On Thursday, August 7th, I attended the “Interested Parties” meeting held in Sacramento by the Medical Board of California. It was well-attended by CNMA, California Birth Center Association (CABCA), California Association of Midwives (CAM), representatives of ACOG and CMA, as well as many community midwives, both LM and CNM. Two agenda items were discussed
1) Contents of the Transfer of Planned Out-of-Hospital Delivery to Hospital reporting form
and more relevant to the subject of this Blog:
2) Pathway for Certified Nurse Midwives to become Licensed Midwives
Kerrie Webb, legal counsel for the MBC, presented a 9-page curriculum comparison chart between the educational requirements for LM licensure by the Medical Board and the educational requirements for CNM certification by the Board of registered nursing, demonstrating that all LM requirements were met by RN/CNM curriculum. The recommendation of the MBC was that any individual with a valid, active CNM certificate from the California BRN would be eligible to apply to the Medical Board for licensing as an LM. No further examination (eg. NARM) would be required. Kerrie also pointed out that student LMs can be supervised by CNMs, further supporting the idea that CNMs meet LM criteria.
This was followed by discussion of the potential legal and disciplinary ramifications of working under two licenses regulated by two different Boards. Per Kerrie Webb, the practitioner would need to make a contract with a client at the outset of the clinical course of care delineating which license she/he is working under and observing the regulations pertaining to that license type.
CNMA made a statement that our primary policy goal is to remove the word “supervision” for all CNMs regardless of site of practice. The dual licensure pathway is a work-around method to protect some of our members primarily practicing out of hospital and unable to obtain physician supervision.
The Medical Board anticipates approximately one year for approval of this licensing pathway and the writing of the necessary Medical Board regulations. However, we are hopeful that CNMs will be well on the way to a legislative fix for autonomous practice by then!