100+ Free SANC Midwifery Registration Exam Practice Questions

Pass your SANC Examination for Registration as a Midwife / Advanced Diploma in Midwifery exam on the first try — instant access, no signup required.

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2026 Statistics

Key Facts: SANC Midwifery Registration Exam Exam

60%

Pass mark required on SANC summative examinations

SANC Examination Regulations

3 h

Time limit per examination paper (180 minutes)

SANC Exam Guidelines

R520

SANC examination fee per paper

SANC Board Notice / Gazette

100

Practice MCQs in this study bank

OpenExamPrep

35%

Weight of Intrapartum Care & Labour Management

SANC Midwifery Outline

4g IV + 10g IM

ESMOE Magnesium Sulfate loading dose

NDoH Maternity Guidelines

The SANC Midwifery Registration Exam requires a 60% pass mark. Official SANC exams use written essay and short-answer formats; this free resource adapts the official curriculum into 100 high-yield English practice MCQs covering antenatal, intrapartum, postnatal, emergency, and legal domains.

Sample SANC Midwifery Registration Exam Practice Questions

Try these sample questions to test your SANC Midwifery Registration Exam exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1According to the South African National Department of Health Guidelines for Maternity Care (Basic Antenatal Care - BANC Plus), what is the recommended minimum number of antenatal contacts for a low-risk pregnant woman and when should the initial booking visit occur?

A.Minimum 4 contacts; initial visit before 20 weeks

B.Minimum 8 contacts; initial visit before 14 weeks

C.Minimum 12 contacts; initial visit before 12 weeks

D.Minimum 6 contacts; initial visit at 16 weeks

Explanation: South Africa adopted the BANC Plus model in line with WHO guidelines, recommending a minimum of 8 antenatal contacts for uncomplicated pregnancies. The first booking visit should occur as early as possible in the first trimester, ideally before 14 weeks gestation, to establish baseline health, screen for complications, and initiate PMTCT or iron supplementation if required.

2A midwife measures the symphysis-fundal height (SFH) of a primigravida at 28 weeks gestation. Which measurement technique correctly follows South African maternity clinical standards?

A.Using a non-stretch tape measure with numbers visible, measuring from the xiphoid process down to the pubic bone

B.Using a non-stretch tape measure with numbers facing down, measuring from the upper border of the symphysis pubis to the top of the fundus

C.Using calipers to measure the anterior-posterior abdominal diameter in centimeters

D.Palpating the fundus using fingerbreadths above the umbilicus without a tape measure

Explanation: Standard SFH measurement in South Africa requires placing a flexible non-stretch tape measure with the scale turned face down (to prevent observer bias) from the top of the pubic symphysis over the abdominal curve to the top of the fundus, which is demarcated by a hand held perpendicular to the maternal abdomen. Between 20 and 34 weeks, SFH in centimeters typically corresponds to gestational age in weeks (± 2 cm).

3During routine booking blood tests at 12 weeks, a pregnant woman's Haemoglobin (Hb) result is 9.2 g/dL. According to South African National Department of Health guidelines, how is this condition classified and managed?

A.Normal haemoglobin in pregnancy; no action required

B.Mild/Moderate anaemia; initiate therapeutic Ferrous Sulfate 200 mg (60 mg elemental iron) 2 to 3 times daily with Folate 5 mg daily

C.Severe anaemia; transfer immediately for urgent blood transfusion

D.Physiological hemodilution; advise dietary modification only without oral iron

Explanation: In South African maternity care guidelines, haemoglobin < 10.0 g/dL defines maternal anaemia (Hb 7.0–9.9 g/dL is mild-to-moderate). Management requires therapeutic oral elemental iron (e.g. Ferrous Sulfate 200 mg 2-3 times daily) combined with Folic acid 5 mg daily, alongside nutritional counseling and re-checking Hb in 4 weeks.

4A 24-year-old pregnant woman tests positive on Rapid Plasma Reagin (RPR) screening at her first antenatal visit at 16 weeks. What is the recommended treatment regimen under South African STIs/Maternity guidelines?

A.Single dose of Oral Azithromycin 1 g

B.Benzathine Penicillin G 2.4 million units IM weekly for 3 consecutive weeks

C.Oral Doxycycline 100 mg twice daily for 14 days

D.Single IM injection of Ceftriaxone 250 mg

Explanation: Under South African guidelines, a positive RPR test in pregnancy indicates maternal syphilis requiring treatment with Benzathine Penicillin G 2.4 million units IM weekly for 3 consecutive weeks to prevent congenital syphilis, miscarriage, and stillbirth. Partner notification and treatment are also mandatory.

5A newly diagnosed HIV-positive pregnant woman presents at 14 weeks gestation. What is the first-line Antiretroviral Therapy (ART) regimen for Prevention of Mother-to-Child Transmission (PMTCT) in South Africa?

