Frequently Asked Questions

General | Licensure Requirements | Examination | Application and Renewal | License Extensions

General

What are the different routes to licensure?

There are a few options for routes to midwifery licensure in Washington

  • Graduate from a Midwifery Education Accreditation Council-approved (MEAC) school;
  • Have a current certified professional midwife (CPM) certification and meet the requirements in WAC 246-834-066. If you don't meet all of the requirements, you may apply for a CPM trainee permit to bridge the gap between the CPM and state licensure requirements; or
  • Graduate from an international school and meet the requirements in WAC 246-834-065.

Licensure Requirements

What are the requirements for licensure?

Licensure requirements are in WAC 246-834-060. Also, depending on your route to licensure, other requirements are likely needed. See the section above for specific laws relevant to licensure.

What are the general requirements for a CPM seeking licensure?
  • Current CPM certification
  • Three years of training and or experience
  • Fifty observed, 30 managed, and 20 active participants for births
  • Courses on epidemiology and obstetric pharmacology
  • Fifty women for prenatal and 50 women for postpartum care exams
  • A preceptor to sign off on legend drugs and devices
What forms do I use to log my births or care exams?

You may use any form as long as it's legible and has, at least: columns for the date, client identifier, notes (including your role at birth), and initials of supervisor. The department may approve exceptions for documentation.

Examination 

What is the Washington State exam like?

The exam consists of 80 multiple-choice questions on paper. The best study advice is to be familiar with the content of the NARM exam. There is no state study guide. The exam consists of questions on labor and delivery, newborns, prenatal, anatomy and physiology, pregnancy, and post-partum. You have 90 minutes to finish the exam.

What is the jurisprudence exam?

The jurisprudence exam is required for all new applicants for midwifery licensure. This short exam is free, open book, and multiple choice. It covers laws and rules applicable to midwives in Washington. The passing score for this exam is 100 percent. You may take the exam as many times as you need.

Who may take the exam for licensed midwife?

To take the exam, the applicant must:

  • Submit the application;
  • Pay the application and exam fees;
  • Meet the licensing requirements for the selected route to licensure: education, births, care exam, experience/training, etc.;
  • Receive a notice of eligibility from the department to sit for the exam.
When, where, and how will the exam be administered?

Midwifery program staff members administer the exam individually by appointment in Tumwater. The exam is also offered online through a testing company. The applicant can choose which option works best for them. It is a multiple choice exam.

How do I request ADA accommodations for an exam?

You must submit requests for ADA accommodations in writing 30 days before the date of the exam you would like to schedule.

Requests must include:

  • Written verification from a healthcare provider indicating the nature and extent of the disability, and how the disability affects the applicant's ability to take the exam. The verification should also include recommended accommodations.
  • Requests can be faxed to 360-236-2901, emailed or mailed to:
    Midwifery Program
    P.O. Box 47852
    Olympia, WA 98504-7852
How do I reschedule or cancel an exam?

If you need to cancel or reschedule an exam you must contact the Department of Health, Midwifery Program at 360-236-4883 or by email.

How many questions are on the exam?

The exam has 85 multiple choice questions.

How long does the exam take?

You are allowed one hour and 30 minutes to complete the exam.

Can I bring reference materials and my own notes to the exam?

No. You are not allowed to bring anything into the testing room.

How much does the exam cost?

The cost of the exam is $155 each time you take it. You can pay ahead with your application or pay at the front counter at the time of the exam. The front counter takes cash, check and credit card.

What topics are covered on the exam?

See exam categories (PDF).

What should I study to prepare for the exam?

Exam content will come from a variety of sources. The primary references for the exam are:

What is the passing score for the exam?

State law requires a score of at least 80 percent. The legislature established that applicants must pass the examination to become credentialed. The legislature did not establish provisions or resources to use the examination results for purposes other than as a pass-fail mechanism. For this reason, we provide applicants only with pass or fail results for the examination.

When will I receive exam results?

Typically you are given your score the day of your exam. If that's not possible, notices will be by email within 10 working days. Examination scores will not be released to anyone except as provided above unless release is authorized in writing by the applicant.

