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Hi everyone,


There's a bill being heard in committee this week by the Virginia State Senate that would once again legalize the midwifery-led model of care in Virginia. This is important!



I'm writing to ask you to take some of your very valuable time to post a comment, make a phone call, and/or send an email to your state senate representative and ask him/her to support Senate Bill 463


You can look up your State Senator on this website: http://whosmy.virginiageneralassembly.gov/


It's easy to post public comments on the bill, even if you're not a registered voter in Virginia: https://legiscan.com/VA/comments/SB463/2016


Please consider posting something on your relevant facebook groups asking others to add their comments at the link above and then contact their state legislators, asking them to support SB 463.





There are three common models of care in the United States: 

1) Medical model. A physician (obstetrician) is the primary care provider 

2) Midwifery-led model. A midwife is the primary care provider, consults with physicians when needed

3) Shared model of care. Midwives and physicians provide care but the midwives are managed or directed by the physician(s).


From 2006 to 2012, all three options were available in Virginia. But in 2012, Option 2 was eliminated for women in Virginia. Certified nurse midwives (CNMs) are now required to work under the management or direction of--rather than in cooperation with--a physician. (The rules are different for certified professional midwives, or CPMs, who can practice independently, usually in out-of-hospital settings like homebirths. An explanation of the difference between types of midwives can be found here: http://mana.org/about-midwives/what-is-a-midwife). 



In this video, Rebecca Dekker of Evidence Based Birth summarizes a study comparing the different models of care: "Research has definitively shown that when we randomly assign women to one of these models of care...midwifery-led care results in fewer complications for low-risk women with no increased risk for their infants." Here's the study if you'd like to refer to it when calling your representative: Sandall et al., Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD004667 (full text)


This bill, SB463, would once again legalize the midwifery-led model of care in Virginia by allowing CNMs to form their own practices and their own relationships with physicians. Let your representative know that we--as women, as consumers, as patients, and as voters--want midwifery-led care to be legal.  


Women should at the very least have the option of choosing the type of care that statistically results in the best medical outcomes.



Legislative Chair of the VA. Chapter of the American College of Nurse-Midwives

This bill improves access to care by removing the requirement for a written practice agreement. Aside from prescriptive authority, it returns our practice authority to the status it held between 2006 to 2012, after SB488 (2006) removed the requirement for supervision. In 2012, a new bill grouped nurse-midwives with all nurse practitioners, and we were required to have a written agreement with a physician-led team.


This bill promotes better access to all levels of care for women, so they may have choices in maternity care. Individually, a CNM is guided by the ACNM Standards of Practice, “to demonstrate a safe mechanism for obtaining medical consultation, collaboration, and referral."  CNM's will always call a physician when needed, but we do not need statutory requirements to define that relationship.


For the physicians and CNM’s who work together, the current statutory requirements create unnecessary paperwork and restrictive hospital policies. They also affect access to care, as CNMs may find it difficult to identify physicians willing to enter into agreements, especially in rural areas or with out-of-hospital births.


Folks are free to e-mail [Jessica] (jordancnm@gmail.com) or call [her] at 804-677-5442 if they want to talk about it. The bill will be heard in committee  [January 25-29]

Please lend your voice to the discussion about your health care and your body!



Peggy Caister, for Birth Matters Virginia



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