Clinical and Skills Requirements

This page contains information on the minimum clinical requirements that every student must meet. During the course of clinical training, most students will require experience beyond the minimum number listed here. All clinical requirements must be supervised by an approved ATMMTP preceptor.

Minimum Clinical Requirements

The below clinical requirements are the minimum number required to fulfill ATMMTP graduation requirements.

Learning phase:

The student must complete a minimum of all of the following:

  •  Attendance at a minimum of 10 births in the role of an observer


In the role of an assistant (learning the skills of a midwife):

  • 20 newborn exams
  • 25 prenatal exams, 3 of which must be the initial physical exam and medical history
  • 10 postpartum exams
  • 20 births – 18 must occur prior to births as Primary Midwife under Supervision

Primary Midwife under Supervision (PMUS)
Students must learn, practice, and perfect the skills necessary to provide all components of each requirement before care can be provided as PMUS. As PMUS the student must be able to competently provide all aspects of care, and be able to communicate the rational for the care and her clinical decisions, all while under the direct supervision of an approved preceptor.

In the role of Primary Midwife under Supervision the student must complete a minimum of the following:

  • 20 Newborn exams
  • 20 Initial physical exams and histories
  • 75 Prenatal exams
  • 40 Postpartum exams
  • 25 Births
  • Each birth must include one prenatal and one postpartum exam


The 25 births as PMUS must include the following:

  • At least 10 of the births as PMUS must be out-of-hospital births
  • 10 “Full Continuity of Care” births (includes 5 prenatal exams as PMUS spanning 2 trimesters, the newborn exam, and 2 postpartum exams)
  • 3 “Continuous Continuity of Care” births (same as above but includes all prenatal care beginning no later than 15 weeks gestation)
  • A total of 3 of births as PMUS may be intrapartum transports; the student must accompany the woman to the hospital. Only 1 of the 3 transports may be a Continuous Continuity of Care client


In addition to the above requirements:

  • At least 2 of the 55 total births must be planned hospital births (any role)
  • At least 5 of the 55 total births must be home births (any role)
  • At least 5 of the 55 total births must be under the supervision of a Licensed Midwife (as opposed to a CNM or physician)


All required clinical requirements must be supervised and verified by ATM approved preceptors.

Click here to download a detailed list of clinical requirements: Clinical Requirements 1/21/13

The student's ATM Clinical Summary forms will be used for verification of the student's performance of each clinical requirement.

The clinical component (apprenticeship period) must be ongoing for a minimum of twenty-four (24) months duration. The clinical time will be verified by the preceptor in a letter stating that the student has completed an apprenticeship period of at least 24 months.


Skills Requirements

Required skills will be learned according to specific techniques described in the Practical Skills Guide for Midwifery, by Weaver & Evans.  Students must demonstrate mastery all required skills, to be verified by the preceptor.  A second verification of certain skill-sets, such as a "basic physical exam" or "newborn exam", will be evaluated by a second, independent preceptor prior to graduation eligibility.


If you have any questions regarding the ATM Midwifery Program, please email

Contact Details

Association of Texas Midwives

P.O.Box 887 Elmendorf, TX 78112

Tel: 432-664-8815



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