California is one of only six states to continue to require physician supervision of nurse midwifery practice (the others are Nebraska, Virginia, Florida, North Carolina and South Carolina). But a movement is underway to get California to join the rest of the country.

The bill AB1306 would remove language in the current law requiring physician supervision for Nurse-Midwives to give care.

"97% of Certified Nurse Midwife (CNM) care in California is provided in hospital settings in close collaboration with physicians. In these settings, nurse-midwives often face arbitrary requirements to demonstrate a supervisory relationship with a physician. This results in limiting the ability of CNMs to provide care in a variety of geographic areas and healthcare facilities, as well as limiting their ability to provide full scope of services in under-served communities {when physicians do not wish to supervise Nurse-Midwives}. Providing supervision to fully qualified CNMs places an outdated and unnecessary burden on physicians. Most facilities require physician co-signatures for admission and discharge, even though the physician may not have been present during care and may not have had a personal encounter with the patient. This results in physicians providing record-keeping documentation when they could be providing direct care to patients" (from

What will AB1306 accomplish?

Nurse-Midwives will continue to practice in collaboration with physicians, but without the barriers imposed by supervisory language. The Board of Registered Nursing will receive support on regulatory issues impacting CNMs via a nurse-midwifery advisory council. Home birth and birth center CNMs will have access to medications and resources necessary for safe care. The home will be specifically included as a location for the provision of CNM services. All newly licensed CNMs will have national AMCB certification, in line with national standards.

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