pays
- What do certified professional midwives (CPMs) make?
- How to become a midwife: three credentials, three paths
- Job outlook for nurse midwives
- Next steps
- Questions people ask
- Sources
Key takeaways
- Nurse midwives earned a median of $134,040 and a mean of $136,980 in May 2025. The middle half earned between $116,510 and $157,400.
- California has the highest mean wage ($194,730), followed by Hawaii, Massachusetts, Arizona and New Jersey. Five of the 10 highest-paying metro areas are in California.
- Outpatient care centers paid nurse midwives the most of any industry, with a mean of $161,090. Offices of other health practitioners paid the least, at $93,380.
- BLS has no category for certified professional midwives. In a 2021 survey of home birth practices, CPMs charged an average global fee of $4,619 per client.
- BLS projects nurse midwife jobs will grow 11% from 2025 to 2035, from 8,200 to 9,100.
Nurse midwives in the US earned a median of $134,040 a year in May 2025, and a mean (average) of $136,980, or $65.86 an hour, according to the Bureau of Labor Statistics [1]. That's the most recent release of BLS's Occupational Employment and Wage Statistics (OEWS) survey. Pay depends heavily on where you work: California's mean is $194,730, more than $80,000 above the lowest-paying states [1].
One caveat before the numbers. BLS's category, "nurse midwives," is defined as midwives with graduate nursing education [1], which in practice means certified nurse-midwives (CNMs). Certified professional midwives (CPMs) aren't counted, and neither are self-employed midwives, because the OEWS survey only covers wage and salary workers [3]. We cover CPM pay further down.
How much do midwives make?
Here's the full national pay range for nurse midwives in May 2025 [1]:
| Percentile | Annual wage | Hourly wage |
|---|---|---|
| 10th | $93,620 | $45.01 |
| 25th | $116,510 | $56.01 |
| Median (50th) | $134,040 | $64.44 |
| 75th | $157,400 | $75.67 |
| 90th | $188,320 | $90.54 |
| Mean (average) | $136,980 | $65.86 |
So half of nurse midwives earned between about $116,500 and $157,400. BLS counted 7,920 nurse midwife jobs in May 2025 [1].
For comparison, registered nurses earned a median of $97,550 and a mean of $101,420 in the same survey [5]. Every CNM is a registered nurse first, so the gap between the two medians, about $36,500 a year, is roughly what the graduate degree adds.
Midwife salary by state
These are BLS's May 2025 estimates for nurse midwives in every state where BLS published a wage. We pulled each state's figures from BLS's public data on October 9, 2026 [2]. "n/a" means BLS published a wage but not a job count.
| State | Nurse midwife jobs | Mean annual wage | Median annual wage |
|---|---|---|---|
| California | 870 | $194,730 | $203,840 |
| Hawaii | n/a | $165,360 | $170,110 |
| Massachusetts | 280 | $162,420 | $159,800 |
| Arizona | 80 | $159,910 | $140,960 |
| New Jersey | 120 | $159,170 | $153,970 |
| Vermont | 60 | $148,100 | $151,030 |
| Oregon | 240 | $146,010 | $146,900 |
| Alaska | 60 | $144,130 | $133,430 |
| New York | 360 | $143,360 | $144,510 |
| Maryland | 240 | $141,880 | $140,120 |
| Washington | 170 | $140,860 | $158,970 |
| Virginia | n/a | $139,620 | $135,710 |
| Colorado | 180 | $138,520 | $137,610 |
| Nebraska | n/a | $137,300 | $138,880 |
| New Hampshire | 60 | $136,610 | $142,960 |
| Rhode Island | 80 | $135,610 | $135,180 |
| Minnesota | 410 | $135,380 | $134,810 |
| Connecticut | 150 | $131,680 | $130,790 |
| Missouri | 80 | $131,470 | $130,220 |
| Maine | 50 | $131,090 | $133,270 |
| Delaware | n/a | $130,610 | $127,510 |
| Utah | 140 | $128,650 | $130,930 |
| Wisconsin | 200 | $127,300 | $133,070 |
| Michigan | 430 | $125,240 | $125,140 |
| Ohio | 180 | $125,210 | $127,730 |
| North Carolina | 240 | $123,920 | $126,040 |
| Iowa | 80 | $123,000 | $131,360 |
| Texas | 290 | $122,910 | $123,380 |
| New Mexico | 50 | $122,130 | $123,350 |
| South Carolina | 100 | $120,550 | $122,390 |
| District of Columbia | 70 | $119,310 | $101,450 |
| Georgia | 300 | $119,120 | $105,510 |
| Louisiana | 60 | $116,840 | $119,280 |
| Pennsylvania | 320 | $116,390 | $119,990 |
| Tennessee | 330 | $115,780 | $116,980 |
| Indiana | 170 | $114,640 | $101,630 |
| Illinois | 280 | $113,800 | $120,840 |
| Florida | 460 | $111,870 | $127,460 |
| North Dakota | n/a | $99,740 | $72,630 |
BLS didn't publish a nurse midwife wage for Alabama, Arkansas, Idaho, Kansas, Kentucky, Mississippi, Montana, Nevada, Oklahoma, South Dakota, West Virginia or Wyoming [2]. That doesn't mean no nurse midwives work there, only that there's no published estimate.
