Direct Entry Midwifery Programs in Texas

Last Updated on January 15, 2023 by Team College Learners

Getting an education in direct entry midwifery is one of the most rewarding experiences in Texas. Direct entry midwives are often the only means of help in areas with little access to medical care. Being a direct entry midwife can give you the opportunity to make a huge impact on people’s lives.

Here you will find some of the most important information on how to become a direct entry midwife , direct entry midwife salary  & direct entry midwife states . Everything you need is right here. You will also discover related posts on direct entry midwifery schools in florida & online midwifery programs on collegelearners.

Online Midwifery Programs

Nurse Midwifery | Texas Tech University Health Sciences Center

A direct-entry midwife is an independent practitioner educated in the discipline of midwifery through self-study, apprenticeship, a midwifery school, or a college- or university-based program distinct from the discipline of nursing. Direct entry midwifery is based upon the European model of professional midwifery practice, which does not require becoming a nurse as a prerequisite, although some nursing skills are taught as part of a comprehensive midwifery education. A direct-entry midwife is trained to provide the Midwives Model of Care to healthy women and newborns throughout the childbearing cycle primarily in out-of-hospital settings.

NMI graduates qualify for the NARM Written Examination, which leads to the CPM credential.

A Direct-Entry Midwife (DEM) is an independent practitioner educated in the discipline of midwifery through apprenticeship, self-study, a midwifery school, or a college/university-based program distinct from the discipline of nursing. A direct-entry midwife provides the Midwives Model of Care to healthy women, pregnant people, and newborns through the childbearing cycle (primarily in out-of-hospital settings including homes and free-standing birth centers) and may also provide gynecological wellness care. Most states have specific legal requirements for education and licensing of direct-entry midwives. Registered Midwives (RM) and Licensed Midwives (LM) are examples of direct-entry midwives.

Certified Nurse Midwifery Schools - Online & Campus Programs ||  RegisteredNursing.org
  •    The ATM Midwifery Training Programs is a Texas licensed midwifery school.

Texas Midwives: The Two Types of Midwives in Texas

There are two types of midwives who may legally practice in the state of Texas: Certified Nurse Midwives (CNM) and Licensed Midwives (LM).  A third credential is the Certified Professional Midwife (CPM).  Both CNMs and LMs may also be a CPM.  A CPM must also have a Texas license or CNM credential to practice legally in Texas.

Alternate Entry Nursing Programs In Texas - College Learners

Lay midwifery is illegal in Texas.

Scope of Practice

  • CNMs independently manage women’s health care services relating to pregnancy, childbirth, the postpartum period, family planning, and routine gynecological needs. They may also provide normal newborn care and primary health care for women.
    They consult, collaborate, or refer to other health professionals for patient care issues outside of their area of competency.
    CNMs may have prescriptive authority delegated by a collaborating physician if the CNM meets the requirements of the BNE.
  • Licensed Midwives may independently manage women’s health care services relating to pregnancy, childbirth, and the postpartum period. They also provide normal newborn care for up to six weeks of age. A licensed midwife with appropriate training and experience may also provide family planning and routine well-woman care according to her individual protocols.
    They consult, collaborate, or refer to other health professionals for patient care issues outside of their area of competency.
    Licensed Midwives have authority to purchase and use oxygen as well as eye ointment for the newborn.



CNMs are registered nurses that have completed a graduate-level program in nurse-midwifery. CNM educational programs are accredited by the American College of Nurse-Midwives (ACNM) and recognized by the U.S. Department of Education. These programs must also meet the standards of the Board of Nurse Examiners for the State of Texas (BNE).

Licensed Midwives

Licensed midwives are midwives that have met all the requirements set forth by the state of Texas. This means they are not required to be nurses. Their education in Texas is based on the Midwives Alliance of North America (MANA) Standards of Practice, MANA Core Competencies, the North American Registry of Midwives (NARM) test and skill specifications, and the Texas Midwifery Basic Information and Instructor Manual, which is created and approved by the Texas Department of Licensing and Regulation. In addition, all licensing candidates must meet minimum clinical education requirements, be certified in healthcare provider CPR, and neonatal resuscitation. Ongoing continuing education is a requirement for re-licensure every two years.

