Certified Nurse-Midwife (CNM) Salary by State
Compare Certified Nurse-Midwife salaries across all 46 states. Select a state below for detailed percentile breakdowns, cost-of-living adjustments, and specialty comparisons.
Our nursing salary data is sourced from the U.S. Bureau of Labor Statistics (BLS) Occupational Employment and Wage Statistics program.
Data
reviewed by 
sirI, MSN, APRN, NP
for accuracy.
Certified Nurse-Midwife Salary Rankings — All States
Key Insights: The Cost of Living Reality
While California offers the highest raw salary for CNMs at $203,840, it is crucial to factor in the state's cost of living (COL index of 142.2). When salaries are adjusted for actual purchasing power, the landscape shifts dramatically.
For example, a CNM in Mississippi making a raw median salary of $128,790 enjoys a COL index of 84.8, effectively giving them a purchasing power of $151,875 compared to the national baseline. States in the South and Midwest often provide a better ratio of income to living expenses, despite appearing lower on the raw salary rankings.
| Rank | State | Median Hourly | Median Annual | COL Adjusted | vs National |
|---|---|---|---|---|---|
| #1 | California | $93.62 | $203,840 | $143,347 | +58% |
| #2 | Hawaii | $79.50 | $170,110 | $88,599 | +32% |
| #3 | Massachusetts | $78.09 | $159,800 | $121,429 | +24% |
| #4 | Washington | $67.72 | $158,970 | $138,115 | +23% |
| #5 | New Jersey | $76.52 | $153,970 | $133,655 | +20% |
| #6 | Vermont | $71.20 | $151,030 | $131,445 | +17% |
| #7 | Oregon | $70.20 | $146,900 | $129,427 | +14% |
| #8 | New York | $68.93 | $144,510 | $103,889 | +12% |
| #9 | New Hampshire | $65.68 | $142,960 | $127,189 | +11% |
| #10 | Arizona | $76.88 | $140,960 | $137,926 | +9% |
| #11 | Maryland | $68.21 | $140,120 | $124,884 | +9% |
| #12 | Nebraska | $66.01 | $138,880 | $150,303 | +8% |
| #13 | Colorado | $66.60 | $137,610 | $130,932 | +7% |
| #14 | Virginia | $67.12 | $135,710 | $131,121 | +5% |
| #15 | Rhode Island | $65.20 | $135,180 | $119,628 | +5% |
| #16 | Minnesota | $65.09 | $134,810 | $138,979 | +5% |
| #17 | Alaska | $69.29 | $133,430 | $107,518 | +4% |
| #18 | Maine | $63.02 | $133,270 | $119,525 | +3% |
| #19 | Wisconsin | $61.20 | $133,070 | $142,779 | +3% |
| #20 | Iowa | $59.13 | $131,360 | $146,935 | +2% |
| #21 | Utah | $61.85 | $130,930 | $127,737 | +2% |
| #22 | Connecticut | $63.31 | $130,790 | $115,949 | +2% |
| #23 | Missouri | $63.21 | $130,220 | $145,011 | +1% |
| #24 | Alabama | $61.92 | $128,790 | $146,186 | Avg |
| #25 | Kansas | $61.92 | $128,790 | $147,357 | Avg |
| #26 | Mississippi | $61.92 | $128,790 | $151,875 | Avg |
| #27 | Oklahoma | $61.92 | $128,790 | $147,021 | Avg |
| #28 | South Dakota | $61.92 | $128,790 | $137,596 | Avg |
| #29 | West Virginia | $61.92 | $128,790 | $146,686 | Avg |
| #30 | Ohio | $60.20 | $127,730 | $139,139 | -1% |
| #31 | Delaware | $62.79 | $127,510 | $123,556 | -1% |
| #32 | Florida | $53.78 | $127,460 | $123,988 | -1% |
| #33 | North Carolina | $59.58 | $126,040 | $133,800 | -2% |
| #34 | Michigan | $60.21 | $125,140 | $136,915 | -3% |
| #35 | Texas | $59.09 | $123,380 | $133,384 | -4% |
| #36 | New Mexico | $58.72 | $123,350 | $131,925 | -4% |
| #37 | South Carolina | $57.96 | $122,390 | $129,788 | -5% |
| #38 | Illinois | $54.71 | $120,840 | $126,402 | -6% |
| #39 | Pennsylvania | $55.96 | $119,990 | $122,189 | -7% |
| #40 | Louisiana | $56.17 | $119,280 | $129,652 | -7% |
| #41 | Tennessee | $55.66 | $116,980 | $129,690 | -9% |
| #42 | Georgia | $57.27 | $105,510 | $118,285 | -18% |
| #43 | Indiana | $55.12 | $101,630 | $112,298 | -21% |
| #44 | District of Columbia | $57.36 | $101,450 | $66,700 | -21% |
| #45 | Idaho | $37.76 | $92,090 | $92,553 | -28% |
| #46 | North Dakota | $47.95 | $72,630 | $77,348 | -44% |
What is a Certified Nurse-Midwife (CNM)?
