TEXAS MIDWIFE LICENSING EXAM – PRACTICE EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2025/2026

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TEXAS MIDWIFE LICENSING EXAM – PRACTICE EXAM QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2025/2026



1. Which hormone is primarily responsible for initiating uterine contractions
during labor?
A. Progesterone
B. Estrogen
C. Oxytocin
D. Prolactin
Oxytocin stimulates uterine smooth muscle contractions and plays a key role in the
onset and progression of labor.


2. What is the normal fetal heart rate range at term?
A. 80–110 bpm
B. 100–140 bpm
C. 110–160 bpm
D. 150–190 bpm
The normal fetal heart rate is between 110–160 beats per minute, indicating
adequate oxygenation.

,3. Which of the following is a contraindication for a midwife to manage at home
birth in Texas?
A. Multiparity
B. Gestational diabetes controlled with diet
C. Severe preeclampsia
D. Maternal age over 35
Texas midwives must refer or transfer care if the client has severe preeclampsia, as
it is outside the scope of safe home management.


4. The primary purpose of Leopold’s maneuvers is to:
A. Detect maternal pelvic adequacy
B. Determine fetal position and presentation
C. Measure fundal height
D. Assess uterine tone
Leopold’s maneuvers allow the midwife to palpate the fetus and determine lie,
presentation, and position.


5. Which vitamin supplement is most critical in preventing neural tube defects?
A. Vitamin B12
B. Vitamin D
C. Folic acid
D. Iron
Folic acid supplementation before and during early pregnancy prevents neural
tube defects like spina bifida.


6. When monitoring labor progress, the “station” refers to:

, A. Cervical dilation V


B. Fetal head position relative to maternal ischial spines
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C. Uterine contraction strength V V


D. Fetal heart variability
V V




Station indicates how far the presenting part has descended into the pelvis,
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measured in relation to the ischial spines.
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7. A midwife in Texas must maintain birth records for a minimum of how
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many years?
V V




A. 3 years
V


B. 5 years
V


C. 7 years
V


D. 10 years
V




Texas Midwifery Rules require retention of birth records for at least 5 years after
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the last treatment.
V V V




8. What is the normal range for maternal hemoglobin in pregnancy?
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A. 8–10 g/dL V


B. 11–13 g/dL V


C. 13–16 g/dL V


D. 15–18 g/dL V




Hemodilution of pregnancy lowers hemoglobin slightly, making 11–13 g/dL the
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expected range.
V V




9. Which maneuver is most effective for relieving shoulder dystocia?
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A. Suprapubic pressure alone V V


B. McRoberts maneuver V