NARM’s mission is to offer and maintain an evaluative process for multiple routes of midwifery education; to develop and administer a standardized examination system leading to the credential “Certified Professional Midwife” (CPM); to identify best practices that reflect the excellence and diversity of the independent midwifery community as the basis for setting the standards for the CPM credential; to publish, distribute and/or make available materials that describe the certification and examination process and requirements for application; to maintain a registry of those individuals who have received certification and/or passed the examination; to manage the process of re-certification; and to work in multiple arenas to promote and improve the role of CPMs in the delivery of maternity care to women and their newborns.
NARM affirms that skilled and responsible midwives should be readily available to all families in North America. NARM affirms the autonomy of the independent midwife, the critical importance of her role as guardian of normal birth, and the value of her compassionate, skilled, and woman-centered care. NARM affirms a woman’s right to choose her birth attendants and place of birth and to involve those she identifies as her family in the bonding of the birth experience. NARM affirms the safety and viability of planned, midwife-attended birth at home, in hospitals, and in freestanding birth centers.
CPM certification validates entry-level knowledge, skills, and experience vital to responsible midwifery practice. This international certification process encompasses multiple educational routes of entry including apprenticeship, private midwifery schools, college- and university-based midwifery programs, and nurse-midwifery.
Certification shall not be construed as defining midwifery in its entirety. NARM acknowledges that midwifery encompasses attributes that defy measurement. NARM intends CPM certification to sanction and build a foundation to support midwives’ work while recognizing that their individuality of study and practice best reflects the needs of the communities they serve. Through CPM certification, NARM seeks to advance the midwifery model of care, to facilitate its integration as a vital component of the health care system, to ensure its wide availability to pregnant women and their families, and to preserve their freedom of choice.
In response to numerous state initiatives that call for the legalization of midwifery practice and the increased utilization of midwives as maternity care providers, midwives across the United States have come together to define and establish standards for international certification. The North American Registry of Midwives (NARM), the Midwives Alliance of North America (MANA) and the Midwifery Education and Accreditation Council (MEAC) have joined together to create this international, direct-entry midwifery credential to preserve the woman-centered forms of practice that are common to midwives attending out-of-hospital births.
These guidelines for certification have been developed with reference to national certifying standards formulated by the Institute for Credentialing Excellence (ICE), formerly the National Organization for Competency Assurance (NOCA). NARM has received psychometric technical assistance from Mary Ellen Sullivan, testing consultant; the Florida Department of Business and Professional Regulation Psychometric Research Unit; the Minnesota Board of Medical Practice; Schroeder Measurement Technologies, Inc.; National Measurement and Evaluation, Inc.; and Personnel Research Center.
A Certified Professional Midwife (CPM) is a knowledgeable, skilled and professional independent midwifery practitioner who has met the standards for certification set by the North American Registry of Midwives (NARM) and is qualified to provide the Midwives Model of Care. The CPM is the only international credential that requires knowledge about and experience in out-of-hospital settings.
Completion of this Certification cannot be seen as legal protection, which is determined by territorial governments.
It is not the intent of NARM to exclude any midwife from certification on the basis of age, educational route, culture, or ethnic group, creed, race, gender, or sexual orientation.
The Certified Professional Midwife (CPM) is a knowledgeable, skilled professional midwife who has been educated through a variety of routes. Candidates eligible to apply for the Certified Professional Midwife (CPM) credential include:
The education, skills and experience necessary for entry into the profession of direct-entry midwifery were mandated by the Midwives Alliance of North America (MANA) Core Competencies and the Certification Task Force; authenticated by NARM’s current Job Analysis; and are outlined in NARM’s Candidate Information Bulletin. These documents describe the standard for the educational curriculum required of all Certified Professional Midwives.
NARM recognizes that the education of a Certified Professional Midwife (CPM) is composed of didactic and clinical experience. The clinical component of the educational process must be at least one year in duration and equivalent to 1350 clinical contact hours under the supervision of one or more preceptors. The average apprenticeship which includes didactic and clinical training typically lasts three to five years.
