Midwifery in North America has culminated in a mosaic of art, science and tradition. The Practical Skills Guide for Midwifery has found its way into the mainstream of midwifery texts as a tool for both apprenticeship and the increasing number of formal midwifery schools. Its format is adaptable to both models of education and will help assure a complete course of skills practice. For experienced midwives, it may serve as a guide for clinical review. It is our desire to keep the art and tradition of midwifery alive while maintaining the integrity of the science. The Practical Skills Guide for Midwifery is used as a study guide in preparation for skills examination. The North American Registry of Midwives (NARM) recommends the use of The Practical Skills Guide for Midwifery as a study guide for the Skills Assessment portion of the NARM Portfolio Evaluation Process (PEP). It is recommended that the candidate refer to the Candidate Information Bulletin (CIB) for both the Written Exam and Skills Assessment specifications.