- Which CPM This Cheat Sheet Covers
- The Exam at a Glance
- Seven Domains and Their Weights
- High-Yield Topics by Domain
- Fees and Money Mechanics
- Scoring, Pass Rates, and the Score-Scale Conflict
- Eligibility and PEP Facts
- Retakes and Recertification
- A Domain-Weighted Study Order
- Certification Is Not Permission to Practice
- Frequently Asked Questions
- The NARM written exam has 300 multiple-choice questions in two three-hour sessions, closed-book, six hours total.
- Labor, Birth, and Immediate Postpartum carries 35% and Prenatal Care 25%, together 60% of the blueprint.
- The preserved blueprint is the 2017 revision; NARM has announced an updated outline but no live replacement date.
- The NARM score scale conflicts across sources (245 versus 75); confirm with NARM before judging readiness.
Which CPM This Cheat Sheet Covers
"CPM" is shorthand used by several unrelated credentials. This page is only about the Certified Professional Midwife credential, issued by the North American Registry of Midwives (NARM), and the NARM written examination that candidates take on the way to it. It is not a nurse-midwifery exam, and nothing here applies to any other credential that happens to share the acronym. If you need background on the name itself, see our explainers on what CPM is and what CPM stands for.
Use this sheet as a fast-recall companion, not a replacement for primary sources. The blueprint figures below come from the Written Test Specifications (revision 2017) printed in NARM's June 2025 Candidate Information Bulletin. Fee and policy details should always be rechecked against NARM's live pages before you pay or schedule anything.
The Exam at a Glance
| Item | Must-Know Fact |
|---|---|
| Issuer | North American Registry of Midwives (NARM) |
| Format | 300 multiple-choice questions |
| Structure | Two three-hour sessions, six hours total |
| Reference materials | Closed-book |
| Delivery | Current provider references name Professional Testing Corporation (PTC), with Prometric test-center and ProProctor remote delivery; follow your individual testing authorization |
| Legacy provider | Prov ceased to be NARM's testing provider on September 1, 2021, so older PROV references are outdated |
| Retake wait | Two months, then retest within six months after the wait |
Two format points trip up candidates. First, six hours is a long sitting, so stamina and pacing are part of the skill set. Second, written-exam time is separate from your clinical training and competency assessment; passing the written test is one component of certification, not the whole route. Commercial practice tests are usually much shorter than 300 questions, so a short quiz score does not tell you how you will hold up across the full exam. For a deeper look at difficulty, read How Hard Is the CPM Exam?
Seven Domains and Their Weights
The nominal weights below are the percentages printed in the detailed Written Test Specifications. They are official exam objectives, not editorial allocations. The summary matrix in the bulletin allows ranges around these figures (for example, 33-37% for the largest domain), so treat the nominal numbers as the center of the target, not exact question counts.
| Domain | Nominal Weight |
|---|---|
| 1. Professional Issues, Knowledge, and Skills | 5% |
| 2. General Healthcare Skills | 5% |
| 3. Maternal Health Assessment | 10% |
| 4. Prenatal Care | 25% |
| 5. Labor, Birth, and Immediate Postpartum | 35% |
| 6. Postpartum | 15% |
| 7. Well-Baby Care | 5% |
For a domain-by-domain breakdown, see CPM Exam Domains: Complete Guide to All 7 Content Areas.
High-Yield Topics by Domain
Because Domains 4 and 5 account for 60% of the blueprint, most of your recall effort belongs there. The lists below frame the kinds of competencies midwifery candidates should be able to reason through; they are study prompts, not recalled exam items.
Domain 5: Labor, Birth, and Immediate Postpartum (35%)
The largest domain, and the one where scenario reasoning matters most.
- Assessing labor progress and distinguishing normal variations from findings that call for action
- Fetal heart rate assessment and recognizing patterns that require a response
- Management of the third stage, including recognizing and responding to postpartum hemorrhage
- Neonatal resuscitation priorities and immediate newborn assessment
- Knowing when to consult, refer, or transfer, and how to communicate a transfer
- Immediate postpartum assessment of the birthing person and baby
Domain 4: Prenatal Care (25%)
Routine care plus the ability to spot deviations early.
- Gestational dating and fundal height, and what discrepancies suggest
- Screening schedules, lab interpretation, and risk assessment across the pregnancy
- Hypertensive disorders of pregnancy: warning signs and follow-up
- Gestational diabetes screening and nutrition counseling
- Anemia, infection, and other common prenatal complications
- Informed consent, shared decision-making, and documentation
Domain 6: Postpartum (15%)
- Normal involution and recovery, versus signs of hemorrhage, infection, or thromboembolism
- Lactation support and common breastfeeding difficulties
- Postpartum mood and emotional-health screening and referral
- Contraception counseling and follow-up care timing
Domain 3: Maternal Health Assessment (10%)
- History taking, physical assessment, and interpreting findings
- Distinguishing normal physiologic change from pathology
- Recognizing when findings exceed your scope and require referral
Domains 1, 2, and 7 (5% each)
- Professional Issues: ethics, scope of practice, record keeping, and working within legal and professional standards
- General Healthcare Skills: infection control, vital signs, and foundational clinical skills
- Well-Baby Care: newborn assessment, feeding, screening, and recognizing newborn danger signs
Small domains still count. Five percent of a 300-question exam is a meaningful block of questions, and Professional Issues and Well-Baby Care are often easier to lock in than the high-complexity clinical domains. Our CPM Study Guide walks through how to build recall in each area.
Key Takeaway
Weight your time to the blueprint, but do not abandon the 5% domains. They are the most efficient places to bank correct answers while you keep drilling Domains 4 and 5.
Fees and Money Mechanics
These are NARM's charges, not education tuition, and they vary by application route. The fees below come from NARM's Payments and Fees page as reviewed for this article; the live fee page takes precedence over any older schedule, so verify before paying.
| Route | NARM Charge (USD) |
|---|---|
| PEP application, phases 1-4 | $240 / $450 / $450 / $135, plus a $1,155 written-examination fee |
| MEAC graduate application | $1,365, including the examination |
| Approved-state-license application | $55, plus $1,155 when an examination is required |
| UK-licensed applicant | $1,210, including the examination |
| CNM/CM applicant | $1,260, including the examination |
| Examination retake | $210 |
| Recertification renewal | $216 before expiration; $270 within the 90-day late period |
The pattern to remember: the exam fee is bundled into some routes and itemized in others, and a retake costs far less than the first attempt. For the full picture beyond NARM's charges, including how candidates budget for education and clinical training, see CPM Certification Cost: Complete Pricing Breakdown.
Scoring, Pass Rates, and the Score-Scale Conflict
This is the area where candidates most often repeat bad information, so read carefully.
- NARM's retrieved 2025 Annual Report gives a scaled passing standard of 245 for both 2025 exam forms.
- Form 343-21-A0-ENG: 229 candidates, 60% pass rate.
- Form 343-21-B0-ENG: 192 candidates, 63% pass rate.
- NARM's FAQ still describes a 75-point scaled passing standard.
The pass rates above are form-specific 2025 results. They are not first-attempt rates, not an official combined rate, and not a forecast for 2026. For a careful walkthrough of what the data does and does not show, see CPM Pass Rate: What the Data Shows and CPM Passing Score: Exactly What You Need to Pass.
Eligibility and PEP Facts
Eligibility is route-specific. Across routes, NARM's requirements include education, clinical documentation, competency verification, current hands-on adult CPR and neonatal-resuscitation credentials, cultural-awareness education, and required practice-document affirmations.
- A high-school diploma or equivalent is required.
- For the Portfolio Evaluation Process (PEP), clinical work must follow that qualification and use registered preceptors.
- The June 2025 bulletin describes at least two years and 55 births across observer, assistant, supervised-primary, and final primary stages for the complete PEP certification route. It also calls for documented prenatal, newborn, and postpartum experience and professional and client references.
- Those PEP minima are not universal prerequisites for every route, and they are not a stand-alone statement of written-exam eligibility.
