Regulation of Prescriptive Authority for Certified Nurse-Midwives and Certified Midwives: A National Overview

Introduction: Certified nurse-midwives (CNMs) and certified midwives (CMs) provide primary care to women across the lifespan. Yet these primary care providers face barriers to practice that include restrictive state laws and regulations regarding prescriptive authority. The purpose of this review is to critically examine and report the regulatory requirements relative to prescriptive authority for CNMs/CMs in the United States. Methods: State statutes and rules relative to midwifery practice were reviewed for all 50 United States and the District of Columbia. Results: CNMs have been granted the authority to write prescriptions in all 50 United States and the District of Columbia, while CMs have been granted prescriptive authority only in the state of New York. Prescriptive authority for CNMs and CMs is regulated by individual state agencies and regulatory boards. Regulations regarding prescriptive authority for CNMs and CMs vary widely from state to state and are described, with a summary for each state presented. Discussion: While CNMs are granted fully independent prescriptive authority in some states, the regulatory requirements relative to prescriptive authority for CNMs/CMs limit patients' access to necessary services in most states. J MidwiferyWomens Health 2011;56:543-556 (C) 2011 by the American College of Nurse-Midwives.