As of January 1, 2009, prenatals, births, newborn exams, and postpartums attended in clinical sites outside of the United States and Canada may not be documented on the PEP forms as primary maternity care unless the site has been approved by NARM. Births attended at unapproved sites may only be counted as “active participant” on the PEP documentation.
A clinical site may apply for approval for primary maternity care by submitting the Application Form included in the Out of Country Primary Clinical Site Application Packet located here .
Click here for a list of NARM OOC approved sites.
The Midwives Model of Care (MMOC) is the foundation upon which the CPM credential is based. As evidenced by the NARM Job Analysis and both the Written and Skills test descriptions, all documented training for entry-level midwives is expected to be within this model. Globally, midwives work in many settings both to provide this level of care to women and babies, and also to train others in the benefits of this evidenced-based approach to maternity care. Sometimes training opportunities for students are not within the MMOC, but still provide beneficial opportunities for both students and the women they serve. NARM recognizes that births in these settings contribute to the midwife's overall experience, and NARM encourages these experiences as a supplement, but not substitute, for meeting the required clinical experiences as a PEP candidate.
Midwifery students seeking certification from the North American Registry of Midwives may seek training in clinical sites outside of the US and Canada (OOC sites). Students must be supervised by a qualified preceptor who is physically present in the room with the student when clinical skills are performed. Births attended by the student may count toward NARM certification requirements as Active Participant births if the student is able to perform various midwifery skills under the supervision of the preceptor, and if the preceptor is able to give instruction and feedback to the student before, during, and after the clinical experience. Births may count as primary births only if specific conditions have been met and if the clinical site has received approval from NARM. Approval by NARM as an out-of-country clinical site does not constitute an endorsement of a particular site based on setting or conditions such as accommodations, sanitation or cultural customs, but rather as verification that the clinical training students receive is in accordance with the NARM guidelines for primary under supervision and the Midwives Model of Care.