Key Responsibilities and Required Skills for Certified Midwife (CM)

🎯 Role Definition

The Certified Midwife (CM) provides comprehensive, evidence-based reproductive, prenatal, intrapartum, and postpartum care for low- to moderate-risk patients across clinic, birth center, and hospital settings. The CM leads individualized care plans, performs skilled labor management and deliveries, triages obstetric emergencies, provides lactation and newborn care education, coordinates interdisciplinary care with obstetricians and pediatricians, and documents care in electronic health records while adhering to state licensure and national certification standards.

📈 Career Progression

Typical Career Path

Entry Point From:

Registered Nurse (RN) with midwifery graduate education or graduate-level midwifery program graduate
Certified Nurse–Midwife (CNM) transitioning or expanding scope
Nurse Practitioner (Women’s Health) or Physician Assistant with obstetrics experience

Advancement To:

Lead Midwife / Senior Midwife
Director of Midwifery or Clinical Manager, Maternal & Child Health
Perinatal Quality & Safety Lead or Clinical Educator for Midwifery

Lateral Moves:

Lactation Consultant / IBCLC
Outpatient Women’s Health Provider (prenatal clinic lead)
Birth center clinical director / practice owner

Core Responsibilities

Primary Functions

Provide comprehensive prenatal care including history and risk assessment, ordering and interpreting prenatal labs and ultrasounds, counseling on prenatal screening and diagnostic options, and creating individualized care plans aligned with evidence-based guidelines.
Manage intrapartum care by triaging labor presentations, conducting continuous or intermittent fetal monitoring, assessing labor progress, documenting cervical exams, and making timely clinical decisions to optimize maternal and fetal outcomes.
Attend and independently manage spontaneous vaginal births and low-intervention deliveries, including management of episiotomy when indicated, controlled cord traction, and active management of the third stage of labor to reduce hemorrhage risk.
Recognize, stabilize, and escalate obstetric complications (e.g., postpartum hemorrhage, preeclampsia/eclampsia, shoulder dystocia, non-reassuring fetal status) per institutional protocols and in collaboration with obstetric and anesthesia teams.
Provide immediate newborn assessment and stabilization, including temperature maintenance, APGAR scoring, basic resuscitation per Neonatal Resuscitation Program (NRP) guidelines, and timely transfer to neonatal care when indicated.
Provide comprehensive postpartum care: assess uterine involution, manage postpartum hemorrhage prevention and treatment, counsel on mood and bonding, and arrange appropriate follow-up and referrals for physical and mental health needs.
Deliver individualized family-centered counseling on breastfeeding and lactation, provide hands-on support during the immediate postpartum period, and coordinate referrals to lactation consultants or IBCLCs as necessary.
Offer contraceptive counseling and provision of reversible contraception (e.g., IUDs, implants consultation and referrals, contraceptive prescriptions) and education on family planning options prior to discharge and during postpartum visits.
Conduct well-woman gynecologic care as part of scope: routine cervical cancer screening, STI screening and management, pelvic exams, and health promotion counseling integrated into perinatal visits.
Maintain accurate, timely, and legally compliant documentation in the electronic medical record (EMR), including labor and delivery notes, informed consent, medication administration, discharge summaries, and quality metrics.
Order, interpret, and act on diagnostic tests (CBC, CMP, urine studies, cultures, fetal monitoring strips, obstetric ultrasound results) to guide clinical decision-making and escalate care when outside scope.
Administer and manage medications commonly used in obstetric care (oxytocin, magnesium sulfate, antihypertensives, analgesics, antibiotics) in accordance with facility protocols and collaborative practice agreements.
Function as an active member of interdisciplinary perinatal teams, communicating clearly with obstetricians, anesthesiologists, pediatricians, nurses, social workers, and case managers to ensure continuity of patient-centered care.
Provide culturally competent prenatal and perinatal education covering pregnancy health, signs of labor, birth plans and informed consent, newborn care, postpartum expectations, and community resources to empower pregnant people and families.
Lead and participate in quality improvement initiatives focused on maternal and neonatal outcomes (e.g., reduce cesarean rates, decrease postpartum hemorrhage, improve breastfeeding initiation) by collecting data and implementing guideline-driven interventions.
Participate in triage and on-call rotations to assess urgent obstetric concerns by phone and in-person, applying clinical judgment to determine level of care and appropriate next steps.
Practice evidence-based risk screening and referral for perinatal mood and anxiety disorders, substance use, intimate partner violence, and social determinants of health; coordinate referrals to behavioral health and community support services.
Educate and supervise students, residents, or junior midwives during clinical rotations; precept learners in clinical decision-making, labor management, and evidence-based practices.
Ensure compliance with legal, regulatory, and credentialing requirements including maintaining active state licensure, national certification (AMCB certification where applicable), and facility privileging documentation.
Maintain emergency preparedness competency by completing regular drills and certification renewals (NRP, BLS, and facility-specific obstetric emergency training like ALSO) and by stocking and checking emergency equipment.
Counsel and manage care for VBAC (vaginal birth after cesarean) candidates within institutional policies, assessing risk, obtaining informed consent, and coordinating backup surgical coverage when needed.
Engage in postpartum contraceptive planning and coordinate community or primary care follow-up to support long-term reproductive health and interpregnancy care.
Contribute to patient safety reporting, sentinel event analysis, and root cause reviews; implement corrective actions and education to reduce recurrence of adverse events.

