State Policy 'Crucial' for Midwifery
Dr. Tara Singleton, a Certified Nurse-Midwife, stated, "State-level legislative advances are crucial for midwifery’s future—especially in Virginia, where recent bills aim to streamline collaborative practice agreements and broaden access to midwifery-led care."
- As of July 1, 2025, House Bill 1904 allows certified nurse-midwives to be on the 24-hour on-call roster for nursery care when a physician is unavailable. This change is intended to address staffing shortages, particularly in rural areas. - Virginia law now allows Certified Nurse Midwives (CNMs) and Licensed Certified Midwives (LCMs) with 1,000 hours of clinical experience to practice without a written practice agreement with a physician. This change aims to reduce barriers to practice and increase access to midwifery care. - In 2023, approximately 30.8% of Virginia's counties were classified as "maternity care deserts," meaning they lack obstetric hospitals, birth centers, and obstetric providers. This highlights the significant need for an expanded midwifery workforce to serve these communities. - Research indicates that midwifery-led care is associated with positive birth outcomes, including lower rates of cesarean births, fewer interventions during labor, and higher breastfeeding rates. Studies have also shown that integrating midwives into maternity care can lead to lower rates of maternal mortality and preterm births. - The Virginia Affiliate of the American College of Nurse-Midwives played a key role in advocating for recent legislative changes. Their ongoing priorities include achieving reimbursement parity for all licensed midwives and ensuring midwives are included in hospital medical staff definitions, which would allow them to have a voice in hospital policies that affect their practice. - Effective July 1, 2025, House Bill 1923 requires insurance companies in Virginia to reimburse Licensed Certified Midwives (LCMs) and Licensed Midwives (LMs) at the same rate as Certified Nurse-Midwives (CNMs). This legislation also directs Medicaid to provide 100% fee schedule reimbursement for LCMs and LMs. - A significant challenge to expanding midwifery care in Virginia is that some hospital policies are more restrictive than state law, which can limit a midwife's ability to practice to the full extent of their training. Additionally, insurance company credentialing and participation requirements can create barriers for midwives to become in-network providers. - The "Midwives for MOMS Act," a federal bill, aims to increase the number of midwives by providing funding for midwifery education programs. This initiative prioritizes funding for programs that work to increase racial and ethnic diversity within the student body and faculty.