Some state figures are less precise than others. BLS's relative standard error on the wage estimate is 13.6% in Arizona and 11.0% in Hawaii, compared with 1.4% in California [1]. Treat small-state numbers as a rough guide, not a precise rank.
Top-paying states and metro areas for midwives
The five highest-paying states by mean wage were California ($194,730), Hawaii ($165,360), Massachusetts ($162,420), Arizona ($159,910) and New Jersey ($159,170) [1].
Metro areas show the same pattern. These were the 10 highest-paying metro areas for nurse midwives in May 2025 [1]:
| Metro area | Mean annual wage |
|---|---|
| San Francisco-Oakland-Fremont, CA | $209,470 |
| Los Angeles-Long Beach-Anaheim, CA | $198,360 |
| Riverside-San Bernardino-Ontario, CA | $193,190 |
| Sacramento-Roseville-Folsom, CA | $189,750 |
| San Diego-Chula Vista-Carlsbad, CA | $172,590 |
| Urban Honolulu, HI | $168,200 |
| Boston-Cambridge-Newton, MA-NH | $165,480 |
| New York-Newark-Jersey City, NY-NJ | $158,770 |
| Seattle-Tacoma-Bellevue, WA | $158,400 |
| Miami-Fort Lauderdale-West Palm Beach, FL | $149,250 |
Many of these metros are also expensive places to live, so compare the pay with local rent and home prices before you move for a job. The metros with the most nurse midwife jobs were Washington, DC (310), Minneapolis-St. Paul (300), New York (240), Atlanta (230) and Los Angeles (220) [1].
Where nurse midwives work, and what each setting pays
Most nurse midwives work in doctors' offices, hospitals and outpatient clinics [1]:
| Industry | Nurse midwife jobs | Mean annual wage |
|---|---|---|
| Offices of physicians | 3,270 | $133,950 |
| General medical and surgical hospitals | 1,820 | $146,680 |
| Outpatient care centers | 1,560 | $161,090 |
| Offices of other health practitioners | 760 | $93,380 |
| Colleges, universities and professional schools | 110 | $134,720 |
Outpatient care centers paid the most, and offices of other health practitioners paid the least [1]. Midwives who own their practice aren't in these numbers at all, since OEWS leaves out the self-employed [3].
Payers set a floor under hospital and clinic pay. Medicare has allowed CNMs up to 100% of the physician fee schedule amount for the same service since January 1, 2011 [8].
What do certified professional midwives (CPMs) make?
No government survey tracks CPM pay. BLS's nurse midwife category requires graduate nursing education [1], and CPMs are certified through a separate route by the North American Registry of Midwives [11]. The CPM credential is built around births at home and in birth centers (our types of midwives guide explains why), so CPM income usually comes from per-client fees rather than a salary.
The closest thing to pay data is the client fee. A 2021 survey of 129 home birth practices in 49 states found an average global fee of $4,650, with a median of $4,400 and a range of $2,000 to $9,921 [6]. CPMs charged an average of $4,619, and CNMs in home birth practice charged $5,202 [6]. The global fee covers prenatal care, the birth and postpartum care, and it has to cover the practice's costs, so it isn't take-home pay.
Medicaid matters too. As of July 2026, 22 states and DC covered CPMs and/or certified midwives (CMs) under Medicaid. Ten states and DC pay them 100% of the physician rate for a vaginal delivery, and the rest generally pay 70% to 90% of it [7].
There are a lot of non-nurse midwives in practice. The September 2026 national provider file lists 8,470 active NPIs with the midwife (non-nurse) taxonomy and 15,796 with the advanced practice midwife (CNM) taxonomy [9]. Those are our counts from the CMS file, and they include people who hold an NPI but bill under a practice.
If you're weighing home birth pay, our midwife cost guide breaks down what families pay by setting.
