A certified nurse-midwife (CNM) is an advanced practice registered nurse (APRN), commonly known as a licensed nurse practitioner. As independent health care providers, CNMs have prescriptive authority in all 50 states and the District of Columbia and are defined as primary care providers under federal law. CNMs have been licensed in Virginia since 1975 jointly under the Boards of Nursing and Medicine.
- Nurse-midwives are Registered Nurses with two years of graduate education at accredited schools. Core competencies of nurse-midwifery practice must be met prior to taking a national certification exam. Certification by the American Midwifery Certification Board is required prior to licensure in Virginia.
- Midwifery practice is the independent management of women's healthcare, including primary care, family planning and gynecologic needs of women throughout the lifespan, pregnancy, childbirth, the postpartum period, and care of the newborn.
- CNMs in Virginia practice within a health care system that provides for consultation, collaborative management, or referral as indicated by the health status of the woman or newborn.
- In Virginia, over 85% of CNMs are employed by physicians and their practices.
- In 2013, there were 102,147 births in Virginia,7.22% were by CNMs
- Out of hospital births: 1.01% by all providers: not just CNMs
- Total births covered by Medicaid: 30.9%, CNM births paid for by Medicaid: 22.98%
To Download a copy of "About Certified Nurse-Midwives" Click Here
Photo of Traci Marin, CNM
ACCESS TO CARE
Reform statutes and regulations to conform to the National Council of State Boards of Nursing’s Consensus Model for APRN Regulation. When APRNs are permitted to practice to the full extent of their education and training, they provide equal, and in some cases, better care1. In coordination with the three other APRN roles, certified registered nurse anesthetist (CRNA), clinical nurse specialist (CNS), and certified nurse practitioner (CNP), CNMs are advocating for progress towards implementing the full Consensus Model in Virginia. In Virginia, 70 counties do not have CNM care.
The Federal Trade Commission has endorsed APRN independent practice2 as “a key component of our nation’s strategy to deliver effective health care efficiently and, in particular, to fill gaps in primary care access.” The FTC further observed that “based on substantial evidence and experience, expert bodies have concluded that APRNs are safe and effective as independent providers of many health care services within the scope of their training, licensure, certification, and current practice.”
HEALTHCARE SAFETY NET
Support and sustain programs, like FAMIS Moms, Comprehensive Health Improvement Program (CHIP), and Healthy Virginia Families, to provide quality prenatal, maternity, post-partum and other medical services to in-need pregnant women. These programs provide essential services to low-income pregnant women that are important for the short and long-term health of them and their babies.
CLOSING THE HEALTH INSURANCE COVERAGE GAP
Support the implementation of the Affordable Care Act’s Medicaid expansion option to provide coverage to over 400,000 Virginians who lack healthcare coverage.
BEST PRACTICES IN PERINATAL SUBSTANCE USE and INCREASED ACCESS TO TREATMENT OPTIONS
Support prevention efforts and comprehensive treatment access for pregnant women dealing with substance abuse. Oppose efforts to further criminalize substance abuse by pregnant women, as it discourages such women from seeking help and treatment.
INCREASING THE MIDWIFERY WORKFORCE
In response to national maternity provider shortages, it has become more necessary to increase access to midwifery care. Primary goals to achieve this objective include:
- Creating accredited educational programs (see our listing of Certified Nurse-Midwifery Schools),
- Encouraging greater participation by preceptors (please, email firstname.lastname@example.org to volunteer to be a mentor and/or preceptor), and
- Increasing numbers of interested midwifery students (see our For Aspiring Midwives page).
For more information, visit the ACNM website.
A Message from the President
August 23rd, 2016
Jessica Jordan, CNM, MSN
As a lifelong Virginia resident and a nurse-midwife for over 20 years, I can tell you that change happens slowly in Virginia, with baby steps. It is easy to see the changes over 20 years. When I became a midwife in Richmond, there was one CNM doing homebirths and none in the hospital. Now there are two CNM’s doing home births, twelve working in the hospital, two hospitals recently added CNM’s to their staff, and a freestanding birth center just opened.
