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.
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.
Wow. That's incredibly disheartening. If I worked 77 hours per week as a staff nurse I'd be far above $79,000 (even with the bonuses). I guess I feel, though, that you really couldn't pay me enough to work 77 hours per week. That being the case in my heart of hearts, maybe I should be rethinking the CNM track. I want to be a CNM, am fascinated by the subject matter, feel excited to provide primary health care to women and thrilled to be capable of delivering babies, but, as a mother, I can't stomach the idea of missing out on so much time with my children in order to do this. 77 hours per week sounds excruciating, for whatever salary (but $79,000? Jeez). That is the truth.
I wonder if these stats are typical of other states? Does anyone know of a national survey of CNMs, or similar surveys done in other areas of the country?
I believe that they may be including "on call time," including the time when you are not actually *at* work in their totals. For example... if you work three 8 hr days in the office, plus two 24hr call shifts, you will have a total of 72 hours- even though you may not go in at all during that 48hrs of call. (how much you can expect to actually be called in will vary based on the birth volume of your practice) But yes, it is possible to be totally slammed and end up working the whole thing.
Also, you can definitely find jobs that are not this time intensive. For example, job 1 is a set 40 hours.
For more salary info, search for the ACNM membership surveys. They conduct them regularly, they include salary info, and they are broken down by region.
Just right off the bat, I don't think I would like on-calls. I would really have to learn to how relax during the day knowing someone could give birth anytime. Give me 40 solid hours of work, where the rest of my free time belongs to me.
Of course if it were my own business and/or partnership, I think I would feel more protective of my clients and be willing to be at the beck and call of their labor.
I totally agree with you, epiphany. I really like the idea of time off really being time off. But how common are midwife jobs that allow you to do this kind of shift work?
How important was your experience as an L and D nurse to these employers? I only have 8 months of experience under my belt because I couldn't take the rotating shifts and I am now finding it hard to get back to L and D because of the economy.
I know you weren't asking me, but being as though I have NO L&D experience (and neither did most of my classmates), I would say that if you can't find another L&D job, you will still be just fine.
Pecola is right - you'll be fine. Most of my classmates did not have L&D experience, and are getting jobs they want.
I did have a friend who went through a second interview, and then was turned down, she was told "because of her lack of L&D experience." That's a little fishy to me - that information was in her resume before they put her through all the interviews, so I suspect it's an excuse. In any case, that particular place turned out to be a place she wouldn't have wanted to work at anyway - the CNM's had no autonomy and the residents had all the say. In the end, she got a job she loved.
Most people hired from the integration. In fact everyone received an offer from the place we were at clinicals, me included. Something to keep in mind when you choose your sites.
I definitely picked an integration site I wouldn't mind working at, hoping to be offered something. (And I think it's a good thing to keep in mind) But they had just hired someone when we arrived, so that was a bust. But I had also picked it for the opportunity to work with midwives of color- which I had never had, and that was GREAT. )
I'd say less than half of the people in my class got offers from their integration site... and a few of those didn't take them because they were moving back to their home states.
I really enjoyed and learned a lot from your posts. I was midwife in my country for 7 years (I have bachelors of Midwifery). In my country L & D unit runs only with midwives, we don't have any nurses in that unit. I worked 5 years in L & D and related antepartum clinic and triage and postpartum...every thing to gether and then worked 2 years at women's health clinic as a physician assistant. Then I moved to USA, and now I am new graduate with BSN. and I have applied for getting my credential as CNM from New York State, It is in processing of evaluation of my midwifery education.My experience as midwife is not recent since I'm living here from 2002. but I have all knowledge of women's health and midwifery with my heart, I love this career.
my question is that does my experience count even though it is out of USA and not recent for getting job as a MIdwife, when I get my credential as CNM?
I have to mention that I could not find any job in hospital yet, but I am working now in a skilled nursing facility.
Thanks so much for posting this! I am beginning school for my BSN next week (finally!) and my long-term goal is to be a CNM. While I am doing this because I am passionate about pregnancy, birth, family planning and women's health, I have been searching for some guiding information regarding salaries in different areas, as well as working situations and conditions. It is awfully hard to come by!
Just wanted to say thanks for all of you, I am really enjoying and appreciating all the information in this thread
I only know that for my last homebirth, my CNM (private practice) charged insurance $9,500 and was reimbursed $4000. She probably does about 5 births a month, so do the math. Her overhead is low too--her office is in her house and she employs one assistant.
) 
what2donow
39 Posts
Wow. That's incredibly disheartening. If I worked 77 hours per week as a staff nurse I'd be far above $79,000 (even with the bonuses). I guess I feel, though, that you really couldn't pay me enough to work 77 hours per week. That being the case in my heart of hearts, maybe I should be rethinking the CNM track. I want to be a CNM, am fascinated by the subject matter, feel excited to provide primary health care to women and thrilled to be capable of delivering babies, but, as a mother, I can't stomach the idea of missing out on so much time with my children in order to do this. 77 hours per week sounds excruciating, for whatever salary (but $79,000? Jeez). That is the truth.
I wonder if these stats are typical of other states? Does anyone know of a national survey of CNMs, or similar surveys done in other areas of the country?