NARM supports a health care system where every family in North America has access to skilled and responsible midwives. The individualized attention provided by the CPM in practice is of critical importance to her role as guardian of normal birth, and to the value of her compassionate maternity care. NARM sets standards for Competency-based credentialing is based on documentation of comprehensive training and testing of knowledge and skills that are relevant to real-life job conditions, as determined by psychometric research within the profession. The credential has been evaluated by independent researchers at Ohio State University and was determined to be a credential that exemplifies the established standards for educational testing as determined by the American Educational Research Association and the National Council of Measurement in Education. In 2002, the CPM credential was accredited by the National Commission on Certifying Agencies (NCCA) and is evaluated yearly for adherence to the national standards.competency-based certification that allow a midwife to support a woman’s right to choose her birth attendants and place of birth and to involve those she identifies as her family in the birth experience. CPMs practice as autonomous health professionals working within a network of relationships with other maternity care professionals who can provide consultation and collaboration when needed.
As numerous studies have affirmed the safety of planned, midwife-attended birth at home, in hospitals, and in freestanding birth centers, NARM recognizes the potential for improved outcomes that include lower costs and fewer interventions to childbearing mothers and their babies when attended by Certified Professional Midwives.
As the CPM emerges as a sought after professional maternity care provider in out of hospital settings, NARM is dedicated to advancing the profession by supporting advocacy efforts for legal recognition at the state and federal level. NARM dedicates a significant percentage of its annual budget for development of advocacy training, offering workshops, participation in legislative, public health, and midwifery conferences, creating promotional materials, and serving on advisory committees for state and federal level initiatives to support the CPM.
The Certified Professional Midwife credential, issued by NARM, is accredited by the National Commission for Certifying Agencies (NCCA), the accrediting body of the Institute for Credentialing Excellence (ICE, formerly NOCA). The mission of ICE is to promote excellence in credentialing for practitioners in all occupations and professions. The NCCA accredits many healthcare credentials, including the Certified Nurse-Midwife. NCCA encourages their accredited certification programs to have an education evaluation process so candidates who have been educated outside of established pathways may have their qualifications evaluated for credentialing. The NARM Portfolio Evaluation Process (PEP) meets this recommendation. The CPM is the only NCCA-accredited midwifery credential that includes a requirement for out-of-hospital experience. Read More >
Certified Professional Midwives (CPMs) are a fast-growing segment of the midwifery profession in the United States today. Certified Professional Midwives are trained and credentialed to offer expert care, education, counseling and support to women for pregnancy, birth and the postpartum period. They have particular expertise in out-of-hospital settings. CPMs practice as autonomous health professionals working within a network of relationships with other maternity care professionals who can provide consultation and collaboration when needed.
How To Become A CPM
The Certified Professional Midwife was developed to provide competency-based certification for midwives who are primarily apprentice-trained in out of hospital birth. The CPM credential allows multiple routes of entry to the profession in order to encourage innovation in education, adaptability to evolving best practices of the profession, diversity in the pool of credentialed midwives and broad accessibility to the profession.The competency-based model for certification assures well-educated, skilled and competent providers.
Aspiring Midwives can:
- Apprentice with a qualified midwife, completing an Entry-Level Portfolio Evalution Process (PEP).
- Attend a midwifery program or school.
- If the school is accredited by MEAC, graduation qualifies you for the NARM written exam. (See [Equivalency Applicant] page for more information)
- If the school or program is not MEAC accredited, you must complete the Entry-Level Portfolio Evaluation Program.
Experienced Midwives can:
- Complete a Portfolio Evaluation Process Application under the Experienced Midwife category. Applications are evaluated on a case by case basis.
- Complete an Application for Certification under the category of Licensed Midwife in an Approved State.
- Complete a Portfolio Evaluation Process Application under the Internationally Educated Midwife category. (for all internationally trained midwives, except UK, who qualify in the next category, below)
- Complete an Application for Certification Examination under the categories of certified as a CNM/CM or Legally Recognized in the UK.
Midwives are the key to increasing access to effective maternity care:
- The American Public Health Association and the World Health Organization recommends midwives as the primary maternity care providers for the majority of women
- The Millbank Report: Evidence-Based Maternity Care recognizes the CPM as the benchmark for low intervention and good outcomes
- Nations with the lowest infant mortality employ midwives as the primary maternity care providers for the majority of women
- Mounting evidence supports the value and cost-savings potential of midwifery care, according to a report issued by the Washington Department of Health in 2010
- Birth centers and planned home births have been shown to be safe for low-risk women, with demonstrated potential to significantly reduce costs to the system
- CPMs are currently legally recognized in 26 states and own approximately half of the birth centers in the U.S.
What is evidenced-based research?
Certified Professional Midwives provide care that is based in the tenants of Evidence-Based Practice (EBP). EBP is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal and unique concerns, expectations, and values. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology. (Sackett D, 2002)
Midwives must avail themselves of the best research evidence related to their practice standards and decision making information for their clients as they support women through the childbearing process. A comprehensive resource for evidence-based research in maternity care can be found at Childbirth Connection.
Evidence-based research citations related to midwifery care and out of hospital birth:
Kenneth C Johnson, Betty-Anne Daviss. Outcomes of Planned Home Births with Certified Professional Midwives: Large Prospective Study in North America. BMJ 2005;330:1416 (18 June), doi:10.1136/bmj.330.7505.1416
Janssen PA, Saxell L, Page LA, Klein MC, Liston RM, Lee SK. Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician. CMAJ 2009; 181(6-7):377-383.
Hutton EK, Reitsma AH, Kaufman K. Outcomes associated with planned home and planned hospital births in low-risk women attended by midwives in Ontario, Canada, 2003-2006: a retrospective cohort study. Birth 2009; 36(3):180-189.
de Jonge A., van der Goes BY, Ravelli AC, melink-Verburg MP, Mol BW, Nijhuis JG et al. Perinatal mortality and morbidity in a nationwide cohort of 529,688 low-risk planned home and hospital births. BJOG 2009; 116(9):1177-1184.
Certified Professional Midwives are regulated on a state by state basis. To find out the specific information for the states that regulate CPMs, please refer to the charts linked here:
Legal Status of Direct Entry Midwifery
Direct Entry Midwifery State Laws and Regulations
See all State information here: