NARM Midwifery Practice and Professionalism 2 — Questions and Answers
Question 1: A midwife discovers that a client's partner has been absent from all prenatal visits and the client appears anxious when asked about him. What is the most appropriate initial action?
- Document the observation and screen for intimate partner violence using a validated tool (Correct answer)
- Contact the partner directly to discuss his involvement in prenatal care
- Report the situation to child protective services immediately
- Discharge the client to a physician who can better manage complex social situations
Correct answer: Document the observation and screen for intimate partner violence using a validated tool
Universal IPV screening using validated tools (e.g., HITS or WAST) is standard of care and allows the midwife to assess safety while respecting client autonomy.
Question 2: Under the NARM Certified Professional Midwife (CPM) credential framework, which body is responsible for establishing the standards of competency that CPMs must demonstrate?
- The American College of Nurse-Midwives (ACNM)
- The North American Registry of Midwives (NARM) (Correct answer)
- The Midwives Alliance of North America (MANA)
- The state licensing board in each jurisdiction
Correct answer: The North American Registry of Midwives (NARM)
NARM is the certifying body that establishes the competency standards and administers the NARM Written Exam and Skills Assessment for the CPM credential.
Question 3: A midwife is attending a birth at home when the baby is born with unexpected respiratory distress requiring neonatal resuscitation. After stabilizing the newborn and transferring to the hospital, what is the midwife's primary professional obligation?
- Await the hospital's findings before documenting anything
- Complete thorough documentation of the birth events, interventions, and transfer as soon as possible (Correct answer)
- Immediately file a self-report with NARM regardless of outcome
- Defer all documentation to the receiving hospital staff
Correct answer: Complete thorough documentation of the birth events, interventions, and transfer as soon as possible
Accurate and timely documentation is a core professional obligation; it supports continuity of care and protects both the client and the midwife.
Question 4: Which of the following best describes 'informed refusal' in midwifery care?
- A client refuses care and the midwife terminates the professional relationship
- A client declines a recommended intervention after receiving complete information about risks and benefits (Correct answer)
- A midwife refuses to perform a procedure outside her scope of practice
- A client refuses to sign consent forms and therefore cannot receive care
Correct answer: A client declines a recommended intervention after receiving complete information about risks and benefits
Informed refusal occurs when a fully informed client chooses to decline a recommended intervention, and the midwife must document this and continue to support the client.
Question 5: A CPM practicing in a state where CPMs are not licensed receives a complaint from a client. Which entity has jurisdiction to investigate the complaint?
- NARM, through its ethics and discipline process (Correct answer)
- The state medical board, since CPMs operate under physician oversight
- The local health department
- No entity has jurisdiction in unlicensed states
Correct answer: NARM, through its ethics and discipline process
NARM has jurisdiction over CPM credential holders regardless of state licensure status through its own ethics and disciplinary process.
Question 6: When a midwife identifies a situation beyond her scope of practice during labor, the most appropriate action is to:
- Proceed cautiously while contacting a backup provider for telephone guidance
- Initiate emergency transport and consult or transfer care to an appropriate provider (Correct answer)
- Continue managing the situation to avoid alarming the client
- Document the situation and address it during the postpartum visit
Correct answer: Initiate emergency transport and consult or transfer care to an appropriate provider
When a situation exceeds the midwife's scope, immediate consultation, collaboration, or transfer to an appropriate provider is the professional and ethical obligation.
Question 7: A midwife is asked by a journalism student to share anonymized case details about an unusual birth outcome. What should the midwife do?
- Share details freely since they are anonymized
- Obtain written client authorization before sharing any case information (Correct answer)
- Decline unless the student provides IRB approval
- Share only with a signed non-disclosure agreement from the student
Correct answer: Obtain written client authorization before sharing any case information
Even anonymized information can sometimes be re-identified; written client authorization is required before sharing any case details outside the professional care team.
NARM Midwifery Practice and Professionalism 2
A midwife discovers that a client's partner has been absent from all prenatal visits and the client appears anxious when asked about him.
What is the most appropriate initial action?