California Nurse-Midwives Association

Worth a Listen!

We applaud Freakonomics for their astute podcast of “Nurses to the Rescue.” This podcast is worth the listen!!! Like Nurse Practitioners (NPs), Certified Nurse-Midwives (CNMs) are Advanced Practice Nurses with graduate level education and rigorous training. In California, our current Bill (AB1612) to remove physician supervision for CNMs has been met with similar opposition from CMA. This is our third attempt to remove physician supervision for CNMs in order to meet the growing demand for women’s health and maternity care services throughout the State. Nine California counties do not have an OBGYN! This podcast explains why full practice authority for Advanced Practice Nurses is so important.

BRN Advance Practice Nursing Committee Needs Volunteers

The California Board of Registered Nursing is convening a NEW committee to advise the BRN on issues related to advanced practice nursing in California. There are two seats available to nurse-midwives. You can find the application here.
The purpose of the advanced practice committee is to provide recommendations to the Board on issues involving nursing advanced practice. The advanced practice registered nurses are nurse practitioner, nurse anesthetist, nurse-midwives and clinical nurse specialists.

The goals of the advanced practice committee:

  1. Clarify and articulate sufficiency of the four advanced practice roles and recommend changes to the Nursing Practice Act and rules
  2. Develop recommendations for joint statements related to scope of practice and advanced practice nurse functions
  3. Review national trends in the regulation of advance practice nurses and make recommendations to the board.
  4. Collaborate with other Board committees on matters of mutual interest

Position open for BRN Nurse-Midwife Advisory Committee

All CNMs are welcome to apply. One CNM will be chosen by the Practice Committee to fill a vacant spot and then forwarded to the Board for appointment. Please find the applications here.

National Health Policy Update

Submitted by Kate Green, CNM

Chair, Government Affairs Committee

Support S783!!! 

Our Senators just returned to Washington.  This is a golden opportunity for midwives to contact Senate offices and ask their Senators to support Senate bill 783 (S783), the Improving Access to Maternity Care Act. Introduced by Democratic Senator Tammy Baldwin from Wisconsin, and co-sponsored by Republican Senator Lisa Murkowski (Alaska), this bipartisan bill is the companion bill to the House of Representatives Bill 315 (HR315) that passed briskly in January with bipartisan support. The bill is currently in the Senate Committee on Health, Education, Labor, and Pensions (usually abbreviated as the Senate HELP Committee), and both ACNM and ACOG are in favor of it.


S 783 (with HR 315) would create a health professional shortage area (HPSA) for maternity care services. The goal is to identify and address areas of the U.S. that are experiencing significant shortages of full scope maternity care professionals, including certified nurse-midwives and other maternity care providers. This legislation will make it possible for the U.S. Department of Health and Human Services to place eligible professionals within the National Health Service Corp (NHSC) in eligible medical facilities (including hospitals, birth centers and other appropriate facilities) in these areas to address identified shortages of maternity care professionals. Expanding access to maternity care professionals in underserved areas can reduce overall maternity care costs in the U.S. by ensuring women have access to necessary prenatal care and delivery options.

What to do: 

·    Contact your senator’s office by phone

How to do it: 

o   Call your Senator’s office. (Phone numbers can be found under the individual senator’s information at Tell the person answering the phone that you are a midwife and a voter in your state. Ask to speak to the health care Aide 

o   Ask the health care Aide to encourage the Senator to support S783, the Improving Access to Maternity Care Act. 

o   Use the information above to describe the act.

o   Thank them for their time at the end, and ask them for their email address! 

o   If they have questions, they can contact Amy Kohl at ACNM’s government affairs office at 240-485-1806 or

o   Follow up with an email: Email to thank the staffer again for their time, and tell them they’ll be hearing from an ACNM advocacy team member as well. Cc that email to me at or Amy Kohl at

Email your senator. 

How to do it:

o   Go to, and email your senator 

o   Tell them you are a midwife, and give them the information on 783 (you can cut and paste from the information above!) 

o   Ask the Senator to support S783. 

o   Thank them for their time at the end! 

o    If they have questions, they can contact Amy Kohl at ACNM’s government affairs office at 240-485-1806 or

ALL Senators are important to co-sponsor S783!! However, contacting your Senator is especially important if your Senator sits on the Senate HELP committee! 




Lamar Alexander (TN), chair

Michael Enzi (WY)

Richard Burr (NC)

Johnny Isakson (GA)

Rand Paul (KY)

Susan Collins (ME)

Bill Cassidy, M.D. (LA)

Todd Young (IN)

Orrin Hatch (UT)

Pat Roberts (KS)

Lisa Murkowski (AK) (BILL COSPONSOR! THANKS!) 

Tim Scott (SC)

Patty Murray (WA), ranking member

Bernie Sanders (VT)

Robert Casey (PA)

Al Franken (MN)

Michael Bennet (CO)

Sheldon Whitehouse (RI)

Tammy Baldwin (WI) (BILL SPONSOR! THANKS!)

