PEP Phases
The Portfolio Evaluation Process is completed in four phases. Each phase documents progressively greater participation and responsibility in midwifery care. All clinical experience must meet NARM’s requirements for supervision, timing, setting, documentation, and verification.
Phase 1 - Births as an Observer
The candidate must attend a minimum of ten births in any setting, in an observational or support capacity. These births may include attendance as an (observer, doula, family member, friend, or beginning student).
At least two Phase 1 births must be planned hospital births. Intrapartum transports do not meet this requirement, although a planned hospital birth following an antepartum referral qualifies.
Phase 1 births may be verified by any individual who was present at the birth.
Phase 2 - Assistant Under Supervision
The candidate must complete the following as an Assistant Under Supervision of a NARM Registered Preceptor:
- 20 births,
- 25 prenatal visits, including at least three initial prenatal exams,
- 20 newborn exams, and
- 10 postpartum visits.
An Assistant Under Supervision participates in care while learning and performing midwifery skills under direct supervision. Observation alone does not qualify as assistant experience.
The candidate must complete at least 18 of the required 20 births as an Assistant Under Supervision before beginning to attend births as Primary Under Supervision. All 20 Assistant Under Supervision births must be completed to satisfy Phase 2 requirements.
Phase 3 - Primary Under Supervision
The candidate must complete the following as Primary Under Supervision of a NARM Registered Preceptor:
- A minimum of 20 births as Primary Under Supervision
- 75 prenatal exams, including 20 initial prenatal exams;
- 20 newborn exams;
- 40 postpartum exams; and
Of the 20 primary births:
- at least five must include full Continuity of Care (COC);
- at least 10 ten additional births must include at least one prenatal visit completed by the candidate in the primary role before labor and birth;
- at least 10 must occur in the community setting; and
- at least 10 must have occurred within the three years preceding submission of the Phase 3 application materials.
Continuity of Care: For each continuity-of-care the candidate must document at least five prenatal visits spanning at least two trimesters, attendance at the birth, a newborn exam, and at least two postpartum exams.
The candidate must also document attendance at a minimum of five home births in any qualifying role.
Primary Under Supervision means that the candidate assumes responsibility for providing and coordinating the required care while the preceptor remains physically present, directly supervises the candidate’s performance and clinical decision-making, and retains final responsibility for care.
Phase 4 - Additional Births as Primary Under Supervision
The candidate must complete five additional births as Primary Under Supervision. Phase 4 births may be completed prior to passing the NARM Examination or up to six months after.
The CPM credential will not be awarded until Phase 4 and all other outstanding certification requirements have been completed and accepted by NARM.
Sequencing of Clinical Experience
Prenatal visits, newborn examinations, and postpartum visits as Assistant Under Supervision must be completed before experience in the same category may be documented as Primary Under Supervision. Primary prenatal, newborn, and postpartum experience may begin before the applicant begins attending births as Primary Under Supervision.
Candidates must use the current NARM forms and instructions for documenting each phase. Clinical experience that does not meet the applicable supervision, sequencing, timing, or verification requirements will not be accepted. All documented births must have occurred in the United States or Canada.