A Certified Nurse-Midwife (CNM) is an advanced practice registered nurse who provides specialized primary, reproductive, and gynecological healthcare, with a focus on pregnancy, childbirth, and postpartum care. Beyond the clinical definitions, we are the steady hand and the "central nervous system" of the birthing suite, balancing the intense physiological demands of labor with a holistic, patient-centered philosophy. Every shift brings a unique clinical weight; we aren't just catching babies—we are navigating complex family dynamics, managing high-stakes obstetric emergencies, and ensuring that every person we care for feels empowered and clinically safe during their most vulnerable moments.
The journey to becoming a CNM requires a rigorous academic foundation, typically a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) from a program accredited by the ACME. To practice, you must pass the national board certification exam administered by the American Midwifery Certification Board (AMCB) and maintain state-specific licensure. In 2026, the landscape of our profession has been transformed by a shift toward collaborative care models and the integration of high-tech tools like AI-driven fetal heart rate monitoring and expanded telehealth for rural prenatal support. We are now seeing a broader scope of practice that allows us to lead maternal health initiatives and address systemic healthcare disparities from the front lines.
What makes this credential a true professional "passport" is the incredible flexibility it affords across the entire spectrum of women’s health. Your CNM license is your entry into high-volume tertiary hospitals, intimate private practices, community birth centers, or even the academic world of clinical research and leadership. Because our expertise spans from puberty through menopause, the demand for our skills is constant and geographically diverse. Whether you prefer the fast-paced adrenaline of a labor and delivery unit or the continuity of care found in an outpatient surgical clinic, being a CNM means you have the autonomy to choose your environment while making a life-changing, generational impact every single day.
Frequently Asked Questions
What is the median Certified Nurse-Midwife salary in the US?
The national median salary for a Certified Nurse-Midwife (CNM) is $128,790 per year, or approximately $63.25 per hour based on 2025 BLS data.
Which state pays Certified Nurse-Midwifes the most?
California offers the highest Certified Nurse-Midwife salary at $203,840 per year, while North Dakota is the lowest at $72,630.
What is the starting salary for a Certified Nurse-Midwife?
Entry-level Certified Nurse-Midwifes in the US typically start around the 10th percentile, earning a national median of $94,939. With significant experience, top earners in the 90th percentile can make upwards of $164,388 annually.
Does the highest paying state for CNMs offer the best standard of living?
Not necessarily. While California offers the highest raw salary at $203,840, its high cost of living means your purchasing power is lower. When adjusted for cost of living, states like Mississippi and Nebraska often provide a better financial return for CNMs.
How much does a Certified Nurse-Midwife make an hour?
On a national level, a Certified Nurse-Midwife makes a median of $63.25 per hour. However, depending on the state and facility, this can range from $45.64 for new graduates up to $79.03 for highly experienced directors or specialists.
Does a Certified Nurse-Midwife make more than a standard Registered Nurse?
Yes, significantly more. While the national median for a standard Registered Nurse is roughly $93,600, a Certified Nurse-Midwife averages $128,790. This premium compensation reflects the advanced MSN or DNP degree and specialized clinical training required for the role.