Certified Nurse Midwife Salary 2026: CNM Pay by State, Setting, and How It Compares to Other APRNs

By NurseCompensation Research Team · 2026-06-07 · 9 min read

Certified Nurse Midwife Salary 2026: CNM Pay by State, Setting, and How It Compares to Other APRNs

CNMs earn a mean salary of $131,570 according to the BLS — the second-highest nursing specialty after CRNAs. Here is the full compensation picture including state variation and practice setting.

National Numbers

The Bureau of Labor Statistics reports for Certified Nurse Midwives (SOC 29-1161, May 2024 data):

  • Mean annual wage: $131,570
  • Median annual wage: $128,790
  • 10th percentile: ~$82,000
  • 90th percentile: ~$179,000+
  • Mean hourly wage: $63.26
  • Total employed: Approximately 11,000+ nationally

CNMs are the second highest-paid nursing specialty after CRNAs ($223,210 mean), and they earn more than the NP median ($132,050) in many states.

Highest and Lowest Paying States

Top-paying states for CNMs (mean annual wage):

  • California: ~$165,000+
  • New Jersey: ~$136,000
  • Alaska: ~$130,000
  • Massachusetts: ~$135,000
  • New York: ~$140,000

Lower-paying states:

  • States in the Southeast and rural Midwest tend to fall in the $95,000-$110,000 range
  • However, cost of living adjustments often make these competitive in real purchasing power

Pay by Practice Setting

Where you work as a CNM significantly affects compensation:

Hospital-based (L&D units):

  • $120,000-$150,000 in most markets
  • Includes call responsibilities (nights, weekends)
  • Benefits package included
  • Most common employment setting (~65% of CNMs)

OB/GYN physician practices:

  • $115,000-$145,000
  • Typically employed model with salary + productivity bonus
  • May or may not include call

Birth centers (freestanding):

  • $90,000-$120,000
  • Published peer-reviewed research (Journal of Midwifery & Women's Health) found birth center-only CNMs earn consistently less than those in blended or hospital settings
  • Trade-off: More autonomy, midwifery model of care, lower intervention rates

Federally Qualified Health Centers (FQHCs):

  • $100,000-$130,000
  • Eligible for National Health Service Corps loan repayment (up to $50,000 for 2-year commitment)
  • Serve underserved populations

Private practice (midwife-owned):

  • Highly variable: $80,000-$200,000+
  • Dependent on volume, payer mix, and overhead management
  • Highest autonomy but also highest business risk

CNM vs. Other APRN Salaries

How CNM pay stacks up (BLS mean annual wages, May 2024):

  • CRNA: $223,210
  • NP (all specialties): $132,050
  • CNM: $131,570
  • Clinical Nurse Specialist: ~$98,000 (limited BLS data)

CNMs earn very competitively with NPs, though the comparison is complicated by the fact that NP encompasses many specialties (FNP, PMHNP, ACNP) with varying pay.

What Drives CNM Compensation

1. Full practice authority. In states where CNMs can practice without physician oversight, they can run independent birth centers and women's health practices, potentially earning more.

2. Call burden. Unlike many NP roles, CNM positions frequently require on-call shifts for births. Facilities that expect heavy call commitment typically pay higher base salaries or call stipends ($1,000-$5,000/month).

3. Volume and acuity. High-volume hospital L&D units in urban areas pay more than low-volume rural practices.

4. Birth rate trends. U.S. births have been declining since 2007 (from 4.3 million to approximately 3.6 million annually). This affects demand in some markets, though CNM scope (gynecologic care, primary care for women) offsets pure obstetric demand.

5. Midwife-attended birth trends. The percentage of births attended by CNMs has grown from about 7.6% in 2010 to approximately 12% in recent years, reflecting growing consumer demand for the midwifery model.

Career Economics

Education investment:

  • BSN (4 years) + RN experience (1-2 years) + MSN/DNP with CNM specialization (2-3 years)
  • Graduate tuition: $40,000-$100,000
  • Total timeline: 7-9 years from start of nursing school

Financial return: A CNM earning $131,000 vs. a staff RN earning $93,600 gains approximately $37,400/year. The education investment is typically recovered within 3-4 years of practice.

Job outlook: BLS projects 11.1% growth for nurse midwives through 2034, driven by demand for midwifery care, physician workforce constraints in obstetrics, and expansion of midwifery scope in many states.

Sources: Bureau of Labor Statistics OEWS (SOC 29-1161, May 2024), BLS Occupational Outlook Handbook, Journal of Midwifery & Women's Health (birth center salary study, Jolles et al., 2022), ACNM workforce data, HRSA NHSC loan repayment terms.