13 Pros and Cons of Being a Nurse Midwife

Written By: Jennifer Schlette MSN, RN

As a nurse-midwife, you will experience the best of both worlds. When it is necessary, you can provide your patients with traditional medical care while also offering them holistic support during their pregnancies and births. Though that might sound like a fantastic job, many challenges come with being a nurse-midwife. Do you know what are the pros and cons of being a nurse-midwife? Do not panic if you do not. Below you will find the top 13 pros and cons of being a nurse-midwife. These pros and cons will help you decide if a career as a nurse-midwife is the path that you should be traveling down.

What Does A Nurse-Midwife Do?

The practice of Nurse-Midwifery is among one of the oldest types of modern medicine. Nurse-midwifery dates back to ancient Egypt. So, what does a nurse-midwife do, exactly?

Some people might think that a nurse-midwife is just like a regular nurse, but with an added focus on maternity care. However, there is actually quite a bit more to it than that. Nurse-Midwives are specially trained in both nursing and midwifery, which allows them to provide holistic care to their patients. They provide prenatal care, delivery care, and postpartum care. In other words, they help pregnant women through all stages of their pregnancy, from before they conceive until after they give birth.

A nurse-midwife is capable of routine delivery of babies as well as babies who need a bit more assistance during the birthing process, such as with forceps or vacuum. They are not able to perform a cesarean birth. The procedure of a cesarean birth must be performed by a physician. Certain states will allow the nurse-midwife to be the first assist during the procedure. In certain states, a nurse-midwife may be permitted to perform a vaginal birth after a cesarean or VBAC.

Nurse-Midwives also offer preventive health services and education to women of all ages. They can provide women with annual exams, preventative care, and contraception as examples.

Where Does A Nurse-Midwife Work?

Nurse-Midwives are an essential part of the health care team, and they work in a variety of settings.

You will find nurse-midwives working in a hospital or in the community. For example, they are often found in prenatal, post-natal, and well-baby clinics. This might sound like it is all about babies, but that is not strictly true because nurse-midwives also are experts in the field of women’s health, such as helping them choose whether or not to use contraception, annual gynecological exams and offer advice on breastfeeding if the mother decides to do so. They can also provide advice on nutrition and other health issues.

Some nurse-midwives even work in the field of sexual health. So, there is really no end to the types of advice and support that a nurse-midwife can offer. Pretty impressive, huh?

What Is A Typical Nurse Midwife Work Schedule Like?

The type of work schedule you will have as a nurse-midwife will depend mainly on your workplace. Nurse-midwives typically can expect to work Monday through Friday, with some variations depending on your employer's needs and patient caseload. Most nurse-midwives work 8-hour days in the clinic, though longer or shorter weekdays are not uncommon. Many do not work weekends, though this answer will vary between employers.

Other nurse-midwives will work in the hospital setting, working 12 hours shifts. You may find that a nurse-midwife will be on call from time to time. This would include weekends and holidays as well. You never know when a baby will be born.

How Much Does A Nurse Midwife Make?

As a nurse-midwife, you can expect to earn a pretty nice salary. In fact, the average nurse-midwife salary has them earning well over the national average income. Let's take a closer look at the wages of a nurse-midwife. The average salary for a nurse-midwife is $55.55 an hour, which will roughly translate to about $115,540 a year. Not too shabby!

If you are new to the field of nurse-midwifery, then you can expect an entry-level salary of about $67,710 a year or $32.55 an hour. Once you gain a bit more experience, your salary will increase significantly to $53.43 an hour or about $111,130 a year. A nurse-midwife with top-level experience will be earning quite an impressive $179,770 a year or $86.43 an hour.

Level of
Average Salary$55.55$115,540
(Source: U.S. Bureau of Labor Statistics)

Job Outlook For A Nurse Midwife

The job outlook for nurse-midwives is in a positive direction for the next decade. According to the Bureau of Labor Statistics, the number of nurse-midwives is projected to increase by 10.96% between 2020 and 2030. Let's break this down a bit more. In 2020 there were 7,300 nurse midwives, which is expected to increase by about 800 positions by 2030. This number accounts for an increase from 7,300 to 8,200. Annual job openings, including new and replacement jobs, are around 500. So, what does this mean? More jobs! Great news if you are looking to enter the nurse-midwifery field or are currently working in the position of nurse-midwife.

in 2020
in 2030
New Employment
Growth (2020-2030)
Annual Job Openings
(New + Replacement)
Number %
7,300 8,200 800 10.96% 500
(Source: U.S. Bureau of Labor Statistics)

Steps To Becoming A Nurse Midwife

1. The first step to take if you wish to become a nurse-midwife is that you must attend an accredited undergraduate nursing program. You must obtain a bachelor's degree in order to proceed to the next step.

2. You must gain some experience in nursing prior to applying to a graduate program. Many graduate programs will require that you have one or more years of experience in the field of nursing not specifically women’s health, before being considered for admission into their programs.

3. Since a nurse-midwife is an advanced practice role, you will need to earn an advanced practice nursing degree. You must obtain a master’s of science in nursing. You can also consider acquiring a doctor of nursing of practice, but it is not required.

4. After you complete your graduate or post-graduate education with a focus in midwifery, you must then sit for your exam to obtain certification. This exam is given through The American Midwifery Certification Board (AMCB). You will be able to take this exam four times within 24 months of completing your graduate program. Your certification will be valid for five years before you need to recertify.

5. Once you are certified, you must register with the state board of nursing.

6. Other certifications that you must obtain are Basic Life Support, Advanced cardiac life support, and the Neonatal Resuscitation Program.


(The following are the top 13 disadvantages of being a Nurse-Midwife.)

1. You will have an irregular schedule.

One of the top disadvantages of being a nurse-midwife is that you may need to work irregular hours. Working irregular hours will make it difficult to make plans with friends outside the profession. It can also be tough to maintain an excellent work-life balance that so many people strive for. This can be frustrating, especially when you have other commitments. Unfortunately, the profession's demands often prevent nurse-midwives from enjoying a healthy work-life balance.

2. You may experience terrible birth outcomes.

Another one of the biggest downsides to being a nurse-midwife is that you will experience terrible birth outcomes during the course of your career. This means that the mother may not live, and/or the baby may not make it. During labor, emergencies can happen, so it is essential to always be prepared. Though these situations are rare, they can occur and do occur. When these situations arise, they can be highly emotional for everyone involved.

3. You may be sued.

The career of a nurse-midwife is a high-risk job. It will not be uncommon for you to find yourself named in a lawsuit as a nurse-midwife. The reason for this is that you may be sued for malpractice. If you are sued, your personal assets could be on the line. This includes any stocks, bonds, and real estate you currently own. Being sued can also put your family and your good name at risk.

4. You will work long hours.

As a nurse-midwife, you can expect to work very long hours. The days are long, and the nights are longer. These extended hours will cause you to be exhausted. Exhaustion can be dangerous, especially in the high-risk career of being a nurse-midwife. You will need to be constantly on your toes, and when you are tired, your reflexes may not be as quick. You may also make mistakes while you are working if you are too tired. This can lead to dangerous situations for you and the patients you are caring for.

5. You may have to be on call.

One of the disadvantages of being a nurse-midwife is you may have to be on call. This can interrupt your plans, and you can be called in the middle of the night. It is just something that comes with the territory. So, if you are someone who likes to plan everything out in advance, or you are not very good at juggling your life, this may not be the career for you.

6. You may work nights

You may have to work nights if you decide on a career as a nurse-midwife. Night shift can be challenging because many other people will be sleeping during off-hours, making it difficult to run errands and shop for groceries. You may also miss out on social and family gatherings because you work nights. Night shift is not for everyone, and you may want to consider this before signing up to take classes to become a nurse-midwife.

