National Fellowship of Direct Entry Midwives
Excellence in Certification, Tradition in Practice
The Certified Direct Entry Midwife (CDEM) Examination
​The National Fellowship of Direct Entry Midwives (NFDEM) is a professional organization that certifies direct-entry midwives in the United States. To become credentialed as a Certified Direct Entry Midwife (CDEM), applicants must meet specific criteria and pass a proctored CDEM examination. The CDEM exam is a comprehensive test designed to assess a midwife's knowledge and clinical skills in various areas of out-of-hospital midwifery practice.
The exam covers a wide range of topics, including:
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Maternal and Fetal Physiology and Anatomy
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Normal Pregnancy, Childbirth, and Postpartum
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Complications of Pregnancy, Childbirth and Postpartum
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Neonatal Exam, Anomalies, and Complications
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Family Planning and Contraception
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Midwifery Practice
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Ethics and Legal Issues​​​​​​
Test development at NFDEM is an ongoing process, guided by analytics from our third-party partners, Prolydian and Proctor360. These partners provide valuable data on question performance, pass/fail rates, and other feedback modalities. Our goal is to ensure a fair and balanced exam for all candidates—one that is free from bias and unnecessary obstacles, focusing solely on validating the essential knowledge and proficiency required to provide exceptional midwifery care in out-of-hospital settings.
Eligibility Criteria for the CDEM Examination
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To be eligible to take the CDEM examination, applicants must meet the following criteria:
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Education:
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For practicing midwives: meet the educational requirements outlined in the applicable pathway.
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For aspiring midwives: meet the education requirements outlined in the CDEM Proficiency Program.
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CDEM Proficiency Program:
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For aspiring midwives: Complete the CDEM Proficiency Program
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Clinical Experience:
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Meet the application requirements as outlined in the Program Pathway
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CDEM Candidate Application & Fee:
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Submit the initial CDEM candidate application with the National Fellowship of Direct Entry Midwives.
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Pay the applicable application and administrative fees.
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Pay the applicable examination fees.
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​Meet all other requirements as outlined in the Certification Directives and Essentials Manual​
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The full manual is available to all valid applicants.​
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You can find other necessary forms, logs and resouces under the links and resources page on this website.
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Reference Material
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The following is a list of textbooks and materials recommended for preparation: you may find other texts available to assist in your didactic learning and preparation.
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Varney’s Midwifery ISBN: 9781284250565
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Openstax Anatomy & Physiology ISBN: 978-1-938168-13-0
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Clinical Practice Guidelines for Midwifery & Women’s Health ISBN-13: 9781284070217 ISBN-10:1284070212
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Prenatal and Postnatal Care, A Woman-Centered Approach ISBN-13:978-1119318347
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Myles textbook for Midwives ISBN: 978-0-7020-7643-5
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Before We Are Born ISBN: 978-0-323-60849-7
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Heart and Hands, Fifth Edition (2019): A Midwife’s Guide to Pregnancy and Birth
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Holistic Midwifery Vol I, Care During Pregnancy ISBN: 978-1-891145-55-1
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Holistic Midwifery Vol II, Care During Labor and Birth 2nd Ed. ISBN: 978-1-891145-67-4
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Physical Assessment of the Newborn 6th Ed. ISBN: 978-0-8261-7451-2
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The Newborn Book; Significance of Physical Findings in the Neonate ISBN-13: 978-1-93851-277-8
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Birth Emergencies for Community Midwives ISBN: 978-1-941700-42-6
Educational Resources for didactic learning: Applicants are not limited to these resources
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The Midwifery Education Accreditation Council (MEAC)
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MEAC Schools
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Florida School of Traditional Midwifery
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Bastyr University Master of Science in Midwifery Program
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Mercy in Action College of Midwifery
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Commonsense Childbirth School of Midwifery
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Midwives College of Utah
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National College of Midwifery
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National Midwifery Institute
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International Institute of Healthcare Professionals, DEM
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Southwest Wisconsin Technical College, DEM Program
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The Way of Tradition School of Birth Arts
Special Circumstances Policy for Proctored Exams with Proctor360
We understand that certain circumstances may require accommodations for candidates taking a proctored exam through Proctor360. Our goal is to ensure all examinees have a fair and accessible testing experience while maintaining the integrity of the exam process.​
Eligibility for Accommodations
Candidates may request accommodations under the following circumstances:
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Disabilities or Medical Conditions – Individuals with documented disabilities or medical conditions that require modifications to the standard testing environment.
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Technical Limitations – Candidates experiencing unavoidable technical issues that may prevent them from meeting Proctor360's system requirements.
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Religious Observances – Candidates who require schedule adjustments due to religious commitments.
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Emergency Situations – Unexpected personal or family emergencies that may impact the ability to complete the exam as scheduled.
Request Process
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Submit a Written Request – Candidates must submit an accommodation request via email at [insert contact email] at least 10 business days before the scheduled exam date.
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Provide Supporting Documentation – Requests must include appropriate documentation, such as medical certification, disability accommodation letters, or other relevant proof.
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Review and Approval – Requests will be reviewed on a case-by-case basis. Approved accommodations will be communicated to the candidate and coordinated with Proctor360.
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Available Accommodations
Depending on the nature of the request, accommodations may include:
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Extended testing time
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Additional breaks
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Alternative scheduling
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Assistive technology compatibility
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Other reasonable modifications based on individual needs
Important Notes
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Requests submitted after the 10-business-day deadline may not be accommodated.
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Approved accommodations do not modify the exam content or passing criteria.
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Candidates are responsible for ensuring they meet all other Proctor360 testing requirements.
For further assistance, please contact us at 844-400-CDEM