What's on the NARM written exam?
Roughly 300 multiple-choice questions, single best answer, across Two 3-hour sessions — weighted across seven content domains that are nothing like equal in size.
The weighting table
This is the part most candidates discover too late. Labor, Birth, and Immediate Postpartum alone is about 35% of the exam — more than the four smallest domains combined. Study time split evenly across seven domains is study time spent badly.
| Domain | Weight | Scored items | Our questions |
|---|---|---|---|
| I. Professional Issues, Knowledge, and Skills | 5% | 12–18 | 22 |
| II. General Healthcare Skills | 5% | 12–18 | 22 |
| III. Maternal Health Assessment | 10% | 24–36 | 45 |
| IV. Prenatal Care | 25% | 69–81 | 112 |
| V. Labor, Birth, and Immediate Postpartum | 35% | 99–111 | 158 |
| VI. Postpartum | 15% | 39–51 | 68 |
| VII. Well Baby Care | 5% | 12–18 | 23 |
Weightings and scored-item ranges are from the CPM NARM Examination Matrix in the Candidate Information Bulletin (June 2025), which contains the Written Test Specifications (rev. 2017). Content is developed from the NARM Job Analysis, based on the MANA Core Competencies.
The thing that catches people out
The exam is setting-specific: it tests competent midwifery practice in home and birth-center settings. That changes the expected answer on a real proportion of questions.
A candidate whose clinical background is mostly hospital-based can know the medicine perfectly and still choose wrongly, because the right answer turns on what a midwife does in a setting without an operating theatre down the corridor — when to consult, when to refer, and when to transfer. If you trained largely in hospital, that is the gap to close, and it will not show up as a knowledge gap. It shows up as judgement questions you keep getting wrong.
How it is scored
Criterion-referenced against a standard NARM sets and does not publish. You are not ranked against other candidates, and passing candidates do not receive a score breakdown. The full answer on scoring →
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