Which states are CNMs permitted to do homebirths? - page 2

by moonredlife 6,807 Views | 21 Comments

I am a pre-nursing student with the long-time goal of becoming a midwife. Since I love homebirth and believe that it is ultimately best for many women/families, I would like to know if anyone knows where to find a list of states... Read More


  1. 0
    Quote from melmarie23
    Legal in NH. And contrary to what an above poster said, they do not need physician oversight to attend home births in that state.
    Not physician oversight, but collaboration. Such as, do you have an accepting physician if you need to transport? I know many midwives just take them (or dump them, sadly) at the ER, but it's much safer and better for the family if she has a collaborative agreement with a physician who has privileges somewhere.
  2. 0
    Quote from klone
    Not physician oversight, but collaboration. Such as, do you have an accepting physician if you need to transport? I know many midwives just take them (or dump them, sadly) at the ER, but it's much safer and better for the family if she has a collaborative agreement with a physician who has privileges somewhere.
    Some states require collaboration and some don't. It seems safer to require this but it really doesn't accomplish a lot other than restrict practice. My state law requires a physician in the state, so they could be 4-5 hours away and still meet the requirement but are surely no help in an emergency. In a non-emergency situation I am not going to refer my patient to them, I am going to send them to someone local. (For the record, I work in an academic medical center, I'm not a homebirth midwife). Even if I have a local doc, if I have a true emergency I am going to get the closest/fastest option, not wait for my doc to show up.

    A family practice doc is not required to have a collaborating cardiologist or ENT in order to see patients for BP management or sore throats. The scope of practice in OB is the same as for a CNM or family practice doc. The same principles should apply.

    Ideally, there is a local hospital with 24 hour in house anesthesia and OB. I wouldn't consider a transfer anywhere else in an emergency. Ideally, transfer wouldn't be hostile and midwives would not have to "dump" their patients for fear of prosecution or harassment. An Emergency room is hardly in a position to be upset about receiving an emergency in any case.
  3. 1
    There are few states where it is legally prohibited for CNMs to attend OOH birth. Nebraska comes to mind as one. Was it North Carolina where it just got real ugly for CNMs working OOH? This year? I think so.

    There are many other states where it is not prohibited by law, but the requirements for a written collaborative agreement with a physician or mandatory malpractice insurance equivalent to what an obstetrician must carry creates barriers to OOH CNM practice.

    Not legally prohibited. Just financially and/or collaboratively difficult.

    Of the CNM practices that were independent (either in hospital or OOH) - they usually had a collaborative relationship with an OB in private practice. And finding an OB in private practice is becoming rarer and rarer. Group practices of physicians don't want to sign on as collaborators for CNMs in private practice. It creates an difficult situation for CNMs.

    And it all gets confusing with the laws that do and don't apply to CPMs and DEMs because the public often does not understand the distinction between the different types of midwives.

    To obtain a license in my state, CNMs require a written collaborative agreement with a physician. CPMs do not.

    A family practice doc is not required to have a collaborating cardiologist or ENT in order to see patients for BP management or sore throats. The scope of practice in OB is the same as for a CNM or family practice doc. The same principles should apply.
    Whole-heartedly agree.
    WantToBeMidwife likes this.
  4. 0
    Quote from klone
    Not physician oversight, but collaboration. Such as, do you have an accepting physician if you need to transport? I know many midwives just take them (or dump them, sadly) at the ER, but it's much safer and better for the family if she has a collaborative agreement with a physician who has privileges somewhere.
    most do have collaboration and have a hospital lined up for transports if need be, yes (I chose these women for the births of my two children). My hospital has a great collaboration with one of the local birth centers and at least once a month on average end up taking one of their patients. In NH though, its CPMs who are the bulk of midwives who practice out of hospital/run birth centers/attend home births. But some CNMs do/have as well. CNMs here are still mostly found in hospital though.

    NH is unique in that for most APRNs, they are not required to have physician oversight and can practice independently. However, most choose to go into partnership with them.
    Last edit by melmarie23 on Nov 9, '12
  5. 0
    CNMs can do homebirths in Florida.
  6. 0
    klone they "dump" them b/c of how THEY will be treated. OBs treat them so badly they should be embarrassed.

    As for the OP's question, I think NJ FL, and NY for sure. I live in TN now and I don't know the law here on it. I will one day when I become a CNM ;-)
  7. 1
    Quote from WantToBeMidwife
    klone they "dump" them b/c of how THEY will be treated. OBs treat them so badly they should be embarrassed.

    As for the OP's question, I think NJ FL, and NY for sure. I live in TN now and I don't know the law here on it. I will one day when I become a CNM ;-)
    Since you are in TN, have you heard of The Farm? I really wanted to go their to deliver, but my husband was opposed, and it was a bit of a drive. Ina May is one of my heroes!
    WantToBeMidwife likes this.
  8. 0
    Yes I live about 35-45 minutes from the Farm. I've never been there, but am going soon to check it out, and plan to do their midwifery assistant workshop next year if I can save $900!!!! Ina May is amazing, I just love her, met her a few times and she's such a sweet lady!
  9. 0
    Alabama and Nebraska are the two states where it is illegal for a CNM to attend a homebirth.
  10. 0
    It is illegal for ANY midwife to attend a home birth in Alabama, not just CNMs but CPMs also!!!!!!


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