Return to Newsroom & Events > Get Connected

Certification, Licensure, and Maintenance - Oh My!

By Stephanie Tillman, CNM, MSN

Whether you are on cloud 9 after receiving an offer from an employer, or still hunting for the perfect employment, getting a head start on all of the necessary licensure is a vital part of the process. I didn’t have quite all the information I needed when I started, and subsequently did not know I was missing my DEA until a pharmacist called me to deny a prescription. Lesson learned, and love passed on to y'all! Let's make sure you have the full list.

Certification – You must pass the exam given by your professional certifying body. For CMs/CNMs, this is the American Midwifery Certification Board (AMCB). Test-takers find out immediately if they pass the exam, but it takes a few weeks to receive the Certificant card and certified number. You must keep up with modules/CEUs or retake the exam to maintain certification, which must be renewed every five years. Cost: $500.

Licensure – Multiple national and/or state approvals are necessary to practice with earned healthcare credentials:

· National Provider Identifier (NPI) - A number assigned to each provider to uniquely identify them, as mandated by HIPAA. Apply here after passing the AMCB certification exam. Cost: Free.

· Registered Nurse (RN) License - For CNMs, an RN license is necessary in each state of practice. Typically there are very long waiting periods, so start this and the APN/CNM application immediately after passing the exam! Cost: Varies by state.

· Advanced Practice Nurse (APN) or CNM/CM License - Advanced practice ability in each state of practice. There is no separate CNM licensure where I practice, so I am licensed under an APN umbrella. Make sure you understand all of the particulars in your state! Cost: Varies by state.

· Controlled Substances Registration - Permits prescription of controlled substances. Each organization requires, and each state allows, approval of certain Schedules* of controlled substances for midwives: check to be sure what you need before submitting this application. Cost: Varies by state.

· Drug Enforcement Administration (DEA) License - National licensure to provide controlled substances. Note: The controlled substance registration number is required prior to application for the DEA license. Cost: $731.

Provider Maintenance - Each practice and state will have different provider requirements, including resuscitation procedures and skill practice. Make sure to know your list and requirements! Here is the starting lineup:

· Basic Life Support (BLS) and CardioPulmonary Resuscitation (CPR) for Healthcare Professionals - Through the American Heart Association, certification for BLS-CPR lasts two years. Make sure you have your training up-to-date! Cost: Varies by training site.

· Neonatal Resuscitation Program (NRP) - This is an online exam is completed 30 days prior to classroom teaching and examination, and completion is valid for two years. There is no formal reminder when you are due for renewal, but you can sign up for an email reminder four months prior to your course expiration at the NRP website. Are you due for your NRP? Find instructors or courses in your area. Cost: Online exam is $23.50, classroom fees at discretion of instructor.

· Continuing Education - CEUs are a way to ensure a continued knowledge-base related to practice. For the AMCB, midwives are required to complete 20 contact hours (2.0 CEUs) per cycle for certification maintenance. There are many options to obtain CEUs, including precepting, conference attendance, publications, and additional trainings.

Looking for a way to keep track of all of this? Try keeping your own log of original and expiration dates. Here’s a spreadsheet that will get you started!

*Schedules are categories of drugs based on potential abuse risk. The State of Connecticut provides a great review of the Controlled Substance Schedules here.

Stephanie Tillman is a recently-graduated Nurse-Midwife now practicing full-scope midwifery in the urban United States, at a Federally Qualified Health Center (FQHC) and as a member of the National Health Service Corps (NHSC). With a background in global health and experience in international clinical care, the impact of public health and the broader profession of midwifery are present in all her thoughts and works. Stephanie's blog, Feminist Midwife, discusses issues related to women, health, and care. Find out more at and follow her on Twitter at @feministmidwife.

Posted By Barbra Elenbaas | 4/25/2013 11:12:56 AM



Any opinions expressed in this blog are those of the individual participant(s) and do not necessarily reflect the views of the American College of Nurse-Midwives. ACNM is not responsible for accuracy of any of the information provided by guest bloggers and/or members via the Comments section. We welcome all feedback – including comments, ideas and suggestions. We also welcome civil, friendly debates. However, any and all content that is deemed inflammatory or rude will not be posted.


American College of Nurse-Midwives.
8403 Colesville Rd, Suite 1550 | Silver Spring MD 20910
Phone: 240-485-1800 | Fax: 240-485-1818
Follow Us