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 AB1612 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 Providing supervision to fully qualified CNMs places an outdated and unnecessary burden on physicians.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 AB1612 accomplish?

Nurse-midwives will continue to practice in collaboration with physicians, but without the barriers imposed by supervisory language. The BRN 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. Clarify the inclusion of the home as a location for CNM services. All newly licensed CNMs will have national AMCB certification, in line with national standards. (from

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