How to Become a NARM Certified Professional Midwife (CPM)

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North American Registry of Midwives (NARM) Mission Statement

The North American Registry of Midwives (NARM) is an international certification agency whose mission is to establish and administer certification for the credential “Certified Professional Midwife” (CPM). CPM certification validates entry-level knowledge, skills and abilities vital to responsible midwifery practice. This international certification process encompasses multiple educational routes of entry, including apprenticeship, self-study, private midwifery schools, college- and university-based midwifery programs and nurse-midwifery. Created in 1987 by the Midwives Alliance of North America (MANA), NARM is committed to identifying standards and practices that reflect the excellence and diversity of the independent midwifery community, in order to set the standard for midwifery.

NARM affirms that skilled and responsible midwives should be readily available to all families in North America. NARM affirms the autonomy of independent midwives, the critical importance of their role as guardians of normal birth and the value of their 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.

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 practice best reflects the needs of the communities they serve. Through CPM certification, NARM seeks to advance the profession of midwifery, 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.

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Setting Standards for Midwifery

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 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.

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What is a Certified Professional Midwife (CPM)?

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.

The Midwives Model of Care is based on the fact that pregnancy and birth are normal life events. The Midwives Model of Care includes:

  • monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle;
  • providing the mother with individualized education, counseling and prenatal care, continuous hands-on assistance during labor and delivery and postpartum support;
  • minimizing technological interventions; and
  • identifying and referring women who require obstetrical attention.

The application of this model has been proven to reduce the incidence of birth injury, trauma and cesarean section.

Copyright © 1996-2001, Midwifery Task Force All Rights Reserved

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.

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Glossary of Acronyms

ACC

 ACNM Certification Council CNM Certified Nurse-Midwife
ACNM American College of Nurse-Midwives   MANA Midwives Alliance of North America
ACNM-DOA ACNM’s Division of Accreditation   MEAC Midwifery Education and Accreditation Council
CIB Candidate Information Bulletin   NARM North American Registry of Midwives
CM Certified Midwife   PEP NARM’s Portfolio Evaluation Process
CPM Certified Professional Midwife      

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North American Registry of Midwives Position Statement:
Educational Requirements to Become a Certified Professional Midwife (CPM)

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:

  • Graduates of programs accredited by the Midwifery Education Accreditation Council (MEAC);
  • Midwives certified by the ACNM Certification Council (ACC), Inc. as CNMs or CMs; and
  • Candidates who have completed NARM’s competency-based Portfolio Evaluation Process, the PEP Program.

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 and the How To Become A Certified Professional Midwife (CPM) booklet. These documents describe the standard for the educational curriculum (course of study) 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 least one year in duration and equivalent to 1350 clinical contact hours under the supervision of one or more preceptors.

The clinical experience includes prenatal, intrapartal, postpartal and newborn care by a student midwife under supervision. A supervising midwife, called a preceptor, must be either:

  • A nationally certified midwife (CPM, CNM, or CM); or
  • Legally recognized in a jurisdiction, province or state as a practitioner who specializes in maternity care; or
  • A midwife who has practiced as a primary attendant without supervision for a minimum of three years and fifty out-of-hospital births.

The preceptor(s) holds final responsibility for confirming that the applicant provided the required care. The preceptor(s) must be physically present in the same room in a supervisory capacity during that care and must confirm the provision of that care by initialing the appropriate NARM forms.

The Certified Professional Midwife practices The Midwives Model of Care in predominantly out-of-hospital settings. The CPM is the only national credential that requires knowledge and experience in out-of-hospital settings.

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General Education Requirements

Educational Content Areas

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) section of the application packet (the CIB can be purchased separately—see ordering form on final page):

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.

Experience Requirements

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.

Skills Requirements

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).

Other Required Documentation

You must provide:

I. A copy of both sides of current CPR (Adult and either Infant or 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 plan.

III. Documentation and verification of experience, knowledge and skills on the appropriate NARM forms (see ordering information on final page) as described below in your specific educational category.