7. You may work weekends.

Another one of the disadvantages of being a nurse-midwife is that you will have to work weekends if you work in the hospital setting in any capacity. You will be at work when your friends and family have off. This can be a bit of a bummer, as you will miss gatherings with friends and family.

8. You may work holidays

One con to being a nurse-midwife is that you may have to work holidays. You will be missing these memory-making events with family and friends. You may be feeling guilty about not being able to be there. Some holidays that you may be required to work are Christmas, Thanksgiving, and Independence Day.

9. You are unable to perform a c-section if a patient needs one

One of the cons of being a nurse-midwife is that you will be unable to complete a c-section should your patient require one. This skill is typically reserved for doctors, as they have the necessary training and experience to safely carry out this procedure. If you are a nurse-midwife and find yourself in a situation where a c-section is required, you will need to transfer your patient's care to a doctor. This can be a difficult task, especially if you have cared for this patient for their entire pregnancy. It can be frustrating for you and your patients when they need to be transferred in the middle of their labor. You may feel defeated knowing that if a patient needs an emergency c-section, you will not be able to perform the procedure.

10. You will not handle high-risk pregnancies

One of the cons of being a nurse-midwife that you will have to consider is that you are not medically qualified to care for high-risk pregnancies. You will need to pass these patients off to a physician. While you may have experience caring for low-risk pregnancies, your skills and qualifications do not extend to dealing with more complicated cases. This means that pregnant women who require additional care and monitoring during their pregnancy will need to be seen by a doctor.

11. Your job can be physically demanding

One of the pros and cons of being a nurse-midwife that you will have to weigh is whether or not you can handle the physical demands of this career. You will be on your feet all day, carrying and moving patients. In addition, you will also have to do a lot of heavy lifting. So, if you are looking for a career that is easy on your body, a nurse-midwife is not the right choice for you.

12. You will be exposed to germs

As a nurse-midwife, you will be exposed to germs such as bacteria and viruses. Having such a high exposure rate to pathogens is definitely one of the cons of being a nurse-midwife. This is simply a fact of life in this profession. Due to being exposed to all of these germs, you can become ill, and you can risk bringing home these germs to your family, and they could get sick.

13. Your job can be stressful at times

As a nurse-midwife, your job and your days will be stress-filled. When you choose a career in nurse-midwifery, you have to be aware that a stressful situation can creep up at any time. If you are a person who loves to be in control and loathes stress, you should choose a different profession.


(The following are the top 13 advantages of being a Nurse-Midwife.)

1. You get to help bring a new baby into the world.

One of the top pros of being a nurse-midwife is witnessing the moment a baby is born. It is an incredible experience that cannot be described in words - you must experience it firsthand. There is nothing quite like seeing a new life come into the world, and nurse-midwives get to do that every day.

2. You will experience the beginnings of a family.

Another great thing about being a nurse-midwife is seeing the beginning of a family. You will be there when a couple first learns that they are pregnant, and you will help them through their pregnancy. You will also be there at the birth of their child, and you will help to care for the child during its infancy. This is an excellent opportunity to form relationships with families, and it can be gratifying to guide future parents through their early struggles as a parent.

3. You will make a great living.

One of the biggest advantages of being a nurse-midwife is the excellent salary you can expect to make. The average salary of a nurse-midwife is $55.55 an hour, about $115,540 a year. An entry-level salary for a nurse-midwife is approximately $67,710 a year or $32.55 an hour. A mid-level experienced nurse-midwife can earn $53.43 an hour or about $111,130 a year. A top-level experience nurse-midwife will be making $179,770 a year or $86.43 an hour.

4. You will be in demand.

As a nurse-midwife, you can rest assured that you have chosen a career that is in high demand. The need for nurse-midwives is increasing yearly due to the increasingly high number of women choosing to have babies later in life. According to the Bureau of Labor Statistics, the number of nurse-midwives is projected to increase by 10.96% between 2020 and 2030. In 2020 there will be 7,300 nurse midwives, and this number is expected to grow by about 800 nurse midwife positions by 2030. This will be an increase from 7,300 to 8,200. Annual job openings, including new and replacement jobs, are around 500.