A.Zidovudine (AZT) monotherapy started at 28 weeks

B.Tenofovir + Lamivudine + Dolutegravir (TLD) fixed-dose combination initiated on the same day

C.Efavirenz + Emtricitabine + Tenofovir (TEE) only after delivery

D.Nevirapine monotherapy taken twice daily

Explanation: South African National PMTCT guidelines mandate lifelong Triple ART with TLD (Tenofovir 300 mg + Lamivudine 300 mg + Dolutegravir 50 mg) fixed-dose combination, initiated on the same day as diagnosis for all pregnant and breastfeeding women regardless of CD4 count or gestational age.

6What is the normal baseline range for Fetal Heart Rate (FHR) auscultated during routine antenatal assessment?

A.90 to 110 beats per minute

B.110 to 160 beats per minute

C.160 to 190 beats per minute

D.140 to 180 beats per minute

Explanation: The normal baseline fetal heart rate range in both antenatal and intrapartum periods is 110 to 160 beats per minute. A rate below 110 bpm is defined as fetal bradycardia, and a rate above 160 bpm is defined as fetal tachycardia.

7A pregnant woman attending her first antenatal visit has no record of prior tetanus vaccination. What is the recommended Tetanus Toxoid-containing vaccine (Td) schedule during pregnancy in South Africa?

A.A single dose at delivery

B.Two doses: Td 1 at booking and Td 2 at least 4 weeks later (before 36 weeks)

C.Three doses administered weekly in the first trimester

D.No tetanus vaccination is given during pregnancy

Explanation: For previously unimmunized pregnant women, South African guidelines recommend at least 2 doses of Tetanus-diphtheria (Td) vaccine during pregnancy: the first dose at initial booking and the second dose at least 4 weeks later (preferably completed before 36 weeks) to prevent maternal and neonatal tetanus.

8A 32-year-old G2P1 with a history of severe pre-eclampsia in her previous pregnancy bookings at 14 weeks. What prophylactic medication regimen is recommended by South African guidelines to prevent pre-eclampsia recurrence?

A.Low-dose Aspirin 150 mg daily at bedtime starting at 12–16 weeks and Calcium supplementation 1.5 g daily

B.Methyldopa 250 mg three times daily throughout pregnancy

C.Furosemide 40 mg daily and low-sodium diet

D.Magnesium Sulfate 5 g IM monthly starting from 20 weeks

Explanation: High-risk women (prior pre-eclampsia, chronic hypertension, renal disease, pre-gestational diabetes) should be prescribed low-dose Aspirin 150 mg daily at night starting between 12 and 16 weeks gestation until 36 weeks, combined with elemental Calcium 1.5 g daily (taken separately from iron) to significantly reduce the risk of pre-eclampsia.

9A midwife performs a 75 g Oral Glucose Tolerance Test (OGTT) at 26 weeks for a woman with a body mass index (BMI) of 34 kg/m². Which plasma glucose result meets the diagnostic criterion for Gestational Diabetes Mellitus (GDM) according to WHO/SA criteria?

A.Fasting plasma glucose of 4.2 mmol/L

B.Fasting plasma glucose ≥ 5.1 mmol/L or 2-hour post-load glucose ≥ 8.5 mmol/L

C.2-hour post-load glucose of 6.5 mmol/L

D.Fasting plasma glucose of 4.8 mmol/L and 2-hour glucose of 7.2 mmol/L

Explanation: Under WHO and South African diagnostic standards, GDM is diagnosed if one or more of the following plasma glucose levels are met on a 75 g 2-hour OGTT: Fasting plasma glucose ≥ 5.1 mmol/L, 1-hour glucose ≥ 10.0 mmol/L, or 2-hour glucose ≥ 8.5 mmol/L.

10Routine midstream urine culture at booking reveals asymptomatic bacteriuria (>100,000 CFU/mL Escherichia coli) in a 22-week pregnant woman. Why is treatment indicated and what is an appropriate first-line oral antibiotic in South Africa?

A.No treatment needed unless dysuria develops; give fluid advice only

B.Treatment prevents pyelonephritis and preterm labor; administer Nitrofurantoin 100 mg 12-hourly for 5–7 days (or Amoxicillin-Clavulanate)

C.Treatment prevents fetal malformation; administer Ciprofloxacin 500 mg twice daily for 14 days

D.Treatment prevents maternal hypertension; administer Co-trimoxazole 2 tablets daily

Explanation: Asymptomatic bacteriuria in pregnancy carries a 20–40% risk of progressing to acute pyelonephritis and preterm labor due to smooth muscle relaxation and urinary stasis. It must be treated with a safe antibiotic such as Nitrofurantoin 100 mg 12-hourly for 5-7 days (avoided at term near delivery) or Amoxicillin-clavulanate.

