- AMCB's 2025 combined CNM/CM pass rate was 74.5% for first-time candidates and 69.8% overall.
- Repeat candidates passed at only 55.5%, showing why first-attempt prep matters more than retake strategy.
- Antepartum and Intrapartum tie as the largest domains at 21% each of the 175-question exam.
- Passing requires a scaled score of 75 on AMCB's 0-100 system, not a percentage of questions correct.
The 2025 AMCB Pass Rate Numbers
The American Midwifery Certification Board (AMCB) is the sole body that administers the national certification examination leading to the Certified Midwife (CM) credential. It's important to be precise here: the exam itself is shared between two pathways - candidates who hold an RN license earn the CNM designation, while candidates who complete an ACME-accredited or pre-accredited midwifery graduate program without an RN license earn the CM designation. AMCB reports pass rates for the combined pool of both credentials, not CM alone, so the numbers below reflect everyone who sat that specific PSI-administered computer-based exam.
For 2025, AMCB's official combined pass rates were:
- 74.5% for first-time candidates
- 55.5% for repeat candidates
- 69.8% overall (first-time and repeat combined)
These are the only pass rate figures AMCB publishes for this exam, and there is no separate breakout isolating CM-only candidates from CNM-only candidates. Anyone quoting a different, CM-specific number is likely conflating this credential with a different "CM" certification - a mistake worth watching for if you're researching this exam elsewhere.
Why First-Time and Repeat Rates Differ So Much
The nearly 19-point gap between first-time (74.5%) and repeat (55.5%) pass rates is the single most useful data point in this whole discussion. It suggests that candidates who fail once are, on average, less likely to close their knowledge gaps before the next attempt than they were to have passed the first time around. There are a few plausible reasons for this pattern, though AMCB does not publish qualitative explanations:
- Candidates who fail often narrow their restudy to the questions they remember missing, rather than rebuilding weak domains systematically.
- The mandatory 30-day wait before a first retake (and 90 days for later retakes) can create pressure to re-test quickly with an incomplete study plan.
- Retaking under time pressure - many candidates are also job-hunting or starting clinical roles during this window - leaves less runway for deep review.
The practical takeaway is simple: your best odds are on attempt one. A structured first pass using a resource like the CM Study Guide 2026: How to Pass on Your First Attempt is a far better investment of time than planning around a retake safety net.
Key Takeaway
Treat your first attempt as the only attempt you're planning for. Build your study calendar around the full four-hour, 175-question exam rather than a partial review aimed at "just enough" to pass.
Where the Exam Actually Tests You
Pass rate data only tells part of the story. To understand why some candidates fail, look at how the exam allocates its 175 four-option multiple-choice questions (which include scattered, unidentified pretest items) across six content domains. These weights have been in effect since January 1, 2023, based on AMCB's 2022 Task Analysis.
| Domain | Weight | Relative Emphasis |
|---|---|---|
| Antepartum | 21% | Tied for largest |
| Intrapartum | 21% | Tied for largest |
| Well Woman/Gyn | 19% | Third largest |
| Postpartum | 18% | Substantial |
| Women's Health/Primary Care | 11% | Moderate |
| Newborn | 10% | Smallest |
Antepartum and Intrapartum together account for 42% of the exam - more than four in every ten questions. That means gaps in prenatal risk assessment, labor management, and fetal surveillance carry outsized consequences on your scaled score. For a full topic-by-topic walkthrough of what each domain actually covers, the CM Exam Domains 2026: Complete Guide to All 6 Content Areas breaks down expected content within each category.
Antepartum (21%)
Covers prenatal screening, risk identification, and management decisions across the full pregnancy timeline.
- Prioritize gestational risk stratification and referral thresholds
- Expect scenario-based questions requiring sequencing of assessments
Intrapartum (21%)
Focused on labor progress, fetal heart rate interpretation, and intervention decision points during birth.
- Fetal monitoring interpretation appears frequently across question stems
- Know when a finding requires escalation versus watchful waiting
Well Woman/Gyn (19%)
Spans routine gynecologic care, screening intervals, and common non-pregnancy-related reproductive health issues.
- Review current screening guideline intervals, not just the conditions themselves
Exam Format and Scoring Mechanics
Beyond content weighting, the exam's structure itself shapes pass outcomes. Candidates sit for four hours to answer 175 four-option multiple-choice items on a computer-based format administered through PSI. Breaks are permitted, but the exam timer keeps running - a detail that trips up candidates who don't practice pacing under continuous time pressure. Calculators are not allowed, so any dosage or timing calculations must be done manually.
