Pathways to the Midwifery Sonography Certificate

A look at two different avenues for earning the midwifery sonography certificate.

The many paths to ultrasound certification can also include the Sonography Workshop at the ACNM Annual Meeting & Exhibition.
The many paths to ultrasound certification can also include the Sonography Workshop at the ACNM Annual Meeting & Exhibition.

By Kristen Ostrem-Niemcewicz, CNM, and Carolyn Gegor, CNM

The Midwife Sonography Certificate was introduced in Spring 2017 by the American Registry of Diagnostic Medical Sonography (ARDMS) as a means of validating a midwife’s knowledge and skills. The certificate is awarded after a candidate passes both a written and a practical component. The practical component entails submitting documentation that demonstrates successful completion of eight cases across defined domains, signed by a witnessing physician or Registered Diagnostic Medical Sonographer (RDMS). Midwives have up to two years to complete both portions of the examination, which allows enough time for midwives to sharpen their skills as well as to find physicians or registered sonographers who are able to observe and verify their scans.  (More information available here.)

For inspiration and suggestions on ways to prepare for the exam, read the stories of how Kristen Ostrem-Niemcewicz, CNM, and Carolyn Gegor, CNM, members of the ACNM Ultrasound Education Task Force, are working toward earning their Midwife Sonography Certificates.

Kristen’s Story: Validating Knowledge and Skills

My use of ultrasound in clinical practice began in 2000 when I attended a two-day Professional Education Center Seminar ( on Women’s Health Ultrasound. With that knowledge under my belt, I worked with my hospital sonographer and my obstetrician colleague to solidify skills and to provide first and third trimester ultrasounds when needed. Over the past 15 years, I have used ultrasound for clinical decision-making fewer than 10 times per month, usually to check placement of an IUD; verify viability of an early pregnancy; or to check for third trimester fetal position, placenta location or amniotic fluid volume.

When ARDMS introduced an exam for midwives in 2017, I was eager to take it. After 17 years of ultrasound practice in midwifery, the certificate seemed the perfect way to validate my knowledge and skills. Even with my years of experience, I knew that to be fully prepared for an exam, I needed to study. Fortunately, I found classes and online materials that were really helpful.

I enrolled in two courses: one at InnovatED, the other at Professional Education Center. I also took advantage of the online Pegasus lectures, In addition, I reviewed a complementary iBook that I had put together for an ultrasound workshop in 2017. I watched useful videos by Diana Dowdy DNP, CNM, RDMS, Tamara Barrett, MBA, RDMS, and Catherine Lukes ND, CNM. Diana Dowdy’s video on knobology helps midwives navigate ultrasound keyboards, providing an orientation to safety, power levels, image adjustment, measurements, and pre-set menus. Basic knobology helps demystify the ultrasound machine, improving the application of new concepts such as gain and resolution.

My journey is almost at its end. I passed the computer-based exam and now I am working diligently on completing the practical exam. As I write this article, I have just one more second trimester OB cervical length scan to check off. Once all eight forms are submitted, I will become the proud recipient of the ARDMS Midwife Sonography Certificate.  

Send your questions about preparing or applying for the Midwife Sonography Certificate examination to Kristen at

Carolyn’s Story: Updating Skills to Feel Well Prepared

My career began as a nurse in 1972. Ultrasound was still new to obstetrics and gynecology, and I learned how to use it on the job from skilled physicians and new sonographers who were struggling just like

me. In 1988, I became a midwife and worked in the fetal assessment center at Johns Hopkins Hospital. There, I taught courses for midwives and nurses to learn how to do Biophysical Profiles, a radical notion at that time.

Full scope ultrasound scanning was part of my clinical practice for many years. In addition, I published ultrasound articles in the Journal of Nurse-Midwifery and other publications and taught ultrasound workshops at ACNM annual meetings. I wrote ACNMs’ first Clinical Bulletin, “Limited Ultrasound in the Third Trimester.” Then, for more than 10 years, my focus shifted to midwifery education, and my clinical use of ultrasound was put on hold. When I returned to clinical practice following my years of teaching, I used ultrasound primarily in OB triage.

When ARDMS offered the new Midwife Sonography Certificate in 2017, I knew I would have to update my clinical scanning skills before taking the examination. So, I enrolled in Pegasus online courses and an online didactic and face-to-face scanning course from Sonosession ( Feeling well prepared, I took the written exam in October 2017 and passed. At the time of this publication, I still have three check-offs to complete for the practical component.

There are a variety of resources from which to choose as you embark on preparing yourself to earn the Midwife Sonography Certificate. One particular publication we would like to highlight is Ultrasound for Advanced Practitioners in Pregnancy and Women’s Health, by Cydney Afriat Menihan CNM, RDMS, published in February 2019. It is an ideal reference to prepare for the Midwife Sonography Certificate. Cydney has been a leader in the use of ultrasound since 1996. She has published articles, written books, and coordinated ultrasound workshops at the annual ACNM meeting for more than 20 years. She has served as chair of the ACNM Ultrasound Task Force and Chair of the ARDMS Midwife Sonography Certificate Assessment, overseeing its development.

A complete list of educational resources may be found on the ACNM Ultrasound Education webpage at: