Frequently Asked Questions

Very few applicants make it through the process without needing to ask a few questions. We have complied some of the more frequently asked questions (and answers!) for you here. If you don’t find your question’s answer here, you can contact us at applications@narm.org

Are online CPR courses accepted by NARM?
No, the CPR course must have a hands on skills component.

Can I use a personal check to pay my fees?
No, pay all fees by Money Order, Cashier’s Check, or Credit Card.

Can I pay with a credit card?
Yes, NARM accepts Credit Card transactions (Visa and MasterCard). You can call the office and we can take your information over the phone, or you can send in your information with your application or recertification package. There is a 7% handling fee for all credit card transactions.

I recently changed my name, what do I need to send to NARM to update my legal name?
Send a notarized copy of your marriage, divorce, or other legal document verifying your legal name change to NARM and we will update your file. You may order a revised certificate and wallet card by sending (the appropriate fee in CIB Fees) along with your name change information.
Send to: NARM Applications Department, PO Box 420, Summertown, TN 38483

If I performed skills or births and had them signed off prior to June 1, 2010 with a preceptor who does not meet the new NARM requirements for preceptors, will their signature for births, skills etc. count towards my application?
Yes, all preceptor signatures prior to June 1, 2010 will be accepted as long as they met the qualifications at that time. However, after June 1, 2010 a preceptor who does not meet the current definition of a preceptor must submit a [preceptor exemption request form] and have it accepted by NARM, before they will be allowed to sign off on anything else.

Do client codes have to be consistent throughout the application?
Each client must have their own individual code that remains the same throughout the application. If listing more than one pregnancy with the same client, use a different client code for each pregnancy.

If I use a client in my application that has had more than one child under my care, can I use the same code for each birth?
No, each client’s birth should have its own unique code.

What is the total fee for a PEP EL applicant going through this process?
The PEP application process is $700.00 and the testing fee is $700.00 for a total of $1400.00
A hard copy of the NARM Application and CIB is available for $50. You may download the NARM Application and CIB free of charge, but must include an additional $25 fee when you send your application. Total NARM Application fees run from $1425.00-$1450.00

I have been a Primary under Supervision off and on for the last few years, is there a time frame I must adhere to in order for my primary births to count in my application?
Yes, 10 of the primary births that you will be using on form 112A and form 200 must be within the last 3 years.

Should a preceptor sign for Initial exams, Prenatal exams, Newborn exams, and Post Partum visits that they did not personally supervise, even though they attended the birth and signed Form 112a?
No, preceptors may only sign for the clinicals if they were present and in the room.

AUDIT MATERIALS QUESTIONS

What is and Emergency Care Form?
An Emergency Care Form is a document that is completed for each client. It should include a place to document:

1. Client name and phone number
2. Back up physician’s name and phone number
3. Pediatrician’s name and phone number
4. Preferred hospital’s name and phone number
5. Closest hospital’s name and phone number
6. Directions to client’s home

Can I fax in my audit materials?
Faxes to the NARM Applications office should be 10 pages or less. Longer documents should be mailed.

Are online CPR courses accepted by NARM?
No, the CPR course must have a hands on skills component.

Can I use a personal check to pay my fees?
No, pay all fees by Money Order, Cashier’s Check, or Credit Card.

Can I pay with a credit card?
Yes, NARM accepts Credit Card transactions (Visa and MasterCard). You can call the office and we can take your information over the phone, or you can send in your information with your application or recertification package. There is a 7% handling fee for all credit card transactions.

I recently changed my name, what do I need to send to NARM to update my legal name?
Send a notarized copy of your marriage, divorce, or other legal document verifying your legal name change to NARM and we will update your file. You may order a revised certificate and wallet card by sending (the appropriate fee in CIB Fees) along with your name change information.
Send to: NARM Applications Department, PO Box 420, Summertown, TN 38483

AUDIT MATERIALS QUESTIONS

What is and Emergency Care Form?
An Emergency Care Form is a document that is completed for each client. It should include a place to document:

1. Client name and phone number
2. Back up physician’s name and phone number
3. Pediatrician’s name and phone number
4. Preferred hospital’s name and phone number
5. Closest hospital’s name and phone number
6. Directions to client’s home

Can I fax in my audit materials?
Faxes to the NARM Applications office should be 10 pages or less. Longer documents should be mailed.

