A BILL TO BE ENTITLED

AN ACT TO AUTHORIZE THE PRACTICE OF MIDWIFERY BY CERTIFIED PROFESSIONAL MIDWIVES.

The General Assembly of North Carolina enacts:

Section 1. Chapter 90 of the General Statutes is amended by adding a new Article to read:

"ARTICLE 10B.

"CERTIFIED PROFESSIONAL MIDWIVES.

"§ 90-178.8. Definitions.

The following definitions apply in this Article:

(1) "Midwife" means any person who provides primary maternity care by affirmative act or conduct prior to, during, and subsequent to childbirth, and who is not licensed as a physician, physician assistant, nurse practitioner or certified nurse midwife.

(2) "Practicing midwifery" means providing primary maternity care that is consistent with a midwife's training, education, and experience to women and their newborns throughout the childbearing cycle, and identifying and referring women or their newborns who require medical care to an appropriate practitioner.

(3) “Midwifery Joint Committee” means the joint subcommittee established under § 90

"§ 90-178.9. Licensure.

(a) It shall be unlawful for any person to practice midwifery in the State of North Carolina or use the title of licensed midwife unless she holds a license issued by the Midwifery Joint Committee. The Midwifery Joint Committee may license an applicant as a midwife after such applicant has submitted evidence satisfactory to the Supervisory Council that she has obtained the Certified Professional Midwife (CPM) credential pursuant to regulations adopted by the Midwifery Joint Committee and in accordance with the provisions of § 90-178.6(a), except that any references to Article therein shall refer to this Article 10B.

(b) Persons seeking licensure as a midwife shall submit such information as required in the form and manner determined by the Midwifery Joint Committee.

c) Persons seeking licensure shall pay the required license fee as determined by the Midwifery Joint Committee.

"§ 90-178.10. Regulations, renewal of license.

(a) The Midwifery Joint Committee shall adopt regulations governing the practice of midwifery. The regulations shall:

(1) Address the requirements for licensure to practice midwifery, including the establishment of standards of care;

(2) Be consistent with the North American Registry of Midwives' current job description for the profession and the National Association of Certified Professional Midwives’ standards of practice;

(3) Ensure independent practice;

(4) Provide for an appropriate license fee; and

(5) Include requirements for licensure renewal and continuing education.

Such regulations shall not:

(1) Require any agreement, written or otherwise, with another health care professional; or

(2) Require the assessment of a woman who is seeking midwifery services by another health care professional.

(b) License renewal shall be contingent upon maintaining a Certified Professional Midwife certification.

(c) The Midwifery Joint Committee shall promulgate regulations to implement the provisions of this act to be effective within 280 days of its enactment.

"§ 90-178.11. Administration.

The Midwifery Joint Committee shall be enlarged to include members specifically responsible for the licensing and regulation of Certified Professional Midwives. The additional members shall have equal representation with the existing members of the Midwifery Joint Committee.

"§ 90-178.12. Requirements for disclosure.

Any person practicing as a licensed midwife shall provide disclosure of specific information in writing to any client to whom midwifery care is provided. Such disclosure shall include:

(1) A description of the midwife's qualifications, experience, and training;

(2) A written protocol for medical emergencies, including hospital transport;

(3) A description of the Midwives' Model of Care;

(4) A statement concerning the licensed midwife's malpractice or liability insurance coverage; and

(5) A description of the right to file a complaint with the Board of Medicine and the procedures for filing such complaint.

"§ 90-178.13. Immunity.

No person other than the licensed midwife who provided care to the patient shall be liable for the midwife's negligent, grossly negligent or willful and wanton acts or omissions. Except as otherwise provided by law, no other licensed midwife, physician, physician’s assistant, nurse, nurse midwife, emergency medical personnel, or hospital, or agents thereof, shall be exempt from liability (i) for their own subsequent and independent negligent, grossly negligent or willful and wanton acts or omissions or (ii) if such person has a business relationship with the licensed midwife who provided care to the patient. A midwife, physician, physician’s assistant, nurse, nurse midwife, emergency medical personnel, or hospital, or agents thereof, shall not be deemed to have established a business relationship or relationship of agency, employment, partnership, or joint venture with the licensed midwife solely by providing consultation to or accepting referral from the midwife.

"§ 90-178.14. Exceptions.

(a) The provisions of this Article shall not prevent or prohibit:

(1) Any licensed midwife from delegating to an apprentice or personnel in her personal employ and supervised by her such activities or functions that are nondiscretionary and that do not require the exercise of professional judgment for their performance, if such activities or functions are authorized by and performed for the licensed midwife and responsibility for such activities or

functions is assumed by the licensed midwife; or

(2) Any person from performing tasks related to the practice of midwives under the direct and immediate supervision of a licensed physician, a certified nurse midwife, or a licensed midwife during completion of the North American Registry of Midwives’ Portfolio Evaluation Process Program within a time period specified in regulations adopted by the Midwifery Joint Committee or while

enrolled in an accredited midwifery education program.

(b) Notwithstanding the provisions of this Article, the practice of midwifery in North Carolina prior to the effective date of this Article shall not constitute grounds for disciplinary action by the Midwifery Joint Committee. The Midwifery Joint Committee may issue a license to a person who has so practiced midwifery upon application and compliance with the provisions of this Article.”

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