How do you qualify to sit the NARM exam?
It is usually described as a choice between a MEAC program and the PEP apprenticeship route. That is not quite right — NARM names five application routes, and which one applies to you is determined by your background, not by preference.
Every route ends at the same place — the NARM written examination and a skills assessment. The routes differ in how you demonstrate eligibility to get there, not in what the exam then asks of you. Whichever route you are on, the exam covers the same seven domains at the same weightings.
MEAC Graduate
You completed a midwifery program accredited by the Midwifery Education Accreditation Council.
MEAC-accredited programs are built to incorporate the MANA Core Competencies together with the clinical experience requirements and the essential knowledge and skills identified by NARM — so the education route and the exam are aligned by design.
Entry Level (PEP)
You trained through apprenticeship rather than a formal accredited program.
The Portfolio Evaluation Process is an educational evaluation route that verifies knowledge and skills through documented clinical experience signed off by a NARM Registered Preceptor. It runs in phases — observation, assisting under supervision, then primary under supervision — each with its own documented minimums for births, prenatal visits, newborn exams and postpartum care.
Note: The phase-by-phase minimums are specific and they change. Get them from NARM’s own application instructions, not from a prep site.
State Licensed Midwife
You already hold a U.S. state midwifery license.
Licensed midwives apply for CPM certification through their own route rather than repeating an entry-level evaluation.
CNM or CM
You are a Certified Nurse-Midwife or Certified Midwife certified by AMCB.
AMCB-certified CNMs and CMs may apply for CPM certification through this route.
UK Registered Midwife
You are a Registered Midwife in the United Kingdom.
This is the international route to CPM certification.
Why we are not listing the PEP numbers
The Portfolio Evaluation Process specifies exact minimums — how many births, how many prenatal visits, how many newborn exams, at which phase, and under what kind of supervision. Those figures are the difference between an application that is accepted and one that is returned.
They also change, and a stale figure can cost you a year of clinical placements. We are a study resource, not the registry. Take the numbers from NARM's own application instructions and check them again before you plan around them.
NARM application routes → Candidate Information Bulletin (PDF)
Once you are eligible
The written examination is roughly 300 multiple-choice questions across two three-hour sessions, weighted across seven content domains, and scored against a standard NARM does not publish.
Full access from $59 — all 450 questions with explanations, three timed mock exams, flashcards and the study guide. One-time, no subscription.
PowerExams is an independent study resource, not affiliated with, endorsed by, or sponsored by the North American Registry of Midwives (NARM) or the Midwives Alliance of North America (MANA). NARM is the only authoritative source on eligibility and application requirements, and those requirements change. Nothing here is eligibility advice. Route names and descriptions are summarised from NARM's public certification pages.