When is the NARM Exam given?
The NARM Exam is given on the third Wednesday of February and August at regional sites. It is also given, usually, on the pre-conference day at site of the annual MANA Conference in the fall. Exact dates and locations are sent when you qualify to take the exam. The usual regional test sites are listed here (link)

How long is the test? How much time do we have?
The test is an 8 hour, 350 question, multiple choice exam. It is given in two parts. Part one begins at 8:00am, and part two begins at 1:00pm. Four hours are allowed for each part. You may leave the testing room when you finish each part.

What is the best way to prepare for the exam?
All content areas should have been taught and evaluated by instructors or preceptors during training. Students should study the content outline and the reference texts listed in the Candidate Information Booklet. Questions may be related to definitions, normal and abnormal signs and symptoms, differential diagnosis, treatment by the mother and midwife, and conditions for appropriate referral or transport.

On the Day of the Exam:

Are there rules about what we can bring to or take from the testing room?
Yes. All purses or bookbags must be left on the floor. All cell phones must be turned off and cannot be used during the testing time. Restroom breaks may be taken by one person at a time by leaving the test booklet and answer sheet with the proctor. No materials may be taken from the room at any time. Water will be available, or you may bring your own.

What do I do if the room is locked when I arrive at the test site?
If the room or building is locked when you arrive, check your site directions to be sure you are in the right place, then attempt to call the site coordinator at the number on your letter, or call the NARM Test Department.

Can I write comments on the test?
All answers are marked only on the answer sheet and not in the test booklet. The proctor will give instructions for filling out the answer sheet.

A comment sheet is provided to each person taking the test. Comments may be written while you take the test, and turned in to the proctor. You may also use the comment sheet as “scratch paper” but you may not take it with you when you leave. The purpose of the comment sheet is to provide feedback to NARM about suggested improvement in the question or answers. The purpose is NOT to write an essay to explain your choice of answer. The comments will not change your score. The comments will be considered as a part of the test revision process.

What is the passing score?
Each version of the exam may have a slightly different raw score for passing, but it ranges between 79%-81%. The score is reported on a scale where 75 is the passing score. A scaled score of 75 or higher is passing.

What happens next if I pass the exam?
A letter reporting your exam results will be sent 3-4 weeks after the exam date. If you have completed all requirements for certification, your CPM certification will be sent 3-4 weeks after notification. If you tested as a student in a MEAC-accredited school, your certification will be sent after the school notifies NARM of your graduation. If you registered for the exam through a state licensing agency rather than through NARM, your scores will be sent to your licensing agency. You may apply for the CPM certification after you receive the license.

What happens next if I do not pass the exam?
Your letter will contain a registration form to retake the exam. Submit the registration form and retake fee by the deadline listed on the form. NARM candidates must retake the exam within a year of notification, or apply for an extension. If a candidate does not pass within three years of application, a “currency” application must be submitted documenting ten additional supervised births. For more information, contact NARM. There is no maximum number of times you may take the NARM exam. Some states that give the exam for licensure do have a maximum number of times the test may be taken.

What else might delay my certification?

• Cardio-Pulmonary Resuscitation (adult) and Neonatal Resuscitation certification cards must be submitted with the application. These must be kept current during the testing process. If the cards are due to expire within three months at the time all certification requirements are met, new cards must be submitted.
• Audits are done on every sixth application. Random audits do not stop the candidate from proceeding through the testing process, but if discrepancies are discovered during the audit, they will need to be resolved before certification is issued.
• Complaints against a CPM candidate must be resolved before the certification is issued.

Applicants with incomplete applications will be sent a notice from the Applications Department if they have not responded to requests to complete the process (i.e., not fulfilling application requirements) within six (6) months.

After one year, applicants with incomplete applications will be required to send the following:

• A letter of intent to complete the application process
• One copy of current drivers license
• One copy of current CPR card
• One current photo, signed on the back

If the application remains incomplete after one year, a letter will be sent notifying the applicant that if the application is not complete within six (6) months from the date of receipt of the letter, the application will be placed in the archives. An application will be returned at the request and expense of the applicant. It will be necessary for the person to re-apply, including paying all fees, should they desire to seek the CPM credential in the future.

Applicants who have completed the application process will be sent an Intent Form for the Skills Assessment. The Skills Assessment should be completed within six months of receipt of the Intent Form. The applicant must submit the remainder of the CPM application and fees within six months of completion of the Skills Assessment. Upon submission of the CPM application and fees, the applicant will receive an Intent Form for the NARM Written Examination. The applicant must sit for the Written Examination within one year of receipt of the Intent Form. If any of these deadlines cannot be met, the applicant may request a six-month extension from the NARM Test Department. If the deadlines and extensions pass without a documented effort on the part of the applicant to complete the certification process, the application will be considered expired and the applicant must reapply.