The clinical experience includes prenatal, intrapartal, postpartal, and newborn care by a student midwife under supervision.
A preceptor for a NARM Entry-Level PEP applicant must be credentialed as a Certified Professional Midwife (CPM), Certified Nurse Midwife (CNM), or Licensed Midwife. The preceptor must have an additional three (3) years of experience or 50 births, including ten (10) continuity of care births beyond the primary birth experience requirements for CPM certification. (effective June 1, 2010)*
* A preceptor who does not meet the above requirements may request an exemption by filling out the preceptor application form at www.narm.org
The preceptor holds final responsibility for confirming that the applicant provided the required care and demonstrated the appropriate knowledge base for providing the care. The preceptor must be physically present in the same room in a supervisory capacity during that care and must confirm the provision of that care by signing the appropriate NARM forms.
The Certified Professional Midwife practices The Midwives Model of Care primarily in out-of-hospital settings. The CPM is the only national credential that requires knowledge and experience in out-of-hospital settings.
The education of all entry-level CPM applicants must include the content areas identified in the following documents, which are included in the Candidate Information Bulletin (CIB) included with the application packet or available for download on the NARM website.
A. The Core Competencies developed by the Midwives Alliance of North America;
B. The NARM Written Test Specifications, which will be used as the outline and Study Guide for the NARM Written Examination;
C. The NARM Skills Assessment Test Specifications, which will be used as the outline and Study Guide for the NARM Skills Assessment;
D. The NARM Written Examination Primary Reference List; and
E. The NARM Skills Assessment Reference List.
I. As an active participant, you must attend a minimum of 20 births.
II. Functioning in the role of primary midwife* under supervision, you must attend a minimum of an additional 20 births:
A. A minimum of 10 of the 20 births attended as primary under supervision must be in homes or other out-of-hospital settings; and
B. A minimum of 3 of the 20 births attended as primary under supervision must be with women for whom you have provided primary care during at least 4 prenatal visits, birth, newborn exam and 1 postpartum exam.
C. At least 10 of the 20 primary births must have occurred within three years of application submission.
III. Functioning in the role of primary midwife* under supervision, you must document:
A. 75 prenatal exams, including 20 initial exams;
B. 20 newborn exams; and
C. 40 postpartum exams.
*The primary midwife has full responsibility for provision of all aspects of midwifery care (prenatal, intrapartal and postpartal) without the need for supervisory personnel.
During the course of their educational process, all CPM applicants are expected to acquire the full range of entry-level midwifery skills as defined in the NARM Candidate Information Bulletin (CIB) and on the NARM Skills, Knowledge and Abilities Essential for Competent Practice Verification Form 201. Requirements for testing and documentation of these skills vary by educational category (see below).
You must provide:
I. A copy of both sides of current Adult CPR and Neonatal Resuscitation Certification;
II. Written verification by you or your preceptor (see specific category requirements below) that you have developed and utilize:
A. Practice guidelines;
B. An informed consent document;
C. Forms and handouts relating to midwifery practice; and
D. An emergency care form.
III. Documentation and verification of experience, knowledge and skills on the appropriate NARM forms as described below in your specific educational category.
The educational components required to become a Certified Professional Midwife (CPM) include didactic and clinical experience. NARM requires that the clinical component of the educational process be at least one year in duration and equivalent to 1350 clinical contact hours under the supervision of one or more preceptors. The average apprenticeship which includes didactic and clinical training typically lasts three to five years.
The first step toward becoming a Certified Professional Midwife is the validation of your midwifery education. You may validate your education through one of the following routes:
Graduates of a MEAC-accredited program must:
I. Fulfill the General Education Requirements.
II. Complete the appropriate NARM application forms.
III. Send either:
A. A notarized copy of the original graduation certificate or diploma; or
B. A final transcript with the school insignia.
Upon approval of your application materials, you will be scheduled for the NARM Written Examination.
After you pass the NARM Written Examination, you will receive your Certified Professional Midwife (CPM) Certificate.
MEAC graduates are expected to apply for NARM Certification within three years of graduation. If application for certification is made after this time, NARM will require additional documentation.
