Virginia Midwifery Scope of Practice Unchanged
There have been no newly reported legislative or regulatory changes to midwifery licensure or scope of practice in Virginia. The policy environment concerning workforce rules, reimbursement, and practice authority remains fluid. Professional groups like the American College of Nurse-Midwives continue to monitor for potential updates.
- Recent legislation has, in fact, significantly altered the midwifery landscape in Virginia; Governor Youngkin signed HB 1923, which establishes Medicaid reimbursement parity for all nationally certified midwives at 100% of the fee schedule, making Virginia the first state to do so for autonomous midwifery practice. - Effective July 1, 2025, House Bill 1904 will permit certified nurse-midwives (CNMs), licensed certified midwives (LCMs), and qualifying nurse practitioners to staff 24-hour on-call rosters for hospital nursery care, a measure intended to address maternity care gaps in rural areas. - Virginia law distinguishes between several types of midwives: Certified Nurse-Midwives (CNMs) are advanced practice registered nurses with graduate-level education, Certified Professional Midwives (CPMs) are nationally certified for out-of-hospital settings and are known as Licensed Midwives (LMs) in Virginia, and Certified Midwives (CMs) have similar training to CNMs but are not nurses. - While Virginia law previously restricted Licensed Midwives from administering medications within their scope, recent changes now allow them to obtain and administer drugs and devices as determined by the North American Registry of Midwives (NARM) Job Analysis, which includes items like antihemorrhagics, medical oxygen, and local anesthetic for suturing. - Both Certified Nurse-Midwives and Licensed Certified Midwives who have practiced for fewer than 1,000 hours are required to have a practice agreement with a licensed physician or an experienced midwife for consultation. After completing 1,000 hours, they can practice without this agreement upon receiving an attestation. - Professional organizations like the Virginia Midwives Alliance and the Virginia Affiliate of the American College of Nurse-Midwives (ACNM) were instrumental in advocating for recent legislative successes, including insurance parity and expanded practice authority. - Lawmakers are planning to create a legislative task force to further investigate and address remaining barriers to midwifery care in the state, ensuring midwives can practice to the full extent of their training.