Because the route you choose changes both documentation and cost, confirm your route first. Details are in CPM Requirements: Eligibility, Prerequisites & How to Qualify, and the timing side is covered in CPM Exam Dates: Testing Windows, Deadlines & Scheduling.
Retakes and Recertification
Retakes. If you do not pass, there is a two-month wait before you can test again, and NARM's examination page then requires retesting within six months after that waiting period. Plan the gap deliberately: use the two months to diagnose weak domains rather than rereading everything.
Recertification. Certification is renewed every three years. The requirements are:
- 30 contact hours, made up of 25 continuing-education hours and five peer-review hours
- Current CPR and neonatal-resuscitation credentials
- Cultural-awareness education
- Required practice affirmations
Retaking the examination can replace the 25-hour continuing-education component, but it does not replace the other mandatory requirements. Renewal costs $216 before expiration or $270 within the 90-day late period, so the late window is a costly default to drift into.
A Domain-Weighted Study Order
Generic study advice matters less than allocating hours where the blueprint puts questions. One way to sequence an eight-week plan around the weights:
Foundation: Domains 1, 2, 3 and 7
- Lock in the smaller domains (Professional Issues, General Healthcare Skills, Well-Baby Care) early for quick wins
- Review Maternal Health Assessment, since assessment logic underlies later domains
Prenatal Care (25%)
- Screening schedules, labs, and risk assessment
- Hypertension, diabetes, anemia, and infection scenarios
Labor, Birth, and Immediate Postpartum (35%)
- Heaviest block of time: progress, fetal assessment, hemorrhage, resuscitation, transfer decisions
- Work case scenarios, not just definitions
Postpartum (15%) and integration
- Recovery, lactation, complications, and mood screening
- Mixed-domain review of weak spots
Endurance practice
- Sit long, mixed blocks to rehearse the six-hour format
- Review misses by domain and reconcile against your references
Scheduling Labor, Birth, and Immediate Postpartum late but giving it the most hours keeps it fresh near test day, while the early weeks build the assessment foundation it depends on. To drill under realistic conditions, use the CPM practice test to check your recall by domain, and pair it with the broader plan in our study guide.
Certification Is Not Permission to Practice
Holding the Certified Professional Midwife credential and being legally allowed to practice are separate questions. State and provincial law governs practice authority, and NARM recognition does not decide licensure eligibility. Earning the credential helps you qualify for licensure in many places, but you need to check the rules where you plan to work.
The same caution applies to career expectations. Do not assume that salary or hiring figures for nurse-midwives describe certified professional midwives; the two credentials follow different education and practice paths. For earnings and career context specific to this credential, see the CPM Salary Guide, and for the bigger decision, Is the CPM Certification Worth It?
Key Takeaway
Treat passing the NARM exam as one milestone. Confirm your state's licensure and legal-practice rules separately, and read the plain-language overview at CPM certification if you are still orienting.
Frequently Asked Questions
The written examination has 300 multiple-choice questions, delivered in two three-hour sessions for six hours total. It is closed-book.
Labor, Birth, and Immediate Postpartum is the largest at a nominal 35%, followed by Prenatal Care at 25% and Postpartum at 15%. These come from the 2017-revision Written Test Specifications in NARM's June 2025 bulletin.
NARM's 2025 Annual Report gives a scaled passing standard of 245 for both 2025 forms, while the FAQ still describes a 75-point standard. Because the sources conflict, confirm the applicable scale with NARM and do not convert either number into a percentage of 300 questions.
An examination retake is $210. You must wait two months, and NARM's examination page then requires you to retest within six months after that waiting period.
Every three years, with 30 contact hours (25 continuing-education plus five peer-review), current CPR and neonatal-resuscitation credentials, cultural-awareness education, and required practice affirmations. Renewal is $216 before expiration or $270 in the 90-day late period.
This cheat sheet reflects the sources reviewed on October 5, 2026. Because NARM is modernizing its test development and updating fees and pathways, confirm every figure against NARM's live pages before you act on it.