Fact Sheet — Licensed Midwife Board

Creating a California Licensed Midwife Board  - Fact Sheet

CALM's legislative proposal transfers administrative authority of the existing Licensed Midwife Program and Licensed Midwife fund from the Medical Board of California to the California Board of Licensed Midwives. In 2022 the MBC agreed that the Licensed Midwife Program be transferred to a California Board of Licensed Midwives and went to the California legislature to ask for such legislation. AB 1767 Boerner Horvath - Midwifery was introduced February 2, 2022.

In its 2020 Sunset Review Oversight Report, the Medical Board of California (MBC) recommended the formation of a Licensed Midwife Board. The recommendation is endorsed by the California Association of Licensed Midwives (CALM), the professional association for midwives providing community-based maternity care in California, along with grassroots advocacy groups California Families for Access to Midwives (CFAM) and Californians for the Advancement of Midwifery (CAM), which together represent over tens of thousands of citizens across the state.

When California’s Licensed Midwife practice act was passed in 1993 it placed regulation of the profession under the Medical Board of California. Today, Licensed Midwives remain the only healthcare profession that is regulated by physicians and not by members of their own profession or by members of the public who use their services.

CALM, CFAM and CAM and other organizations have long advocated for a Licensed Midwife Board in California for a number of reasons, including:

  • California is one of only four states that continue to regulate midwives under the board of medicine. Other states have recognized the conflicts of interest and potential for regulatory capture inherent in this model, which creates unnecessary barriers to access and threatens public health and safety.

 

  • An analysis of agency budget reports and projected revenue from fees, as well as the Licensed Midwife’ Fund’s existing reserves clearly shows that transitioning the existing licensed midwifery program to a licensed midwife board is budget neutral, with the board well positioned to operate far more efficiently and cost-effectively than it would if it remains under the jurisdiction of the Medical Board

 

  • A Licensed Midwife Board comprised of members who are educated, trained, and highly skilled and experienced in the provision of community-based midwifery care is necessary to protect the public from inappropriate or unsafe care when it does not meet professional standards of practice.

 

  • The regulation of Licensed Midwives by physicians under the Medical Board creates an inherent conflict of interest that has needlessly obstructed the regulatory process, resulting in a regulatory stalemate that has remained unresolved for over seven years.

 

  • Midwifery is a long-established profession that is unique and distinct from obstetrics, nursing, and medicine. Despite this history, under the current regulatory structure licensed midwives are managed and disciplined as though their profession is a lesser subspecialty of obstetrics and nursing.

 

  • The medical profession’s control of midwifery through the current regulatory structure, as well as its on-going efforts to impose physician-permission requirements to limit access to midwifery care, are deeply rooted in paternalistic attitudes about the professionalism of midwives and the decision-making capacity of the women who seek their care.

 

  • Licensed Midwives are the only health care professionals in California that do not have their own board.

 

  • By limiting its regulatory and disciplinary functions to the management of a small profession with an established fund that includes cost-recovery capacity, a Licensed Midwife Board will be free from the inflated costs and inefficiencies that have contributed to the Medical Board’s insolvency.

 

  • A Licensed Midwife Board is necessary in order to achieve cost efficiencies by ensuring that the Licensed Midwife Fund is dedicated solely to the regulation, discipline, and professional development of Licensed Midwives and not to regulatory or disciplinary programs for other licensees.

 

What is a Licensed Midwife?

Licensed Midwives undergo specialized clinical training to qualify as experts in community-based maternity care provided in private homes and freestanding birth centers. Since the start of the COVID19 pandemic, demand for licensed midwife services has nearly doubled, freeing up critical health-care personnel and resources in hospitals throughout the state.

There are 500 plus Licensed Midwives in California, serving approximately 6,000 families each year.

What is the difference between a Licensed Midwife and a Nurse-Midwife?

Licensed Midwives and Nurse-Midwives represent two separate professions with distinct but complementary training and skills. While Licensed Midwives are trained to provide maternity care in out-of-hospital settings, Nurse-Midwives are trained to provide hospital-based maternity care.

Nurse-Midwives are regulated by the California Board of Registered Nursing.