If I do not pass the exam, when can I retake it?

You must wait at least 14 days from the date of your most recent exam.

Can I find out which questions I missed on the exam?

State law prohibits us from releasing examination questions, per RCW 42.56.250. Whether you pass or fail the exam, we cannot provide you with the questions you answered incorrectly.

Application and Renewal

What materials do I include with my application?

Please see the application for complete instructions. All applicants must submit:

  • High school transcripts or their equivalent
  • Current plan for consultation, emergency transfer, and transport
  • Proof of 50 observed births
  • Proof of 50 managed births; 30 as the primary attendant, 20 as an active assistant
  • Proof of 50 women for pre-natal care exams and 50 women for early post-partum care exams
  • Proof of three academic years of midwifery training such as: graduating from an approved school, obtaining the CPM certification, and bridging the gap requirements or other practical midwifery experience that meets requirements in RCW 18.50.040.
  • Successful North American Registry of Midwives (NARM) results
What is the renewal cycle?

You are required to renew every year on your birthday.

What are the renewal requirements?

Submitting the Consultation, Emergency Transfer and Transport form. You may fill this form out electronically online or download, print and mail it in.

Data submission on all courses of care for every mother and newborn under your care to a department-approved research organization. The department-approved research organizations are Midwives Alliance of North American (MANA stats), American Association of Birth Centers (AABC), and Community Birth Data Registry (CBDR).

Participation in a peer review program. At least five clinical cases every two years are required.

Thirty hours of continuing education (CE) every three years:

  • A minimum of 25 hours must be directly related to the clinical practice of midwifery.
  • Any remaining hours may be in professional development activities that enhance the practice of the licensed midwife.

A licensed midwife shall obtain CE hours through one or more of the categories listed in WAC 246-834-355. Documentation for all activities must include licensee's name, date of activity, and number of hours.

License Extensions

How many license extensions are there? 

There are three license extensions: limited prescriptive, medical devices, and implants. You can get one, two, or all three of them, but you cannot get the medical devices extension or the implants extension unless you also get the limited prescriptive extension simultaneously.

Is there a fee for the license extensions?

No. Currently there is no fee to get the license extensions.

What are the requirements for license extensions?

License extension requirements are provided in Chapter 246-834 WAC. 

Limited prescriptive  

  • 15 additional obstetrical pharmacology didactic training hours that include the prescription classifications listed in WAC 246-834-250(4) and that provide skills and knowledge beyond entry-level skills or knowledge in antibiotics and contraceptives; and  
  • Evidence of completion of additional training on family planning and treating common, low-risk prenatal and postpartum conditions. A clinical experience of at least 20 cases reviewed in consultation with a licensed health care professional who, within their scope of practice, is qualified to use and administer legend drugs and devices described in RCW 18.50.115 and WAC 246-834-250; or  
  • A clinical training course or courses approved by the Department of Health. Contact the midwifery program for more information on this option. 

Medical devices 

  • Requirements for the limited prescriptive license extension (see above);  
  • Submit evidence of completion of training as required by the medical device manufacturers, or an equivalent. The training must include at least three simulated medical device insertions under direct supervision; and 
  • Submit evidence of completion of a clinical experience under direct supervision of four inserted medical devices and one medical device removal.  
  • See Chapter 246-834 WAC for additional information. 

Implants 

  • Requirements for the limited prescriptive license extension (see above);  
  • Submit evidence of completion of training as required by the implant manufacturers, or an equivalent. The training must be under direct supervision and include at least three simulated implant removals; and  
  • Submit evidence of completion of a clinical experience under direct supervision of one inserted implant and three implant removals. 
  • See Chapter 246-834 WAC for additional information. 
How do I apply for one of the license extensions?

You can find the applications on our midwifery licensing webpage.

Do I have to renew the license extension?

You will attest on your renewal application that you have been actively practicing the elements of the extension(s).

How will people know that I have a license extension?

Your license will display any license extensions you have obtained.