Scoring is reported on AMCB's 0-100 scaled-score system, and the passing score is 75. This is not the same as answering 75% of questions correctly - scaled scoring adjusts for item difficulty, so the raw percentage needed to reach a scaled 75 can differ from test to test. For a deeper explanation of how this scoring model works, see CM Passing Score 2026: Exactly What You Need to Pass. Results are issued at the testing center immediately after you finish, so you'll know your outcome before you leave.
Fees, Retakes, and the 24-Month Clock
The financial and scheduling mechanics around this exam directly interact with the pass rate data above. The initial exam fee is $425, and each retake costs $350. Given the retake pass rate of 55.5%, a failed attempt isn't just a scheduling setback - it's a real added cost, which is one more reason to weight your first-attempt preparation heavily rather than budgeting for a second try.
Candidates are allowed four attempts within 24 months of completing their midwifery program. After a failed attempt, the first retake requires a 30-day waiting period; any later retake requires 90 days. That means a candidate who fails twice could burn through a significant portion of their 24-month eligibility window just waiting between attempts, on top of restudy time. For the full cost picture across the credentialing process - not just the exam fee - see the CM Certification Cost 2026: Complete Pricing Breakdown, and for eligibility mechanics that determine when your clock starts, review CM Requirements 2026: Eligibility, Prerequisites & How to Qualify.
Key Takeaway
Because retake windows are mandatory and pass rates drop sharply on repeat attempts, the math strongly favors thorough first-attempt preparation over a "test and adjust" approach.
Turning the Data Into a Study Plan
Given that Antepartum and Intrapartum alone make up 42% of the exam, and that repeat pass rates lag first-time rates by nearly 19 points, your study calendar should be weighted deliberately rather than split evenly across six domains. A domain-proportional approach - spending roughly twice as many review hours on Antepartum and Intrapartum combined as on Newborn - mirrors how the exam is actually built.
Antepartum and Intrapartum
- Build a risk-assessment and fetal monitoring reference framework
- Run timed practice sets isolating these two domains first
Well Woman/Gyn and Postpartum
- Review screening intervals and postpartum complication triggers
- Cross-reference against the full domain guide for gaps
Newborn and Women's Health/Primary Care
- Cover the two smallest-weighted domains without skipping them entirely
Full-Length Timed Practice
- Simulate the 175-question, four-hour format with no calculator
- Review missed items by domain, not just by question number
If you're still deciding how much runway this preparation actually requires, How Hard Is the CM Exam? Complete Difficulty Guide 2026 walks through difficulty factors beyond the raw pass rate, and a condensed reference like the CM Cheat Sheet 2026: One-Page Review of Must-Know Facts is useful for the final week before test day. You can also run full domain-weighted practice sessions on the main practice test platform to see how your scores track against the actual exam blueprint.
Who Actually Sits This Exam
Because AMCB's published pass rates combine CM and CNM candidates, it's worth understanding who makes up the CM side of that pool. CM eligibility requires completing a graduate degree or institutional graduate-degree requirements through an ACME-accredited or pre-accredited midwifery program, along with program-director verification and an attestation of safe beginning-practitioner performance - all without holding an RN license beforehand. This is a distinct pathway from CNM candidates, who come in with existing nursing licensure.
Employers hiring for CM roles are typically looking for candidates who can independently manage antepartum, intrapartum, postpartum, and well-woman gynecologic care within their scope of practice. If you're weighing whether this credential fits your career plans, Is the CM Certification Worth It? Complete ROI Analysis 2026 and CM Salary Guide 2026: Complete Earnings Analysis cover the career-outcome side, while CM Jobs gives a sense of the hiring landscape. For a broader orientation to the credential itself before diving into exam mechanics, What Is CM Certification? and CM Certification lay out the fundamentals, and CM Exam Dates 2026: Testing Windows, Deadlines & Scheduling covers when you can actually schedule your seat.
Frequently Asked Questions
AMCB reported a 74.5% first-time pass rate, 55.5% repeat pass rate, and 69.8% overall pass rate for the combined CNM/CM national certification exam in 2025.
No. AMCB reports pass rates for the exam as a whole, which is shared between CNM and CM candidates. There is no publicly separated CM-only figure.
Candidates have up to four attempts within 24 months of completing their midwifery program. The first retake requires a 30-day wait, and any subsequent retake requires a 90-day wait.
AMCB uses a 0-100 scaled-score system that adjusts for item difficulty rather than a simple raw percentage, so the number of questions you need correct to reach a scaled 75 can vary by test form.
Antepartum and Intrapartum, tied at 21% each, carry the most combined weight at 42% of the exam, making them the highest-leverage areas for study time.