North American Registry of Midwives (NARM) Practice Exam

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At what gestational age can the sex of the fetus be clearly distinguished by direct examination?

10th week
12th week
14th week
16th week

The correct answer is: 14th week

The ability to distinguish the sex of a fetus through direct examination typically becomes clearer at around 14 weeks of gestation. At this stage, the external genitalia of the fetus begin to develop significantly, allowing for visual identification of male or female characteristics during an ultrasound examination. Before the 14th week, the genital tubercle is present but is not yet distinctly identifiable as male or female. By 16 weeks, this identification becomes even more certain and reliable for practitioners, but the question asks for the earliest time when sex differentiation can be clearly seen. Therefore, 14 weeks is recognized as the earliest time at which the sex can typically be distinguished by direct examination, making it the correct answer in this context.