5. You will have a great deal of autonomy in certain states.

Nurse-midwives have full practice authority in some states. This means that they can provide primary care to patients and deliver babies without being in collaboration or overseen by a physician. In states where they do not have full practice authority, nurse-midwives often work in partnership with physicians. Full practice authority will allow you to provide more comprehensive care to your patients. Having full practice authority is a lot of responsibility. Your ability to handle so much responsibility is something you need to consider when evaluating the pros and cons of being a nurse-midwife.

6. You will have various practice environments to practice in

Another one of the pros of being a nurse-midwife is that you get to work in a variety of practice environments. You do not have to just choose one; having a few options can be helpful when going through tough times. Some of these environments that you can choose from are homebirths, hospital-based clinics, group practices or offices, outpatient clinics or facilities, and research projects/programs that involve nurse-midwives. There are many more places to work, but these are just some of the most popular. You can also work in pretty much any state, which is great if you are looking to travel. If you do not like one environment, try another! As long as you have the proper certification, you can find a job.

7. You will be performing meaningful work with pregnant women

As a nurse-midwife, you will be performing meaningful work to improve the health of mothers and their children. Your work will ensure that pregnancies are healthy and go smoothly and that a new mother receives the care they need after giving birth. You will also be an essential part of educating new parents about childbirth and parenting.

8. You will be helping women.

One of the advantages of being a nurse-midwife is that you will be helping women through one of the most critical times in their lives. You will be providing them with comprehensive care, both before, during, and after their pregnancies. As a nurse-midwife, you will also be responsible for educating women about preconception topics, pregnancy, childbirth, and postpartum care.

9. You can always find a job

One of the most excellent advantages of being a nurse-midwife is that you will have no trouble finding a job. Whether you are looking for a full-time or part-time job or you want to work in a hospital or clinic setting, there are plenty of opportunities out there for you. Plus, a career as a nurse-midwife is a recession-proof career, so you do not have to worry about your job security.

10. In certain states, you can have your own practice

As a nurse-midwife, you will be able to establish your own practice depending on which state you are in. This will allow you to have more control over your work schedule and the patients that you see. You will also be able to receive a higher salary than if you were working in a hospital setting. Basically, you are the boss. Being your own boss is one of the pros of being a nurse-midwife.

11. You will have a well-respected career.

As a nurse-midwife, you will have a well-respected career. You will be viewed as an expert in your field. One of the top pros of being a nurse-midwife is that you will be an essential member of the healthcare team. You will be able to make a real difference in the world.

12. You will work in a trusted profession

Nurse-midwives are one of the most trusted professions in the world. You provide care to your patients during their best and worst times. You are always there for them, whether they need advice or just a listening ear. You are a vital part of the healthcare community.

13. You can be proud of yourself

As a nurse-midwife, you can be proud of yourself. Not everyone can do it – it takes a lot of skill and training to provide care for pregnant women and deliver babies. But you have got what it takes, and you are making a real difference in the lives of your patients.

My Final Thoughts

All in all, being a nurse-midwife is an intriguing and fulfilling career. As with any career, there are always pros and cons that need to be considered. The pros and cons of being a nurse-midwife are sometimes difficult to distinguish. One must be aware that the job is challenging in emotional and physical terms and extremely rewarding when it goes well. This may seem like too much work for some, but for others, it is an opportunity not to miss out on life-changing experiences! We hope this article on the top 13 pros and cons of being a nurse-midwife has helped you decide if this is the right career for you.

Jennifer Schlette MSN, RN
Jennifer Schlette is a registered nurse in pediatric critical care in New York City. She is the former Director of Undergraduate Nursing at a college located in New York. After obtaining her BSN from the College of Mount Saint Vincent, she went on to complete her MSN.