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Requirements for Certification by Educational Category

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:

  • Graduation from a MEAC-Accredited Program.
  • Certification by the ACC as a CNM/CM.
  • Legal recognition in states previously evaluated for educational equivalency.
  • Completion of NARM’s Portfolio Evaluation Process (PEP) Program.

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Graduation from a Midwifery Education Accreditation Council (MEAC)-Accredited Program

Graduates of a MEAC-accredited program must:

I. Fulfill the General Education Requirements (described on pp. 4-5).

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.

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Certification by the ACC as a CNM/CM

Candidates certified by the American College of Nurse Midwives Certification Council (ACC) must:

I. Fulfill the General Education Requirements (described on pp. 4-5).

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.

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Legal Recognition in States Previously Evaluated for Educational Equivalency

The purpose of this category is to expedite the application process for individual midwives applying from a state listed below. Candidates from states marked with an asterisk (*) must submit additional documentation to comply with NARM standards. The state’s additional documentation form will be provided upon request with the application packet.

Alaska* California Louisiana* Montana Texas
Arizona* Colorado New Hampshire* Oregon Washington
Arkansas Florida New Mexico South Carolina* United Kingdom*

Candidates who are legally recognized in states previously evaluated for educational equivalency must:

I. Fulfill the General Education Requirements (described on pp. 4-5).

II. Complete the appropriate NARM application forms.

III. Submit a notarized copy of your current state endorsement process (i.e. certification, licensure, registration, or documentation).

Upon approval of your application materials, you will be scheduled for the NARM Written Examination if you have not already taken it.

After you pass the NARM Written Examination, you will receive your Certified Professional Midwife (CPM) Certificate.

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Completion of NARM’s Portfolio Evaluation Process (PEP) Program

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 two PEP categories: Entry-Level and Special Circumstances. The Special Circumstances category includes the Internationally Educated Midwife, Physicians, and Experienced Midwives.

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.

Entry-Level PEP

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 plan.

V. Provide three professional letters of reference.

VI. Pass the NARM Skills Assessment given by a NARM Qualified Evaluator (QE).

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.

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Special Circumstances PEP

This category is for candidates with special or non-conventional training, experience and needs. These applications must be evaluated by the Special Circumstances Committee to determine whether your training and experience are equivalent to NARM’s certification standards. Examples of categories of Special Circumstances include:

  • The Internationally Educated Midwife who has received most or all training in a country other than the USA;
  • The Experienced Midwife, whose training and experience is extensive, but does not fit the required Entry-Level Application documentation. Experienced midwives must have been in primary practice for a minimum of five years.

For consideration as a Special Circumstances candidate:

The midwife or physician 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., 7245 Bryan Dairy Rd., Suite 810, Bryan Dairy Business Park II, Largo, FL 33777. Once a verification confirmation is sent to NARM Applications, the application is then forwarded to Special Circumstances. IEM applications may be processed with less than the seventy-five (75) primaries as required for Experienced Midwives, but must meet Entry-Level requirements. Twenty (20) out of hospital births will be required.

Physicians must apply through the Portfolio Evaluation Process (PEP). Applicants may choose either the Entry-Level or Special Circumstances. In either case, in addition to any hospital experience, the applicant must document attendance as the primary midwife at ten out-of-hospital births (Three of these births must include a full course of continuity of care.) These ten out-of-hospital births must be under the direct supervision of a CPM or licensed midwife.

If the midwife has extensive training and experience but does not fit into the other categories of application, the midwife may submit a written request for consideration.

Experience Requirements.

All Special Circumstances candidates must document attendance as primary midwife at a minimum of 75 births within the last 10 years (at least 10 births must be within the last two years), including the following:

I. 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 75 births must be available. The Special Circumstances evaluation committee may request selected charts.

All Special Circumstances candidates must validate their experience and skills through NARM’s Portfolio Evaluation Process (PEP) Program before applying for certification. The Special Circumstances Committee may contact you for further documentation. Physicians who have not received documented midwifery training should contact NARM for application requirements.

