Study Recommends “Independent Practice” for Nurse Midwives

A legislative subcommittee on Nurse Midwives presented its final report to the full Joint Legislative Oversight Committee on Health and Human Services last Wednesday. The subcommittee’s charge was to study whether certified nurse-midwives (CNMs) should be given more flexibility in the practice of midwifery, in particular whether a CNM should be allowed to practice in collaboration with, rather than under the supervision of, a physician as currently is required.   The North Carolina Medical Society (NCMS), in partnership with the NC Obstetrical and Gynecological Society, opposes the elimination of supervisory agreements between physicians and nurse midwives.

After three meetings the subcommittee made a recommendation to “allow the independent practice of midwifery by CNMs who have had at least 2,400 hours and 24-months experience in the practice of midwifery under the supervision of a physician or a CNM with four or more years of experience; and provide for a 90-day grace period for a CNM to obtain a written practice agreement when the CNMs existing practice agreement is terminated.”

This recommendation must be approved by the full Joint LOC on Health and Human Services before it can be introduced as a bill during the short legislative session that begins in May. The NCMS supports continued collaboration between doctors and CNMs, but cannot support the elimination of supervisory agreements in the interest of patient safety.


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