Process
Six months
One year
18 months
Submission of incomplete application

Resubmit driver’s license, CPR, & photos, request extension
Expired
Skills Assessment
Request extension
Expired

CPM application
Request extension
Expired

Written Exam

Request extension
Expired

An applicant must complete all required work within the timetable listed above, including written extensions. An applicant whose application has expired will forfeit all fees. Candidates should keep copies of all application materials submitted. If the candidate needs to have expired application materials returned, a $100 fee will be required. Requests for extensions must be received in writing by the deadline listed. Every effort will be made by NARM to notify applicants of approaching expiration deadlines, but NARM cannot be responsible for notifying candidates who have moved or who do not receive mail at the address listed on the application. The responsibility for meeting deadlines and/or requesting extensions is the candidate’s. If unusual circumstances prevent an applicant from meeting these deadlines, NARM will consider further extensions on an individual basis if submitted in writing prior to the deadline. NARM recommends continued supervised practice throughout the application and testing process.

Retakes

Candidates who have failed either the Skills Assessment or the Written Exam are expected to complete the certification process within the time frames listed above. There is no limit to the number of times a candidate may take either exam. If multiple retakes are required, the candidate may not be able to complete certification within the expected time frame. If a candidate does not complete the certification process within three years of application, documentation of continued supervised clinical practice is required. The candidate must submit Form 112a (amended) documenting ten (10) supervised births that have occurred within three years of submitting the next retake form.

All Certified Professional Midwives are required to have written Practice Guidelines. In the CPM Application, the candidate and her preceptor sign affidavits that the candidate maintains these documents. In the recertification application, the CPM again signs a statement verifying that she has written Practice Guidelines and utilizes Informed Consent in sharing these protocols with her clients. NARM does not require that these protocols be turned in with every application, but random audits of applications and recertifications are conducted. Audits require candidates to send copies of their Practice Guidelines and other documents to the NARM Board to verify compliance with NARM’s standards.

NARM recognizes that each midwife is an individual with specific practice protocols that reflect her own style and philosophy, level of experience, and legal status, and that practice guidelines may vary with each midwife. NARM does not set protocols for all CPMs to follow, but requires that they develop their own practice guidelines in written form.

Practice guidelines are a specific description of protocols that reflect the care given by a midwife. Protocol may contain absolutes, such as, “I will not accept as a client a mother who does not agree to give up smoking,” or may list conditions under which a midwife will make this decision, such as: “I will accept a client who smokes only if she agrees to cut down on smoking, maintains an otherwise exceptional diet, and reads the literature on smoking which I will provide for her.” (The example concerning smoking is given only as an example and is not meant to convey that smoking must be covered in a midwife’s practice protocols.) Another example of a protocol could reflect action taken when a client completes 42 weeks gestation. The protocols could state that at 43.1 weeks, the client will be referred to a back-up physician for further care. Or they could read that at 43.1 weeks the client will be given information on the risks and benefits of continuing to wait for labor, and on options such as home induction or referral to a physician. It is Informed Consent that allows the mother and midwife to work together in developing a plan of care.

Practice guidelines are the specific protocols of practice followed by a midwife, and they should reflect the Midwifery Model of Care. Standards, values, and ethics are more general than practice guidelines, and they reflect the philosophy of the midwife. Practice guidelines are based upon the standards, values and ethics held by the midwife. NARM recommends that the midwife base the practice guidelines on documents such as:

• The MANA Standards and Qualifications for the Art and Practice of Midwifery;
• The MANA Statement of Values and Ethics;
• The MANA Core Competencies;
• The Midwives Model of Care;
• NACPM Essential Documents;
• Standards for the Practice of Nurse-Midwifery;
• Core Competencies for Basic Midwifery Practice;
• Code of Ethics for Certified-Nurse Midwives;
• Rules and regulations governing the practice of licensed midwifery in the midwife’s state, if licensed.

Read these for more information:
MANA Documents
ACNM Documents
The Midwives Model of Care

Sample Practice Guidelines

NARM provides links below to Practice Guidelines of people or organizations who have consented to have them shared.
Tennessee Midwives’ Association Practice Guidelines
Standards, Duties, and Guidelines for Practice written and used by Debbie Pulley, CPM
Sample Emergency Transport Form