STEP 1: Verification of Experience and Skills

All Special Circumstances candidates must:

I. Complete the appropriate NARM application forms.

II. Send a letter of request explaining your special circumstances.

III. Send the best documentation possible that you have fulfilled the experience and skills requirements, including any relevant certificates, diplomas, licenses and degrees.

IV. Using the instructions for Other Category on Form 201, provide a notarized, written account of how you acquired the skills required for NARM Certification (see p. 5).

V. Submit a copy of both sides of current CPR (Adult and either Infant or Neonatal Resuscitation) Certification.

VI. Provide written verification 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 plan.

VII. Pass the NARM Skills Assessment

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 Special Circumstances 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.

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CPM Certification: A Summary

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 previously evaluated for educational equivalency.

D. Completion of NARM’s Portfolio Evaluation Process (PEP) Program.

III. Pass, or submit evidence of having passed, the NARM Written Examination.

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Recertification

  • Certification must be renewed every three years.
  • Thirty (30) continuing education contact hours are required during the three-year period. These must include 5 contact hours of peer review (see below.)
  • One contact hour is defined as fifty-five (55) clock minutes of time. .5 (half) contact hours are awarded for thirty (30) minutes to fifty-five (55) minutes. Fewer than 30 contact minutes will not be awarded continuing education contact hours.

Mandatory Areas

  • Peer Review—5 contact hours (Participation in Peer Review and/or attendance at Peer Review workshop)
  • Current Adult CPR and either infant CPR or Neonatal Resuscitation
  • Affirmation of current use of informed consent
  • Demographic information

Two Options for Recertification

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.

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Directory
NARM General Information
5257 Rosestone Dr.
Lilburn, GA 30047
1-888-84-BIRTH
(1-888-842-4784)(E)
info@narm.org
www.narm.org		 Midwifery Education Accreditation Council (MEAC)
360-466-2080
info@meacschools.org
www.meacschools.org
For information about MEAC accredited midwifery programs
Midwives Alliance of North America (MANA)
611 Pennsylvania Ave SE #1700
Washington DC 20003-4303
888-923-MANA
Info@mana.org
www.mana.org		 Practical Skills Guide for Midwives (PSGM)
Morningstar Publishing
PO 671427
Chugiak, AK 99567
888-609-PSGM

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Fee Schedule

All fees must be submitted by certified check, money order, or credit card.  Personal or business checks will not be accepted.

PEP Fee $700
Certification Fee $700
Recertification Fee $150

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. This fee reflects the amount of work and time required for processing a PEP candidate's application and administering the NARM Skills Assessment.

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Request Form for NARM CPM Certification Application Packet Portfolio Evaluation Process (PEP) Application Packet Candidate Information Bulletin (CIB)

Click here for a printable version of the request form only.

Please print while filling out the following in black ink.

Name: ______________________________________________________

Address:_____________________________________________________________________

City: ______________________________________

State/Province: _________________

Country: ___________________________________

Postal code: ___________________

Phone (home): ______________________________

Phone (work): ___________________

Pager:______________________________________

Fax: ___________________________

Social Security Number: ________________________________

Date: __________________

Attached is my non-refundable:

__ Certified Check, or

__ Money Order made out to the North American Registry of Midwives (NARM) in U.S. funds (NARM does not accept personal checks), or

__ Please charge* this to my ___Visa or ___MasterCard.

          Card Number ____________________________  exp. date__________ 

          Signature________________________________

*There will be handling fee for all credit card requests and any application mailed outside the United States.

Personal or Business checks will be returned.

___  CPM Application Packet (for all routes of entry) and Candidate Information Bulletin (CIB)  $50.00
___  Candidate Information Bulletin (without application packet)  $10.00

Mail this form and the accompanying fee to:

NARM Applications
PO Box 420
Summertown, TN 38483

Your application will be mailed to you by USPS Returned Receipt Signature required.

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Updated 1-28-2008