Legislative Efforts

DSC_0004The North Carolina Affiliate of the American College of Nurse-Midwives (NCACNM) is committed to providing safe, high-quality, satisfying, individualized care to women and their families. We believe that better access to the kind of care certified nurse-midwives provide is essential to improving the health of North Carolina’s women and babies.

Certified nurse-midwives have been licensed and practicing in North Carolina for over 30 years. We practice in hospitals, health clinics, birth centers and homes across the state. Certified nurse-midwives are advanced-practice registered nurses who are required to earn Master’s or Doctoral degrees and have achieved certification by the American Midwifery Certification Board.

We have been working with leaders in medicine, nursing and the legislature to promote the practice of nurse-midwifery and update our state practice act. One of the barriers to midwifery practice in North Carolina is the archaic and unnecessary requirement of physician supervision. This requirement doesn’t ensure safety or improve access to care, however it does make it harder to practice as a certified nurse-midwife in North Carolina and does limit access to midwifery services. And that compromises health outcomes for women and babies and increases health costs.

When 31 of 100 North Carolina counties have no practicing ob-gyn, and we rank 44th in the nation in infant mortality, limiting the practice of expert maternity care providers isn’t a solution, which is why only 6 states still require physician supervision for certified nurse-midwives. Studies have shown that care provided by certified nurse-midwives decreases rates of low birth weight, neonatal and infant mortality, cesarean section, and medical intervention.

Experts agree.

The American College of Obstetricians-Gynecologists, in a joint statement with the American College of Nurse-Midwives has stated that “Ob-gyns and certified nurse-midwives are experts in their respective fields of practice and are educated, trained, and licensed, independent providers who may collaborate with each other based on the needs of their patients.”

Additionally, the Institute of Medicine has found access to care from certified nurse-midwives has improved primary health care services for women in rural and inner-city areas and recommends removing scope-of-practice barriers such as requirement of physician supervision and allowing certified nurse-midwives to practice to the full extent of their education and training.

In the 2013-14 legislative session, a group of state legislators studied the flexibility of midwifery practice without physician supervision. The study recommended North Carolina’s requirement of physician supervision places some unnecessary restrictions on CNM practice and can result in well-qualified CNMs choosing to practice in other states. The lawmakers recommended an update and modernization of the Midwife Practice Act which will allow greater flexibility for certified nurse-midwives in their practice, greater access to midwifery care, and better outcomes for women and babies across the state. We are anticipating progress toward this recommendation in the 2015-16 legislative session with the passage of the Modernize Nursing Practice Act (S695/H807).