American College of Nurse-Midwives
Virginia State Affiliate
ABOUT CERTIFIED NURSE-MIDWIVES & CERTIFIED MIDWIVES IN VIRGINIA
A certified nurse-midwife (CNM) is an advanced practice registered nurse (APRN) with specialty training in midwifery. A certified midwife has the same specialty training in midwifery, without nursing education or practice. 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 at least two years of graduate education (master or doctorate) in midwifery at accredited schools. Core competencies of 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.
- Certfieid midwives have at least two years of graduate education (master or doctorate) in midwifery at accredited schools. Core competencies of midwifery practice must be met prior to taking a national certification exam by the American Midwifery Certification Board. As of 2020, CMs are not currently licensed to practice 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 and CMs 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%
ACCESS TO CARE
License Certified Nurse-Midwives and Certified Midwives to provide care for women and newborns consistent with education, clinical training, and national certification. This includes full-practice and prescriptive authority.
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 Midwifery Schools for CNMs and CMs)
- Encouraging greater participation by preceptors (please, email [email protected] to volunteer to be a mentor and/or preceptor), and
- Increasing numbers of interested midwifery students (see our For Aspiring Midwives page).
1Journal of Nursing Economics, Sept/Oct 2011
2Policy Perspectives: Competition and the Regulation of Advanced Practice Registered Nurses, Federal Trade Commission, March 2014