Candidates certified by the American College of Nurse Midwives Certification Council (ACC) must:
I. Fulfill the General Education Requirements.
II. Complete the appropriate NARM application forms.
III. Send a notarized copy of current ACC CNM/CM certificate.
IV. On the NARM form provided in the application packet, submit documentation of functioning in the role of primary midwife or primary under supervision for:
A. A minimum of 10 births in homes or other out-of-hospital settings;
B. A minimum of 3 births with women for whom you have provided primary care during at least 4 prenatal visits, birth, newborn exam and 1 postpartum exam.
Upon approval of your application materials, you will be scheduled for the NARM Written Examination.
After you pass the NARM Written Examination, you will receive your Certified Professional Midwife (CPM) Certificate.
The purpose of this category is to expedite the application process for individual midwives applying from a state/country listed below. Candidates from states/countries marked with an asterisk (*) must submit additional documentation to comply with NARM standards. The additional documentation form will be provided upon request with the application packet.
| Alaska* | California | Louisiana* | New Mexico | Texas |
| Arizona* | Colorado | Montana | Oregon | Washington |
| Arkansas | Florida | New Hampshire* | South Carolina* | United Kingdom* |
Candidates who are legally recognized in states/countries previously evaluated for educational equivalency must:
I. Fulfill the General Education Requirements.
II. Complete the appropriate NARM application forms.
III. Submit a notarized copy of your current state/country endorsement process (i.e. certification, licensure, registration, or documentation).
Upon approval of your application materials, you will be scheduled for the NARM Written Examination (only given in the U.S.) if you have not already taken it.
After you pass the NARM Written Examination, you will receive your Certified Professional Midwife (CPM) Certificate.
This category has been developed to facilitate applicants who are primarily apprentice-trained and/or have not graduated from a MEAC-accredited program, are not certified by the ACC as a CNM /CM, or are not legally recognized in their states. NARM’s Portfolio Evaluation Process (PEP) is a competency-based educational evaluation process that includes NARM’s Skills Assessment.
There are three PEP categories: Entry-Level, Internationally Educated Midwife, and Experienced Midwife.
Candidates applying for certification through NARM’s PEP Program will undergo a 2-step process:
STEP 1: Verification of experience and skills through NARM’s PEP Program. Upon successfully completing NARM’s PEP Program, you will be sent a Letter of Completion that can be submitted as educational equivalency in the CPM process.
STEP 2: Application for Certification.
STEP 1: Verification of Experience and Skills
Entry-level PEP candidates must:
I. Fulfill the General Education Requirements (described on pp. 4-5).
II. Document the fulfillment of these requirements on the appropriate NARM application forms.
III. Provide verification from the preceptor(s) that you have achieved proficiency on each area listed on the Skills, Knowledge and Abilities Essential for Competent Practice Verification Form.
IV. Provide an affidavit from the preceptor(s) asserting that you have developed and utilize:
A. Practice guidelines;
B. An informed consent document;
C. Forms and handouts relating to midwifery practice;
D. An emergency care form.
V. Provide three professional letters of reference.
VI. Pass the NARM Skills Assessment given by a NARM Qualified Evaluator (QE) or submit completed Second Verification of Skills form.
Upon fulfillment of the above requirements, you will be sent a Letter of Completion of NARM’s PEP Program.
STEP 2: Application for Certification Examination
Entry-level PEP candidates must:
I. Submit the CPM Application Form (400) and your Letter of Completion of NARM’s PEP Program.
Upon approval of your application materials, you will be scheduled for the NARM Written Examination.
After you pass the NARM Written Examination, you will receive your Certified Professional Midwife (CPM) Certificate.
The midwife who has been educated in another country must provide verification of all supportive documentation (licenses, diplomas and certificates). Applicants who received midwifery training in another country must have transcripts verified by International Credentialing Associates (ICA), Inc., 10801 Starkey Road, Suite 104, Seminole, FL 33777. Once a verification confirmation is sent to NARM Applications, the applicant will be notified and the PEP application may be submitted.
