some truths about CNM salaries and benefits

[epiphany]

What school did not prepare me for was how much salary I should expect to get, and how to negotiate it, so I'm here to share my experience with you because salary seems to be a bit of a elusive topic. Nobody wants to talk about how much they make, so it's hard to pin it down.

I have had people offering me and my classmates a range of salaries from over 75K to over 100,000K (over many areas and states). One outlier, a private OB hiring a CNM for the first time, offered me 65K. He had googled it and was sincerely surprised that when I told him it was far too low. After doing some googling myself, I realized that there sites out there that really underrates our pays.

Google "salary cnm" and you are usually led to payscale.com, which uses a special scientific method (sarcasm intended) to rate it unrealistically low.

Go to midwifejobs.com, the official ACNM site, and it's on the FAQ, but they won't commit to giving a range ("widely varies").

So far, I found this site to be most realistic representation of what I am personally seeing.

http://swz.salary.com/salarywizard/layouthtmls/swzl_compresult_national_HC07000229.html.

As far as benefits and hours go, private companies seem to be able to give less, but make you work more. In one private practice, I was to work 5 days a week 8 hours a day, but on 2 of those days, I am also on call 24 hours. In addition, I had to be on call every third weekend. I was quite shocked at how they expect me to physically function that way - that is, if you are up 24 hours, how do go in for another 8 hours of seeing patients?

Then I realized that mostly, the providers sleep in the call rooms until it's time to catch a baby.

In some big hospitals and birth centers, the standard that I have seen are 40 hours - 2x8hours clinics, and 2x12hours. I like that because besides working under more humane conditions, I am able to provide labor support and spend more time with my laboring women when I'm on. Many hospital do have calls.

Bigger places come with bigger benefits, usually, not not necessarily - average 4 wks vacation, 1 wk paid CME, personal days, better healthcare, and Liability Insurance.

I know nothing about women who start their own practices, but that's probably a whole different experience.

So.... I hope that gives some of you a better idea. If anybody can share their experiences, I would love to hear.

[l&drocks]

I am interested in knowing when is the best time to start sending resumes to potential employers? Do you wait until boards are passed? I'm just getting a little ansy. Any insight into this would be helpful.

[THELIVINGWORST, ASN, RN]

oh my gosh this thread is awesome!

[mommadoula]

I am a Birth Doula: for Frontier, they will consider other experiances such as Doulas and Lactation Consultants in lieu of nursing experiance.

I am also a doula/CBE and working on my prerequisite for nursing school right now. I am also hopping to use CBE/Doula experince in lieu of nursing experince. Do you know how many births/years of CBE you need for them to use it? I have been think about starting a hospital based doula program just working on the funding so I hope that will help.

[midwife228]

I have worked in 2 private practices, one in a large suburban practice and the other in a small community hospital-owned practice, and now am working on-staff for a large health care provider so I have seen a variety of salaries and schedules. Don't know if this will help but...

I started out at a low salary, not much more than I made as an RN but I was so excited to be a CNM! I worked in the office 5 days a week, totalling 30 hours, plus midwife call 1 in 2 and total practice call 1 in 4. That was in the large suburban practice.

In the community-hospital practice I started at $60,000 and worked 32 hours in the office plus 1 in 2 call, which was supposed to go to 1 in 4 call but never did. I made close to $70,000 when I left.

As a staff midwife my salary is much higher (though that is largely because I have 20 years seniority with this facility, including time as an RN and per diem CNM and it is a union position). I work three 12 hour shifts per week, no on-call. However, I only get to catch a baby if the private MD is not going to get there in time. I really miss the deliveries but like the time off to see my grandchildren. Plus I totally burned out at the last private practice. So while I have mixed feelings, I most likely will stay with this job until retirement.

[Devie06]

What is malpractice insurance like for you guys? I have heard its ridiculously high!

[midwife228]

It is ridiculously high - around $25,000 per year for midwives in private practice. Compare that to $2500 which is what it was when I started my first CNM job just 10 years ago. I work for a health care system so they pay our malpractice as part of their huge corporate policy so it is probably less per person that way. I know midwives who have settled for less salary in return for their physician employer continuing to pay for their malpractice and it's probably a major reason why there are so few of us in private practices anymore; physicians figure one of them has to be on call as our backup anyway so why not just hire another physician who can also bring in money from surgeries, etc. The other, of course, if the competition factor since women really do like midwife care but that's a topic for another whole thread...

[Devie06]

So in your opinion, is it worth the cost of school to become a midwife? At this point Im thinking it would be better to just be an RN. Seems like its hard to get a job or make a living as a midwife. So sad

[midwife228]

If being a midwife is your passion, it's about more than the salary. I have taken pay cuts for jobs I really wanted as a CNM. But the availability of midwife jobs is another issue to look at. I live in a state where malpractice is very high and I am in a very medically conservative part of the state so other areas and other states have better employment opportunities, I think. You can check out midwifejobs.com to start. I also know midwives who are working in offices as NP's but the women are really getting midwifery care, though not a midwife delivery. There are options so I wouldn't give up if it's really what you want.

[danceluver]

Curious, does being dual certified as an FNP/CNM help out with the increase in salary in any way? Is it a very marketable position (more than say a WHNP/ANP) in more than the obvious way?

[mrs.diamond2025]

Thank you so much for posting this! I am a CNA now, planning to start nursing school in the spring & I am just starting to explore the idea of becoming a CNM. I'm looking for all the information I can get my hands on!!