Midwifery Practice Questions and Answers: 30 Questions for NMCN, NMC and Prometric Midwifery Exams

Whether you’re preparing for the NMCN midwifery professional exam, the NMC Test of Competence for midwives or a Gulf licensing exam, practice questions help you apply knowledge under pressure. Here are 30 midwifery questions with answers and rationales.

These are original revision questions, not real exam items. Follow WHO and national guidelines in practice.

Antenatal care

1. A woman’s last menstrual period started on 10 March 2026. Using Naegele’s rule, what’s her estimated date of delivery?

1. 10 December 2026
2. 17 December 2026
3. 3 December 2026
4. 17 November 2026

Answer: b. Add 7 days and 9 months (or subtract 3 months and add 1 year): 17 December 2026.

2. How many antenatal contacts does WHO recommend for a positive pregnancy experience?

1. 4
2. 6
3. At least 8
4. 12

Answer: c. WHO’s 2016 model recommends a minimum of eight contacts.

3. At 20 weeks of pregnancy, the fundus is usually at the level of:

1. The symphysis pubis
2. The umbilicus
3. The xiphisternum
4. Halfway between symphysis and umbilicus

Answer: b.

4. Which supplement is recommended in pregnancy to reduce neural tube defects (ideally started before conception)?

1. Vitamin C
2. Folic acid
3. Calcium
4. Vitamin A

Answer: b.

5. A pregnant woman’s haemoglobin is 9.2 g/dL at 28 weeks. What does this indicate?

1. Normal for pregnancy
2. Anaemia
3. Polycythaemia
4. Dehydration

Answer: b. WHO defines anaemia in pregnancy as Hb below 11 g/dL.

6. Which is a danger sign in pregnancy that needs urgent referral?

1. Mild ankle swelling in the evening
2. Severe headache, blurred vision and epigastric pain
3. Occasional heartburn
4. Back ache

Answer: b. These suggest severe pre-eclampsia.

7. Intermittent preventive treatment of malaria in pregnancy (IPTp) uses:

1. Chloroquine
2. Sulfadoxine-pyrimethamine
3. Artesunate
4. Quinine

Answer: b. Given from the second trimester in malaria-endemic areas, as per national guidelines.

Labour

8. In the WHO Labour Care Guide, active first stage of labour begins at:

1. 2 cm
2. 4 cm
3. 5 cm
4. 7 cm

Answer: c. WHO’s 2020 Labour Care Guide uses 5 cm as the start of active labour. Older partographs used 4 cm.

9. How often should the fetal heart be auscultated during the active first stage in low-risk labour?

1. Every 2 hours
2. Every 30 minutes
3. Every 15–30 minutes, per guideline
4. Only at delivery

Answer: c. WHO recommends every 15–30 minutes in the active first stage, and every 5 minutes in the second stage.

10. Normal fetal heart rate is:

1. 80–100 bpm
2. 110–160 bpm
3. 160–200 bpm
4. 60–80 bpm

Answer: b.

11. Meconium-stained liquor during labour may indicate:

1. Normal progress
2. Possible fetal compromise
3. Imminent delivery
4. Maternal infection only

Answer: b. Monitor fetal heart closely and escalate per protocol.

12. Which is part of active management of the third stage of labour?

1. Fundal pressure
2. Uterotonic (oxytocin 10 IU IM) within one minute of birth
3. Immediate cord pulling before uterine contraction
4. Waiting 2 hours for placenta

Answer: b. Oxytocin is the uterotonic of choice. Controlled cord traction is optional where skilled attendants are available.

13. Delayed cord clamping is recommended for at least:

1. 10 seconds
2. 1 minute
3. 10 minutes
4. Until the placenta delivers

Answer: b. WHO recommends not earlier than 1 minute after birth (unless the baby needs resuscitation).

14. The second stage of labour is from:

1. Onset of contractions to full dilatation
2. Full dilatation to birth of the baby
3. Birth of the baby to delivery of the placenta
4. Delivery of the placenta to 1 hour after

Answer: b.

Obstetric emergencies

15. What is the most common cause of postpartum haemorrhage?

1. Trauma
2. Uterine atony
3. Retained tissue
4. Coagulopathy

Answer: b. Remember the 4 Ts: Tone, Trauma, Tissue, Thrombin.