  •    The ATM Midwifery Training Programs is a Texas licensed midwifery school.

How to become a certified midwife in Texas

The Texas Board of Nursing regulates the practice of nurse-midwifery through licensure of advanced practice registered nurses (APRNs). To become a nurse-midwife in Texas, RNs must successfully complete a number of steps to meet all requirements for national certification through the American Midwifery Certification Board and APRN licensure through the Texas Board of Nursing:

Step 1. Earn a Qualifying Master’s Degree or Higher in Nurse-Midwifery

To become an APRN in nurse-midwifery in Texas, RNs must first complete a master’s degree or other graduate degree in nurse-midwifery accredited by the American Commission for Midwifery Education (ACME).

In addition to traditional nurse-midwifery programs, many institutions now offer dual specialization programs in nurse-midwifery/women’s health. These dual specialization programs allow students to expand their knowledge of women’s healthcare and expand their practice and certification options upon graduation.

ACME-accredited degree programs in nurse-midwifery often boast program features designed to appeal to working RNs. For example, part-time programs and programs offered either partially or completely online allow students to earn a master’s in nurse-midwifery at a more relaxed pace. Due to the lack of nurse-midwifery programs in the United States, online programs have become commonplace. For example, there are just two nurse-midwife degree programs in Texas: one in Waco and one in Lubbock.

Admission Requirements

For RNs who possess a Bachelor of Science in Nursing (BSN), the clear path to APRN licensure is the Master of Science in Nursing (MSN) in nurse-midwifery or the Master of Science (MS) in Nurse-Midwifery.

Candidates for nurse-midwifery programs must possess a Bachelor of Science in Nursing (BSN) and a current and unencumbered RN license. Many institutions also require students to possess:

  • Minimum undergraduate GPA
  • Letters of recommendation
  • Nursing experience
  • Admissions essay

In addition to MSN and MS degrees, ACME accredits a number of other graduate programs designed specifically for RNs at different stages of their education. For example:

  • RN-to-MSN Degree Programs: RN-to-MSN bridge programs combine all aspects of a Bachelor of Science in Nursing (BSN) and a Master of Science in Nursing (MSN) in one accelerated dual-degree program designed for associate’s degree-prepared RNs.
  • Post-Graduate Certificate Programs: Post-graduate certificate programs appeal to RNs who already possess a master’s degree in nursing but want to pursue initial APRN licensure as a nurse-midwife.

Program Components

Nurse-midwifery and nurse-midwifery/women’s health master’s degree programs prepare nurses to serve as expert providers of healthcare to women across the lifespan. Graduates of these programs are prepared to provide and/or collaborate in the care of women and the healthy newborn in a variety of settings and serve as educators, leaders, consultants, and advocates.

The didactic component of a nurse-midwifery program allows students to incorporate knowledge from nursing and the related sciences into the delivery of advanced nursing care across diverse populations. The core curriculum of these programs includes study in:

  • Theoretical foundations of advanced nursing practice
  • Nursing in research
  • Pathophysiology
  • Pharmacological principles
  • Advanced health assessment
  • Women’s health
  • Antepartum/postpartum
  • Intrapartum/newborn care
  • Evidence-based care in nurse-midwifery

The clinical component of a nurse-midwifery or dual-focus nurse-midwifery/women’s health master’s program consists of up to 1,000 hours of practice, and allows students to receive valuable experience in a variety of clinical settings, such as hospitals, OB/GYN practices, birth centers, and women’s health clinics, and community health settings.

While campus-based programs in nurse-midwifery generally require students to complete their clinical rotations in established settings within close proximity to campus, institutions offering online programs often partner with clinical sites throughout the U.S., thereby allowing students to complete the clinical component of their nurse-midwifery program at sites close to home.

In Texas, nurse-midwifery students may satisfy some of their clinical requirements in settings such as:

  • The Woman’s Hospital of Texas, Houston
  • Texas Medical Center, Houston
  • Texas Children’s Hospital – Pavilion for Women, Houston
  • Conroe Regional Medical Center, Conroe
  • University of Texas Medical Branch at Galveston, Galveston
  • Texas Health Presbyterian Hospital, Plano
  • Methodist Mansfield Medical Center, Mansfield

Step 2. Take and Pass the National Certification Examination to Become a CNM

After graduating from am ACME-accredited nurse-midwifery program, RNs in Texas must take and pass the Certified Nurse-Midwife (CNM) examination through the American Midwifery Certification Board to qualify for initial APRN licensure as a nurse-midwife.

Graduates of dual-focus nurse-midwifery/women’s health programs may also take the Women’s Health Care Nurse Practitioner (WHNP) examination through the National Certification Corporation to earn the WHNP designation and dual APRN licensure as a nurse-midwife and women’s health nurse practitioner.

Candidates must qualify to take the CNM and WHNP by completing an application and receiving approval from the appropriate certifying body. Once they receive approval to test, candidates must schedule to take the test through one of the Applied Measurement Professionals (AMP) testing centers located throughout the country.

In Texas, candidates may schedule to take their exam at one of the following AMP testing centers:

  • Austin
  • Dallas
  • El Paso
  • Fort Worth
  • Houston
  • Lubbock
  • McAllen
  • San Antonio

Step 3. Apply for APRN Licensure as a Nurse-Midwife through the Texas Board of Nursing

To earn initial APRN licensure as a nurse-midwife in Texas, RNs must complete an Application for Licensure as an Advanced Practice Registered Nurse and Prescriptive Authority.

Candidates may also complete an online application. Candidates not applying for prescriptive authority DO NOT need to answer questions 11 and 12.

In addition to a completed application, candidates must:

  • Submit an official transcript related to their advanced practice nursing education
  • Enclose evidence of current national certification as a CNM
  • Enclose an application fee of $100 or $150 if applying for APRN licensure with prescriptive authority

Candidates may only check ONE APRN specialty on the application. Candidates pursuing specialization as a women’s health nurse practitioner must complete a separate application.

Prescriptive Authority for Controlled Substances

Nurse-midwives in Texas requesting the authority to prescribe controlled substances must possess full licensure as an APRN with prescriptive authority and must meet all requirements (along with the delegating physician) as set forth by the Texas Medical Board (TMB). Nurse-midwives can contact the TMB at 512-305-7030.

After the TMB issues a controlled substances permit, nurse-midwives must apply for a DEA registration number.

Step 4. Explore Nurse-Midwife Career Options in Texas and Maintain Credentials

Certified nurse-midwives in Texas must maintain both their national certification(s) and APRN licensure as a nurse-midwife to practice midwifery in the State of Texas.

APRN License Renewal Requirements (Texas Board of Nursing)

Maintaining an APRN license in nurse-midwifery in Texas requires the completion of at least 20 contact hours of targeted continuing nursing education in nurse-midwifery on a biennial basis. CNMs that complete these contact hours satisfy both their RN and APRN license requirements.

CNMs with prescriptive authority must also complete at least five additional contact hours in pharmacotherapeutics.

Nurse-midwives must renew their RN and APRN licenses online.

CNM Renewal Requirements (American Midwifery Certification Board)

The American Midwifery Certification Board features a Certification Maintenance Program, which allows CNMs to satisfy their continuing education requirements by completing one of the following:

  • Option 1: Complete at least 3 AMCB Certificate Maintenance Modules during each five-year certification cycle and at least 20 contact hours of approved continuing education units; pay annual fees
  • Option 2: Retake the AMCB Certification Examination and pay the $500 examination fee in lieu of annual fees

WHNP Renewal Requirements (National Certification Corporation)

The National Certification Corporation requires WHNPs to take a continuing competency assessment at the beginning of each three-year maintenance cycle. The number of continuing education credits required for renewal is dependent upon the result of the assessment.