We are on the cusp of great things happening in our state, but we still work in a restrictive regulatory environment. Last year we began to work with other organizations to make some changes in Virginia. We met with the Virginia Council of Nurse Practitioners, the Clinical Nurse Specialists, and the Certified Registered Nurse Anesthetists to form a united front in changing our regulations. We wanted the state to adopt the consensus model of the National Boards of Nursing for regulating APRN’s. Unfortunately, that is too big a step for Virginia to take at one time.
We also began meeting with the Virginia Section of the American College of OB-Gyn’s (ACOG) and the Virginia Midwives Alliance, an organization that is predominately Certified Professional Midwives. These meetings facilitated understanding of the barriers to practice and true collaborative relationships. The CNM’s and CPM’s were invited to an ACOG educational meeting for the first time in my recollection.
As the General Assembly approached, the APRN’s knew that we wanted full practice authority, but we also knew the battles to be fought. So the nurse practitioners proposed a bill for full practice authority, and the CNM’s also proposed a bill for full practice authority. We asked for ACOG’s support and sat down at the table with them and the Medical Society of Virginia. We agreed on a compromise bill, and SB 463 became law on July 1st, 2016. Working together with our physician colleagues is crucial to our success in Virginia. The work is not over because we have not achieved full practice authority.
There is much more work to be done by every midwife in Virginia. We need more midwives so every woman has access to a midwife. Midwives have a responsibility to educate the public and our legislators. There is still much confusion about the initials behind our name, and our scope of practice. I will continue to push for full practice authority, but I know that change takes time, and I need every midwife pushing with me.
Our new regulations are not perfect. We still have to have evidence of a consultation agreement with a physician, and sometimes the doctors are hard to find. We can now prescribe Schedule VI drugs without a practice agreement, but if we prescribe Schedules II through V, it needs to be addressed in the practice agreement with the physician. By removing the “physician-led team” language, we should be able to change restrictive hospital policies. To do that, we need every midwife examining the medical bylaws in her hospital, and alerting the administration that this law changes our relationships and requirements.
Over the next two years, we will continue to expand our organizational relationships with other professionals. We will continue to support full practice authority for all APRN’s. And we will keep taking baby steps until every woman in Virginia has access to a midwife
President: Amber Price DNP, CNM
President Elect: N/A
Secretary: Leslie Fehan, CNM
Treasurer: Erin Baird CNM
- Finance Committee: Erin Baird CNM
- Membership Committee Chair: Tana McCoull, CNM
- Nominating & Bylaws Committee Chairs: Tana McCoull, CNM
- Legislative & Governmental Affairs Committee Chair: Mary Ellen Bouchard CNM and Nichole Wardlaw, CNM
- Public Relations/Marketing Committee Chair: Reid Byrne, CNM
- Representative to VCNP Government Relations Committee: Amber Price DNP, CNM
- Liaison to the Joint Boards Advisory Committee: Wendy Dotson CNM
- Representative to the Virginia Maternal Mortality Review Team: Amber Price DNP, CNM
- Liaison to Virginia Rural Health Association: Juliana Fehr CNM
- Liaison to the Virginia Health Commissioner's Infant Mortality Work Group: Traci Marin, CNM
- Facebook: Amber Price DNP, CNM and Contact Katie Page, CNM
- Birth Matters Liaison: Kathleen McClelland CNM
- Student Nurse-Midwife Liaison: Open
- Finance Committee
- Legislative and Advocacy Committee
- Membership Committee
- Nominating and Bylaws Committee
- Public Relations and Marketing Committee
- Shenandoah Valley & Charlottesville Region- Open
- Northern Region- Open
- Richmond Region- Open
- Southwest Region- Open
- Peninsula/Tidewater Region- Open
- Student Nurse Midwife Liaison- Open
If you are interested in joining any committee, email Contact Leslie Fehan, CNM