Pathways ForwardCurricula · Hands-On Healthcare · Walla Walla Valley
Licensed Midwife: the Walla Walla Path
A licensed midwife attends births at home and in birth centers. She is not a nurse; she trains by apprenticeship or at a midwifery school and earns the national CPM credential. It is self-employed work that a family can size to fit.
Why this field is on the list · as of September 2026
Income depends on caseload. BLS publishes no figure for licensed midwives. At an assumed $5,000 per birth, about 21 births a year reaches the three-child bar before business costs. Ask local midwives what they actually charge.
The schedule is the family’s. A midwife chooses how many clients to take, and is on call around their due dates.
Watch for: births attended before a high school diploma do not count toward the NARM requirements. Start the formal count after graduation.
01 · Two kinds of midwifeNurse or not
Licensed midwife (CPM)
Trained by apprenticeship or a midwifery school, certified by NARM and licensed by Washington. Home and birth-center births.
Certified nurse-midwife (CNM)
An RN with a graduate midwifery degree. Mostly hospital births. See nursing.
Doula
Support in labor, no clinical care. A good first step and a way to see many births.
02 · The ladderApprenticeship to license
NARM counts only births attended after high school.
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CPR, neonatal resuscitation and doula training
Adult CPR and the Neonatal Resuscitation Program, and a doula course.
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Observing births
Attend births as a doula or assistant.
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Apprenticeship or school
Either the NARM Portfolio Evaluation Process with a registered preceptor, or a MEAC-accredited school (several are distance programs with local clinical placements). At least two years, about 55 births in set roles, plus prenatal, newborn and postpartum exams. Usually 3–5 years.
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NARM exam and CPM
A 300-question exam. Renew every three years.
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Washington license
Washington licenses midwives who are not nurses as Licensed Midwives (L.M.) through the Department of Health. The usual route is a state-approved midwifery education program followed by the NARM exam. Washington also requires specific education hours and supervised births on top of the NARM minimums, so confirm the current rule with the Department of Health before choosing a school or preceptor.
03 · The incomeCaseload and pay
| Births a year | Gross at $5,000 each | Against the Walla Walla County bars |
|---|---|---|
| 8 | $40,000 | a second income |
| 12 | $60,000 | a second income |
| 20 | $100,000 | clears the two-child bar |
| 30 | $150,000 | clears the three-child bar |
Gross, before costs: insurance, supplies, travel, certification and a second attendant at births. The $5,000 fee is an assumption; ask local midwives.
For a parent at home
A small caseload (six to ten births a year) is skilled work that fits around a family, but on-call weeks need a backup plan for the children.
04 · The home-school yearsWhat to add to the core path
Grades 9–10
- Everything in the shared core, with strong biology and anatomy
- Neonatal and adult CPR
Grades 11–12
- A doula course
- Anatomy and physiology through Running Start
After high school
- Apprenticeship or a MEAC school, then the NARM exam and the Washington license
Tie to the Verification Track
A midwife checks the baby’s heart rate against her own count and chart, and knows the conditions that mean a transfer to the hospital. The Verification Track trains that habit.
05 · SourcesWhere these facts come from
Checked 2026-09-26
- Wages: U.S. Bureau of Labor Statistics, OEWS May 2025, the Walla Walla metro area and the state of Washington. bls.gov/oes
- Income bars: MIT Living Wage Calculator, Walla Walla County. livingwage.mit.edu/counties/53071
- NARM pathways: narm.org; MEAC schools: meacschools.org
- Washington midwife licensing: Washington State Department of Health (search “midwife license requirements”)