The Midwifery Education Accreditation Council (MEAC) is recognized by the U.S. Secretary of Education as a national accrediting agency for direct-entry midwifery education programs and institutions. The standards for accreditation address curriculum requirements, faculty qualifications, facilities and student services, fiscal responsibility and administrative capacity. MEAC accreditation requires that midwifery schools incorporate the Core Competencies adopted by MANA and the clinical experience requirements and essential knowledge and skills identified by NARM. They must also provide evidence that graduates are capable of passing the NARM written examination and becoming CPMs and/or meeting the requirements for state licensure.
Requirements for Certification:
Graduates of a MEAC-accredited program must:
- Fulfill the General Education Requirements.
- Complete the appropriate NARM application forms.
- Send either:
- A notarized copy of the original graduation certificate or diploma; or
- A final transcript with the school insignia.
Upon approval of the application materials, the NARM Written Examination will be scheduled.
The Certified Professional Midwife certification will be issued after all requirements are met.
General Education Requirements UPDATE:
- All students must submit evidence of a high school diploma or equivalent.
- All students must complete a module related to Cultural Competency for Health Professionals.
- The title “Active Participant” Births will be changed to “Assistant under Supervision” and must be supervised by a qualified preceptor. NARM will continue to accept Active Participant births for clinicals obtained prior to September 1, 2012. MEAC Applicants are still required to have the additional skills/clinicals listed on the current Form 111. For example, if you have Active Participants births on the old Form 111, prenatals, postpartums, etc listed on the new form will still be required.
This is a description of the changes to the minimum requirements established by NARM for entry-level midwives. MEAC standards for accreditation require that the curriculum in accredited programs fulfills the minimum requirements established by NARM (Standard 2, Benchmark C). MEAC will therefore require that programs revise their curriculum as necessary in order that:
- Students enrolled in a MEAC program prior to January 1, 2013 and graduating prior to January 1, 2015 may apply using the old application requirements. This application can be found at the bottom of the MEAC Application download page.
- All students enrolled after January 1, 2013 will meet the new eligibility requirements; and
- All graduates, even those enrolled before January 1, 2013, will meet the new requirements if graduating after January 1, 2015.
New Clinical Requirements
Births as an Observer
Document attendance at ten births in any setting in any capacity (observer, doula, family member, friend, beginning apprentice). These births may be verified by any witness who was present at the birth.
Clinicals as Assistant Under Supervision
Document at least 20 births, 25 prenatals (including 3 initial exams), 20 newborn exams, 10 postpartum visits as an assistant under the supervision of a qualified preceptor. Eighteen births in this category must be completed before beginning Primary under Supervision births. Determination of readiness for serving as Primary under Supervision is at the discretion of the supervising preceptor, and may require more births as an assistant before moving to the next step.
Clinicals as Primary under Supervision
Document 20 births, 75 prenatals (including 20 initial prenatals), 20 newborn exams, and 40 postpartum exams as a primary midwife under supervision. Two intrapartum transports are allowed if labor began in an OOH setting.
Continuity of Care:
Of the 20 Primary births required under Supervision in Phase 3, five require full Continuity of Care and ten more require at least one prenatal under supervision.
Full Continuity for 5 Primary Births:
Five Continuity of Care as a primary midwife under supervision will include 5 prenatals spanning two trimesters, the birth, newborn exam and two postpartums. Multiple preceptors can verify the continuity of care. The newborn exam must be done within 12 hours of the birth; maternal postpartum exams must be done between 12 hours and 6 weeks following the birth.
Prenatals for 10 Additional Primary Under Supervision births:
Students must have attended at least one prenatal (in a primary or assisting role) with the mother prior to her labor and birth for 10 of the 20 primary births under supervision in Phase 3 (in addition to the 5 with full COC).
Five Additional Births as Primary Under Supervision
Document five additional births as Primary under the supervision of a Qualified Preceptor. These may have occurred after the last birth on Phase 3 documentation, and may be submitted before or after the Written Exam. Only one maternal transport may be included if the labor begins in the OOH setting. Submission of this form is expected within six months of passing the exam unless a request for an extension is made.
Experience in Specific Settings:
A minimum of five home births must be attended in any role. A minimum of two planned hospital births must be attended in any role. These cannot be intrapartum transports but may be antepartum referrals.
Ten out-of-hospital primary births must occur within the last three years. All clinicals must occur within ten years.
Duration of Clinical Experience:
Minimal time frames for clinical education must span at least two years. [Further details for MEAC programs will be forthcoming.]
Delayed Application for CPM after Graduation
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 documentation of ten (10) primary births, twenty-five (25) hours of continuing education, and five (5) hours of peer review within the three (3) years prior to the application submission. Form available upon request.