Resources for Nurse-Midwives in Texas

From large hospital systems to small midwifery practices, Texas nurse-midwives have a vast array of opportunities when starting or advancing their careers. Just a few of the locations in Texas where nurse-midwives may find job opportunities include:

  • The Women’s Specialists of Houston, Houston
  • Austin Area Birthing Center, Austin
  • Birth & Women’s Center, Dallas
  • Women’s Care Center, Houston
  • West Houston Birth Center, Houston
  • Corpus Christi Birth Center, Corpus Christi
  • House of Birth, Sherman
  • Childbirth Services, Tyler

Although the following job posts (sourced in 2015) are for illustrative purposes only, they do provide job hunters with a good idea of the types of nurse-midwives jobs available to CNMs in Texas:

  • Certified Nurse-Midwife, Texas Health Physicians Group, Kaufman
  • Certified Nurse-Midwife, Texas Children’s Hospital, Houston
  • Nurse-Midwife/Women’s Health Nurse Practitioner, UT Health Science Center at Houston, Houston
  • Nurse-Midwife, Parkland Health & Hospital System, Dallas
  • APRN Nurse-Midwife, Department of the Army, El Paso

Certified nurse-midwives in Texas interested in branching out on their own and starting a birth center or other private midwifery practice may find professional associations in Texas to be valuable sources of information and assistance:

  • Association of Texas Midwives
  • North Texas Midwives
  • Consortium of Texas Certified Nurse-Midwives
  • Texas Nurse Practitioners
  • North Texas Nurse Practitioners

Direct Entry Midwife Salary in Texas

According to the National Vital Statistics Report published by the Centers for Disease Control and Prevention (CDC) in 2010, a total of 5,964 out-of-hospital births took place in Texas between 2005 and 2006. The location of those births was split nearly equally between those that took place in-home and those that took place in birthing centers. That year 49% were home births, while 51% occurred within freestanding birthing centers.

In 2019, occupational data from the U.S. Bureau of Labor Statistics indicated that the average midwife salary in Texas was $92,560. The average starting salary was $69,650 with a statewide median salary of $ 84080.

Job Forecast for Certified Nurse-Midwives in Texas

In 2018, the U.S. Department of Labor projected that the demand for nurse anesthetists would increase by 25.3% in the 10-year period between 2018 and 2028 while the number of nurse practitioners would increase 31.9% for the same time period, so you can expect that the number of nurse-midwives in Texas would increase in the same ballpark as the two other nursing professions.

Certified Nurse-Midwife Salaries in Texas by Location

Quite often, salary is affected by geographic location, as occupational demand tends to vary within different regions of the state. Shown here is a list of nurse-midwife salaries in Texas by location, based on data published by the BLS in 2019:


  • Entry-Level: $69,650
  • Median: $84,080
  • Average: $92,560
  • Experienced: $128,410

Dallas-Fort Worth-Arlington

  • Entry-Level: $69,110
  • Median: $79,840
  • Average: $85,720
  • Experienced: $120,490

Houston-The Woodlands-Sugar Land

  • Entry-Level: $74,910
  • Median: $103,800
  • Average: $105,640
  • Experienced: $136,630

(Salary data for nurse-midwives reported by the U.S. Bureau of Labor Statistics in May 2019. Figures represent state data, not school-specific information. Job growth data provided by Projections Central, a resource funded by the U.S. Department of Labor’s Employment and Training Administration. Conditions in your area may vary. Information accessed March 2021.)

Direct-Entry Midwife Salary

The average Direct-Entry Midwife in the US makes $78,859. Direct-Entry Midwives make the most in San Francisco at $118,150, averaging total compensation 50% greater than the US average.

Salary Ranges for Direct-Entry Midwives

The salaries of Direct-Entry Midwives in the US range from $15,291 to $403,140 , with a median salary of $73,141 . The middle 57% of Direct-Entry Midwives makes between $73,141 and $182,598, with the top 86% making $403,140.

How much tax will you have to pay as a Direct-Entry Midwife

For an individual filer in this tax bracket, you would have an estimated average federal tax in 2018 of 22%. After a federal tax rate of 22% has been taken out, Direct-Entry Midwives could expect to have a take-home pay of $65,570/year, with each paycheck equaling approximately $2,732*.

* assuming bi-monthly pay period. Taxes estimated using tax rates for a single filer using 2018 federal and state tax tables. Metro-specific taxes are not considered in calculations. This data is intended to be an estimate, not prescriptive financial or tax advice.

Quality of Life for Direct-Entry Midwife

With a take-home pay of roughly $5,464/month, and the median 2BR apartment rental price of $2,506/mo**, a Direct-Entry Midwife would pay 45.86% of their monthly take-home salary towards rent.

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