About the SANC Midwifery Registration Exam Exam

The SANC Midwifery Registration Examination (under Regulation R.1497 for the Advanced Diploma in Midwifery or legacy R.254) is the official assessment required for professional registration as a Midwife in South Africa. This comprehensive practice question bank contains 100 single-best-answer multiple-choice questions aligned with the South African National Department of Health Guidelines for Maternity Care, ESMOE protocols, BANC Plus, WHO partogram guidelines, and the SANC Nursing Act No. 33 of 2005.

Assessment

Comprehensive summative evaluation covering 5 core domains: Antenatal Care (25%), Intrapartum Care (35%), Postnatal & Neonatal Care (20%), Obstetric Emergencies (10%), and SANC Scope & Laws (10%).

Time Limit

3 hours (180 minutes)

Passing Score

60% overall pass mark

Exam Fee

R520 per paper (SANC exam fee); R840 registration fee upon qualification (South African Nursing Council (SANC))

SANC Midwifery Registration Exam Exam Content Outline

25.00%

Antenatal Care, Fetal Assessment & Maternal Health

BANC/BANC Plus, fundal height, maternal screening (RPR, HIV PMTCT, anaemia, GDM), Rh isoimmunization, pre-eclampsia screening

35.00%

Intrapartum Care & Management of Normal/Complicated Labour

Partogram, stages of labor, cardinal movements, fetal heart monitoring, AMTSL, episiotomy, shoulder dystocia, breech delivery

20.00%

Postnatal Care & Neonatal Management

APGAR score, neonatal resuscitation (Helping Babies Breathe), vitamin K, PMTCT infant prophylaxis, Kangaroo Mother Care, jaundice

10.00%

Obstetric Emergencies & High-Risk Midwifery

ESMOE protocols, Magnesium Sulfate for eclampsia, PPH management, uterine rupture, cord prolapse, maternal collapse

10.00%

SANC Midwifery Scope, Ethics & SA Reproductive Health Laws

Nursing Act 33 of 2005, SANC Scope of Practice (R.259), Disciplinary Rules (R.387), CTOP Act 92 of 1996, National Health Act

How to Pass the SANC Midwifery Registration Exam Exam

What You Need to Know

Passing score: 60% overall pass mark
Assessment: Comprehensive summative evaluation covering 5 core domains: Antenatal Care (25%), Intrapartum Care (35%), Postnatal & Neonatal Care (20%), Obstetric Emergencies (10%), and SANC Scope & Laws (10%).
Time limit: 3 hours (180 minutes)
Exam fee: R520 per paper (SANC exam fee); R840 registration fee upon qualification

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

SANC Midwifery Registration Exam Study Tips from Top Performers

1Master the ESMOE algorithms, particularly the Magnesium Sulfate loading and maintenance regimen for severe pre-eclampsia/eclampsia.

2Thoroughly understand WHO and SA Partogram plotting rules (action line, alert line, latent phase vs active phase starting at 5 cm dilation).

3Memorize the PMTCT ART regimens for pregnant women (TLD - Tenofovir, Lamivudine, Dolutegravir) and infant post-exposure prophylaxis (Nevirapine/AZT).

4Review the 4 Ts of Postpartum Hemorrhage and the step-by-step active management of the third stage of labor (AMTSL).

5Understand the key provisions of SANC Nursing Act No. 33 of 2005, Scope of Practice R.259, and Choice on Termination of Pregnancy Act 92 of 1996.

Frequently Asked Questions

What qualification leads to SANC registration as a Midwife in South Africa?

Under current SANC regulations, the primary qualification is the Advanced Diploma in Midwifery (Regulation R.1497) or a Bachelor of Nursing and Midwifery degree. Legacy qualifications include Regulation R.254.

What is the passing score for the SANC Midwifery Examination?

The pass mark for SANC summative and professional entrance examinations is 60%.

Is this MCQ practice test an official SANC examination paper?

No. Official SANC summative examinations traditionally utilize written short-answer and essay questions. This practice bank is an English-language multiple-choice question (MCQ) study adaptation created to assist candidates in preparing for SANC and NEI assessments.

How much are the official SANC examination and registration fees?

As per SANC fee schedules published in the Government Gazette, the examination fee is R520 per paper. Registration as a Midwife upon passing costs R840, and the annual practising certificate (APC) fee is R870–R920.

What clinical guidelines are tested in SANC midwifery examinations?

Examinations heavily reference the National Department of Health Guidelines for Maternity Care in South Africa, ESMOE (Essential Steps in Managing Obstetric Emergencies), BANC Plus guidelines, and WHO intrapartum care standards.

Can registered midwives perform termination of pregnancy (TOP) in South Africa?

Yes. Under the Choice on Termination of Pregnancy Act 92 of 1996 as amended, registered midwives who have completed the prescribed TOP training are legally authorized to perform first-trimester terminations (up to 12 weeks gestation).