16. WHO recommends tranexamic acid for postpartum haemorrhage within:

1. 24 hours of birth
2. 3 hours of birth
3. 12 hours of birth
4. 1 week of birth

Answer: b. Give 1 g IV as soon as possible within 3 hours of birth, alongside standard care.

17. During shoulder dystocia, which manoeuvre is usually tried first?

1. Fundal pressure
2. McRoberts’ manoeuvre with suprapubic pressure
3. Pulling hard on the baby’s head
4. Zavanelli manoeuvre

Answer: b. Never apply fundal pressure.

18. The drug of choice for preventing and treating eclamptic seizures is:

1. Diazepam
2. Magnesium sulphate
3. Phenytoin
4. Labetalol

Answer: b.

19. Signs of magnesium toxicity include:

1. Hyperreflexia
2. Loss of patellar reflexes, respiratory rate below 12 and reduced urine output
3. Tachycardia only
4. Hypertension

Answer: b. Stop the infusion and give calcium gluconate as per protocol.

20. Painless bright red vaginal bleeding in the third trimester suggests:

1. Placental abruption
2. Placenta praevia
3. Labour
4. Cervical ectropion only

Answer: b. Avoid vaginal examination until praevia is excluded by ultrasound.

21. Painful bleeding with a hard, tender uterus suggests:

1. Placenta praevia
2. Placental abruption
3. Normal show
4. Vasa praevia

Answer: b.

Postnatal care

22. Lochia rubra usually lasts:

1. 1 day
2. About 3–4 days
3. 3 weeks
4. 6 weeks

Answer: b. Then lochia serosa, then alba.

23. Which postnatal finding needs urgent action?

1. After-pains during breastfeeding
2. Fever, foul-smelling lochia and abdominal tenderness
3. Mild perineal soreness
4. Tearfulness on day 3

Answer: b. Suggests puerperal sepsis.

24. A woman feels tearful on day 3 after birth but is coping. This is most likely:

1. Postpartum psychosis
2. Baby blues
3. Postnatal depression
4. Dementia

Answer: b. Baby blues usually resolve within two weeks. Persistent low mood needs assessment.

25. Exclusive breastfeeding is recommended for:

1. 2 months
2. The first 6 months
3. 12 months
4. 3 weeks

Answer: b. With continued breastfeeding up to 2 years or beyond alongside complementary foods.

Newborn care

26. Breastfeeding should be started:

1. After 24 hours
2. Within the first hour of birth
3. After the first bath
4. Only after the milk comes in

Answer: b.

27. A baby isn’t breathing at birth after drying and stimulation. What’s the next step?

1. Continue stimulating for 5 minutes
2. Open the airway and start bag-and-mask ventilation within the first minute (“Golden Minute”)
3. Give IV fluids
4. Hang the baby upside down

Answer: b. As taught in Helping Babies Breathe.

28. Which is a danger sign in a newborn?

1. Sneezing
2. Not feeding well, convulsions or fast breathing (60 or more breaths/min)
3. Hiccups
4. Milia

Answer: b.

29. Kangaroo mother care is recommended for:

1. Only term babies
2. Low birth weight and preterm babies, started as soon as possible
3. Babies over 3 months
4. Only in neonatal units

Answer: b. WHO now recommends starting it immediately after birth for small and preterm babies where possible.

30. Which newborn should be referred for urgent assessment of jaundice?

1. Mild yellowing on day 4 in a well, feeding baby
2. Jaundice appearing in the first 24 hours of life
3. Jaundice of the face only on day 3
4. A baby with pink skin

Answer: b.

Study tips for midwifery exams

• Know your emergencies: PPH, eclampsia, shoulder dystocia, cord prolapse, breech and neonatal resuscitation.
• Understand the partograph or WHO Labour Care Guide.
• Learn normal values: fetal heart, fundal height, Hb, BP thresholds.
• Revise drug doses and antidotes for oxytocin, misoprostol, magnesium sulphate and tranexamic acid.
• Practise questions under timed conditions.

Further reading

• WHO Labour Care Guide
• WHO recommendations on antenatal care for a positive pregnancy experience