Internationally Educated Midwife candidates must:
Step 1:
I. Fulfill the General Education Requirements
II. Submit paperwork to ICA for verification
Step 2:
I. Complete the appropriate NARM application forms including documentation of:
A. Currency of practice – ten (10) primary births in the last three (3) years
B. A minimum of ten (10) births in homes or other out-of-hospital settings;
C. A minimum of three (3) births with women for whom you have provided primary care during at least four (4) prenatal visits, birth, newborn exam, and one (1) postpartum exam.
II. Submit:
A. Practice guidelines;
B. An informed consent document;
C. Forms and handouts relating to midwifery practice;
D. An emergency care form.
III. Pass the NARM Skills Assessment given by a NARM Qualified Evaluator (QE) if required.
Additional documentation may be required.
STEP 3: Application for Certification
All Internationally Educated Midwife candidates must:
I. Submit the CPM Application Form (400) and your Letter of Completion of NARM’s PEP Program.
Upon approval of your application materials, you will be scheduled for the NARM Written Examination.
After you pass the NARM Written Examination, you will receive your Certified Professional Midwife (CPM) Certificate.
The Experienced Midwife must have been in primary practice for a minimum of five years and attended at least 75 births as a primary midwife after their training. This category requires currency of at least ten births in the last two years.
Experience Requirements:
All Experienced Midwife candidates must document attendance as primary midwife at a minimum of 75 births within the last ten (10) years (at least 10 births must be within the last two years), including the following:
I. Twenty (20) or more out-of-hospital births;
II. Three (3) births with women for whom you have provided primary care during at least four (4) prenatal visits, birth, newborn exam and one (1) postpartum exam;
III. 300 prenatal visits (among 50 different women
IV. 50 newborn exams;
V. 75 postpartum visits.
Charts or written documentation of all five (5) births must be available. The applications department may request selected charts or additional documentation.
STEP 1: Verification of Experience and Skills
All Experienced Midwife candidates must:
I. Complete the appropriate NARM application forms.
II. Send the best documentation possible that you have fulfilled the experience and skills requirements, including any relevant certificates, diplomas, licenses and degrees.
III. Using the instructions for Other Category on Form 201provide a notarized, written account of how you acquired the skills required for NARM Certification.
IV. Submit a copy of both sides of current Adult CPR and Neonatal Resuscitation Certification.
V. Submit:
A. Practice guidelines;
B. An informed consent document;
C. Forms and handouts relating to midwifery practice;
D. An emergency care form.
VI. Pass the NARM Skills Assessment or submit completed Second Verification of Skills form.
Upon fulfillment of the above requirements, you will be sent a Letter of Completion of NARM’s Portfolio Evaluation Process.
STEP 2: Application for Certification
All Experienced Midwife candidates must:
I. Submit the CPM Application Form (400) and your Letter of Completion of NARM’s PEP Program.
Upon approval of your application materials, you will be scheduled for the NARM Written Examination. After you pass the Exam, you will receive your Certified Professional Midwife (CPM) Certificate.
You must:
I. Complete the NARM General Application and CPM Application forms.
II. Submit educational validation (along with additional documentation if necessary) for one (1) of the following educational routes of entry:
A. Graduation from a MEAC-Accredited Program.
B. Certification by the ACC as a CNM/CM.
C. Legal recognition in states/countries previously evaluated for educational equivalency.
D. Completion of NARM’s Portfolio Evaluation Process (PEP) Program.
1. Entry-Level Midwife
2. Internationally Educated Midwife
3. Experienced Midwife
III. Pass, or submit evidence of having passed, the NARM Written Examination.
1. Mandatory Areas + 25 contact hours from a mixture of categories
2. Mandatory Areas + retaking the NARM Written Examination, which is the equivalent of 25 contact hours.
All fees must be submitted by certified check, money order, or credit card. Personal or business checks will not be accepted.
Midwives who have previously passed the NARM Written Examination may subtract the fee paid for the examination taken from the certification fee. NARM Written Exams taken prior to 1995 will no longer be accepted for CPM Certification.
*The PEP Program was specifically designed to enable midwives to obtain certification by providing a mechanism for evaluating their knowledge, skills and experience.