Christopher Murphy (CT)

Elizabeth Warren (MA)

Tim Kaine (VA)

Maggie Hassan (NH)



And… a huge shout out of thanks to YOU for all you do for midwives and the women we serve!!!! 

Current regulations make it difficult for nurse-midwives to practice equitable, team-based care. In effective team-based care, each provider is integral to the team and each is able to offer the full scope of what they have to offer, which ultimately provides better health care overall. The “supervision” concept creates a sense of hierarchy that is antithetical to effective team-based care. As providers tethered to physicians, CNMs are unable to promote midwifery care without supervisory permission. Physician supervision also fosters interprofessional tension because of the erroneous idea that the physician is legally responsible for the CNM’s actions.      


Midwives are often invisible within the healthcare system by not being counted/included as providers by insurance companies or hospitals. Currently, Medi-Cal and private health plans do not track where CNMs work and what we do. That means our impact is often invisible to policy makers, insurance companies, and the general public—but not to budget administrators, who may well eliminate a CNM “line item” because our worth is not known.                                                                                    

Economic Stability.  

Removal of the word “supervision” would expand market opportunities for CNMs and the physicians with whom we collaborate. It will also make it easier for a CNM to obtain hospital privileges and become a full hospital staff member; to work with physicians who are no longer fearful of liability issues; to start a midwife-owned private practice; and to contract with health plans. Likewise, it will be easier for hospitals to hire the appropriate number of CNMs and physicians required for optimal patient care rather than basing hiring decisions on supervision ratios. Removal of supervisory requirements does not, of course, preclude a CNM from working within a physician or hospital group if she or he so chooses.  

The Health Policy Committee is responsible for assisting in the fulfillment of these specific purposes of the California Nurse-Midwives Association (CNMA):

  •       Represent the membership regarding issues impacting the practice of midwifery in the state of California in accordance with the bylaws and policy guidelines of the American College of Nurse-Midwives.
  •       Promote the health and well-being of women and families in the state of California by furthering the profession of midwifery.
  •       Establish a mechanism for cooperation with other groups and organizations in promoting the health and well-being of California families.
  •       Achieve legislation and regulation that is favorable to midwifery practice.
  •       Support and foster appropriate professional licensure regulations and legislation related to midwifery and women’s health issues in California.

Wondering how to get involved?

Join fellow CNMA members that are active proponents of our health policy goals, in either the Health Policy Committee (3 yr commitment) or the Health Policy Workgroup for smaller projects:

  1. Engage locally: Determine what is going on in your local chapter. Does your chapter have a Health Policy liaison? What issues face your local CNM community?; Where do CNMs work in your community? Can you identify local supporters? Build a relationship with your local representatives.
  2. Attend CNMA Lobby Day! Volunteer to help organize!
  3. Make in-district lobbying visits with your legislator, closer to home!
  4. Help CNMA fundraise!
  5. Represent CNMA at coalition, BRN, or other meetings!

Contact the Chair or Vice Chair of the CNMA Health Policy Committee to find out how you can help.


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The CNMA works to improve women's health through midwifery. Help us accomplish our maternal legislative goals by donating NOW! Click here to learn more about how we improve the health of women and their families.

Helpful Resources for In-District Advocacy

  1. How-to-Videos Re: Advocacy
  2. Legislative Visits – What to Expect
  3. Plan Your In-District Visit
  4. Talking Points for Legislators
  5. Materials for the In-District Visit
  6. Rainy Day Advocacy - Phone Prompt
  7. Find your CA Legislators HERE
  8. NEW: Customizable PowerPoint Presentation for In-District Visits

Health Policy Members:

Kim Q Dau, Co-Chair

Holly Smith, Co-Chair

Kavita Noble, Vice Chair

Djina Ariel, Davis

Jenna Breton, Mendocino

Karen Ruby Brown, San Diego

Carol Bryan, Humboldt Co

Mary Croyle Farrell, San Diego

Roberta Frank, San Diego

Parie Lambert, Napa

Timmi Pereira, Santa Cruz
BJ Snell, Orange County

Health Policy Workgroup Members

Emily Beck (SF Bay Area Liaison)

Hannah Brodsky-Pena (San Francisco Bay Area)

Yelena Kolodji (Santa Cruz)

Sarah Levitan (Santa Cruz)

Cara Rasmussen (Santa Cruz)
Natalie Martina (East Bay)

Mari Oxenberg (Los Angeles)

Holly Smith (Sacramento)

Susan Stone (Sacramento)


Links to CNMA Coalitions:

California Action Coalition

California Coalition for Reproductive Freedom

Californians Allied for Patient Protection

Sacramento Women + Health Care Reform Coalition


Find Your Local Representative:


Comparison of California Certified Nurse-Midwives (CNMs) and Licensed Midwives (LMs): PDF

State Fact Sheet - California: PDF

Certified Nurse-Midwives in California: PDF

Please Submit Your Comments and Issues on:

  • practice barriers
  • CNM practice in CA
  • openings and closings of CNM practices
  • BRN investigations
  • billing/reimbursement issues
  • women's health policy concerns
  • legislative suggestions


Email Kim at