Secondary Functions

Participate in community outreach and patient education events that promote maternal-child health, prenatal care access, and safe birth practices.
Support documentation audits, benchmarking, and reporting for internal quality metrics and external regulatory agencies.
Assist in protocol and guideline development for the maternity service line, ensuring alignment with the latest evidence-based recommendations.
Mentor and develop midwifery staff, support staff training, and contribute to workforce development strategies.
Coordinate referrals and transitions to specialty care (maternal-fetal medicine, addiction medicine, pediatric subspecialists) and ensure robust handoffs to inpatient teams.
Participate in departmental and hospital committees focused on perinatal safety, patient experience, and clinical education.
Maintain inventory and supply coordination for midwifery equipment and supplies used in labor, delivery, and newborn care.

Required Skills & Competencies

Hard Skills (Technical)

Advanced maternal and fetal assessment, including interpretation of electronic fetal heart rate tracings and intrapartum monitoring.
Skilled labor and delivery management with competency in low-intervention births, operative vaginal birth support when trained, and physiological management of labor.
Neonatal basic resuscitation and stabilization according to NRP recommendations; ability to recognize when neonatal specialist escalation is required.
Proficiency in obstetric medication management (oxytocics, antihypertensives, magnesium sulfate, analgesics, antibiotics) and safe administration practices.
Clinical ultrasound basics for obstetric triage and collaboration with sonography teams; ordering and interpreting standard prenatal imaging reports.
Emergency obstetric procedures knowledge (postpartum hemorrhage algorithms, uterine massage, bimanual compression, IV fluid and blood product management coordination).
Electronic Medical Record (EMR) proficiency for documentation, order entry, and quality metric reporting (e.g., Epic, Cerner, Meditech).
Contraception counseling and provision knowledge, including counseling for long-acting reversible contraception and postpartum scheduling/placement processes.
Familiarity with perinatal screening tools for depression, substance use, intimate partner violence, and social determinants and executing appropriate referrals.
Competency in infection control, sterile technique, wound repair and suturing for perineal lacerations and episiotomies.

Soft Skills

Exceptional interpersonal communication and patient education skills that foster trust, informed consent, and shared decision-making.
Strong clinical judgment and rapid decision-making under pressure during labor and obstetric emergencies.
Cultural humility and ability to provide trauma-informed, patient-centered care across diverse populations.
Collaborative team leadership, including effective coordination with obstetricians, anesthesia, pediatrics, nursing, and support services.
Empathy, emotional resilience, and capacity to support patients and families through high-stress events and bereavement if needed.
Time management and organizational skills to balance clinic schedules, on-call responsibilities, documentation, and performance improvement tasks.
Teaching and mentorship abilities for precepting students, new staff orientation, and facilitating clinical education sessions.
Commitment to continuous learning and evidence-based practice, including the ability to interpret clinical literature and implement practice changes.

Education & Experience

Educational Background

Minimum Education:

Master's degree in Midwifery (or equivalent graduate-level midwifery education) and successful completion of an accredited midwifery program.

Preferred Education:

Doctor of Nursing Practice (DNP) or Doctor of Midwifery, post-graduate certificate in advanced obstetric care, or additional graduate training in maternal-child health.

Relevant Fields of Study:

Midwifery
Maternal and Child Health / Public Health
Nursing with graduate midwifery specialization

Experience Requirements

Typical Experience Range: 1–7 years clinical midwifery experience in prenatal, labor/delivery, and postpartum care.

Preferred: 3+ years of active labor and delivery experience, prior experience with hospital-based practice and collaborative care models, demonstrated competency in emergency obstetric management and quality improvement work. Must hold active state licensure as a Certified Midwife (CM) or equivalent, national certification where applicable (e.g., AMCB), current NRP and BLS certifications, and meet facility privileging requirements.