How to become a midwife: three credentials, three paths
There are three national midwife credentials. Our guide to CNM vs CPM vs CM compares what each one can do. Here's how you get there:
| Credential | Education | Exam | Recertification |
|---|---|---|---|
| Certified nurse-midwife (CNM) | RN, plus a master's or doctoral degree from an ACME-accredited midwifery program [10] | AMCB national certification exam [10] | Through AMCB [10] |
| Certified midwife (CM) | Same graduate midwifery education, without the nursing degree [10] | AMCB national certification exam [10] | Through AMCB [10] |
| Certified professional midwife (CPM) | NARM's Portfolio Evaluation Process (PEP), a MEAC-accredited school, or another route such as a state midwifery license [11] | NARM exam [11] | Every 3 years [11] |
CNM and CM graduate programs are accredited by the Accreditation Commission for Midwifery Education (ACME), and you must graduate from one to sit for the AMCB exam [10]. Only CNMs enter midwifery as registered nurses [10].
NARM's fees for CPM certification as of 2026 [12]:
- MEAC graduates: a $1,365 application fee, with the exam included.
- PEP applicants: four phase fees ($240, $450, $450 and $135) plus a $1,155 exam fee.
- Recertification: $216 every three years if you renew before your certification expires.
Note that a CPM's legal right to practice comes from state law, and not every state licenses CPMs. Check your state's midwifery board before you invest in training.
Job outlook for nurse midwives
BLS projects nurse midwife employment will grow 11% from 2025 to 2035, from about 8,200 jobs to 9,100, an increase of about 900 [4]. Nurse anesthetists, nurse midwives and nurse practitioners as a group are projected to grow 36%, mostly because of nurse practitioners [4]. BLS also notes that APRNs who deliver babies may need to be on call [4].
Next steps
- See who's practicing near you in our midwife directory.
- Already practicing? List or claim your profile so families can find you. If you already have an NPI, you can claim your listing directly.
- Thinking about other birth work? Compare doula pay, lactation consultant pay and how to become a doula.
- Browse doulas and lactation consultants in your area to see who you'd be working alongside.
Questions people ask
Who gets paid more, a midwife or an RN?
A nurse midwife. In May 2025, nurse midwives earned a median of $134,040, compared with $97,550 for registered nurses. Every CNM is also an RN, and the graduate degree is what raises the pay.
What state pays nurse midwives the most?
California, with a mean annual wage of $194,730 in May 2025. Hawaii ($165,360), Massachusetts ($162,420), Arizona ($159,910) and New Jersey ($159,170) round out the top five.
How long does it take to become a midwife after RN?
CNM programs are graduate programs, so it depends on the program and on whether you already have a bachelor's degree. Programs grant a master's or doctoral degree, and you need to graduate from an ACME-accredited program to sit for the national certification exam.
How much do certified professional midwives (CPMs) make?
There's no government data on CPM income. CPMs mostly earn per client. A 2021 survey of 129 home birth practices found CPMs charged an average global fee of $4,619, which covers prenatal care, the birth and postpartum care.
Is midwifery harder than nursing?
It takes more schooling. A certified nurse-midwife has to be a registered nurse first, then finish a graduate midwifery program and pass a national certification exam. That extra training is a big part of why CNMs out-earn RNs by about $36,500 a year at the median.
Sources
Numbers in brackets in the guide link to these sources.
- 1.OEWS Profiles: 29-1161 Nurse Midwives, May 2025U.S. Bureau of Labor Statistics, 2026
- 2.Occupational Employment and Wage Statistics (OEWS) Tables: May 2025 state estimatesU.S. Bureau of Labor Statistics, 2026
- 3.Occupational Employment and Wage Statistics OverviewU.S. Bureau of Labor Statistics, 2026
- 4.Occupational Outlook Handbook: Nurse Anesthetists, Nurse Midwives, and Nurse PractitionersU.S. Bureau of Labor Statistics, 2026
- 5.OEWS Profiles: 29-1141 Registered Nurses, May 2025U.S. Bureau of Labor Statistics, 2026
- 6.The Cost of Home Birth in the United States (Anderson and Gilkison, International Journal of Environmental Research and Public Health 18(19):10361)International Journal of Environmental Research and Public Health, via PubMed Central, 2021
- 7.State Medicaid Coverage of Certified Professional Midwives and Certified MidwivesNational Academy for State Health Policy (NASHP), 2026
- 8.42 CFR 414.54, Payment for certified nurse-midwives' servicesLegal Information Institute, Cornell Law School (Code of Federal Regulations)
- 9.NPPES Downloadable File (NPPES Data Dissemination, September 14, 2026)Centers for Medicare & Medicaid Services (CMS), 2026
- 10.Certified Nurse-Midwife and Certified Midwife Education and Certification in the United StatesAmerican College of Nurse-Midwives (ACNM), 2025
- 11.Certification/RecertificationNorth American Registry of Midwives (NARM), 2026
- 12.Payments and FeesNorth American Registry of Midwives (NARM), 2026