MEAC Students – Early Testing
The NARM board has recently initiated a new policy to allow students who are in their last semester of a MEAC program to take the NARM Written Examination prior to graduation. This policy has been created due to the many school graduates who need to pass the NARM Written Examination in order to receive their state midwifery license, but who graduate several months before the regular NARM test dates thus delaying their ability to get their license well past their graduation date.
In the past, a midwife who did not yet have a MEAC diploma had to apply through the PEP process, which cost extra money and also required the NARM Skills Assessment. After graduation, the student could skip the PEP process and go straight to the CPM Application for the NARM Written Examination. Under the new policy, the student who is in the last semester of the MEAC program and who is expected to graduate within six months, and who has met all the NARM experience requirements, and who has the approval of the director of the school, may submit a CPM application and register to take the NARM Written Examination.
The student must first order an application from NARM or download the application forms linked here. The student must fill out the General Application and the CPM Application (not the PEP application), and submit these applications along with the appropriate fee, to NARM Applications. In lieu of the MEAC diploma, the student may submit the specified letter from the director of their school.
When the application materials and the letter have been received and approved by NARM Applications, the candidate will receive notification and a Written Examination Intent Form from the NARM Test Department. The student will then return the Intent Form to the Test Department, indicating the chosen date and site for the NARM Written Examination. After the examination, the student will receive the results from the NARM Test Department. That letter may be used to provide evidence to the state of passing the NARM Written Examination. If the state requires a letter from NARM, the student must request that the letter be sent. (NARM does not notify any state agency of exam results without the written permission of the candidate, except when the candidate registers for the exam through the state agency.)
In order to receive the CPM certificate, the candidate will need to send a notarized copy of the MEAC diploma, or an official transcript from the school indicating completion of requirements, to NARM Applications. No additional payments will be needed, but proof of MEAC graduation will be required.
The letter from the school that must be sent with the CPM application must contain specific language required by NARM and must be on official school stationary and signed by both the candidate and the director of the school. The specific language is included with this letter, and may be retyped, copied or pasted onto the school stationary. The school may then continue to use that form for each candidate unless notified by NARM of any changes.
For more information, or any questions, please contact the NARM Test Department at email@example.com or 1-888-353-7089.
Policies for MEAC Students Testing Before Graduation
- Students in MEAC accredited programs who have passed exam under the early testing option but not graduated:
- Students in MEAC accredited programs who passed the exam under early testing but who have not graduated within six months of passing the test will be sent a reminder letter from NARM with an additional two months to submit the extension request, letter from the school, and $50 extension fee. The NARM Applications department may request assistance from the school if the student cannot be located.
- Students in MEAC accredited programs who have applied to NARM through the early-testing option, who have passed the test, but who have not graduated within six months of taking the NARM exam, must submit a request for an additional six-month extension of their NARM application. The request must be accompanied by a letter from their school indicating that they are still enrolled and are expected to graduate within the following six months. The request must include a $50 extension fee. Additional six month extensions may be sought under the same criteria.
- Students who do not respond by the deadline indicated in their reminder letter will have their application terminated and archived. They may reactivate their application within two years of the deadline on their original reminder letter by submitting new and current application forms with a $100 administrative fee. Their NARM test results will be considered valid within this period. Two years after the deadline, this option is no longer open, and the student must submit a new application, pay current application fees, and re-take the NARM written exam.
- Students who have passed the NARM exam under the MEAC early-testing option and who have dropped out of their MEAC accredited program before graduation:
Students who have passed the NARM exam under the MEAC early-testing option and who have dropped out of their MEAC accredited program before graduation may reapply as a PEP applicant, submitting all PEP documentation and fees. PEP application documentation must be submitted within two years of their initial testing date in order to have their test results apply toward CPM certification. Two years from their testing date, if no action has been taken to complete a PEP application, the test results will no longer apply. Future options would require completion of a new application and testing requirements for any category of application.
- Students who have failed the NARM exam under the MEAC early testing option:
Students who have failed the NARM exam under the MEAC early testing option must continue to retake the exam at least once a year. There is no final number of times a student may retake the text. If the exam cannot be retaken within a year, a six month extension may be requested. Extensions must include a written request, a letter from the school indicating they are still enrolled in the program, and a $50 extension fee in addition to the $400 exam retake fee. If no request is made or granted, the application may be terminated and archived. To reactivate the application within two years, the student must submit a new application, letter from the school indicating ongoing enrollment, a $100 reactivation fee, and the $400 exam retake fee. After two years of inactivity, the student must reapply with all current information and testing fees.
If the student maintains an active application through the retesting period but the births on the application are more than three years old, a currency application must also be submitted indicating 10 births under supervision within the most recent three years. The currency documentation form is available from NARM by request to firstname.lastname@example.org
Extensions and fees should be submitted to NARM Applications, P.O. Box 420, Summertown, TN 38483