I am a 16-year resident of Richmond, VA, and currently a graduate student at Thomas Jefferson University in their Master of Science - Midwifery program. I will finish my program in two years and be qualified to seek certification through AMCB as a midwife. My hope is to continue living and working in Virginia as a Certified Midwife, serving the same community where I live and my children go to school. I hope that these regulations can be passed expeditiously so that more midwives can help provide access to quality care to women throughout their reproductive health lifespan. 

Increasing the number of midwives in the healthcare workforce in Virginia is crucial for meeting the demand for maternity care, improving maternal and newborn outcomes, addressing disparities, promoting woman-centered care, reducing healthcare costs, and ensuring access to care in underserved areas. It requires strategic investments in midwifery education, training programs, and supportive policies to foster the growth and integration of midwives within the healthcare system.

My name is Maryann Long. I am a certified nurse-midwife (CNM), now retired after 35+ years of work as a midwifery clinician and educator. I am still an active participant on the Accreditation Commission for Midwifery Education (ACME), which is the body that accredits education programs for CNMs and Certified Midwives (CMs) in the United States.

I am writing to strongly support the promulgation of regulations governing the practice of Certified Midwives in Virginia. We must increase the number of midwives in the healthcare workforce to meet the demand for maternity care. Midwifery care results in better maternal and newborn outcomes, while reducing healthcare costs. In addition, in Virginia there are many rural areas where there are no maternity care providers at all, a shocking source of inequity that must not be ignored. 

Recognizing the CM credential, as Virginia has wisely chosen to do, is a means of increasing our maternity care workforce without imposing the barrier of requiring nursing education as a prerequisite. When I review a program as an ACME site visitor, I verify that every CM graduate demonstrates the very same knowledge and competencies as every CNM who completes an ACME-accredited midwifery education program. Now we in Virginia must make it possible for CMs to practice to the full scope of their education by generating the regulations that will enable them to do so. Our Virginia families and communities will thus be far better served.

Thank you.

I am the former and first Executive Director of the Accreditation Commission for Midwifery Education (ACME) and I am writing to express my support for licensure and regulation as proposed for licensed, certified midwives (CMs) in Virginia.

The Accreditation Commission for Midwifery Education is an agency established to advance and promote excellence in midwifery education. The aim of ACME is to ensure that programs are performing at the highest level of quality and providing learning experiences that will lead to optimal outcomes for midwifery students. ACME is a reliable authority regarding midwifery education. Since 1982, ACME has been recognized by the U.S. Department of Education (USED) as a nationally recognized programmatic accrediting agency for nurse-midwifery and midwifery education programs. In May 2018, ACME was awarded the maximum five-year recognition for remaining in full compliance with the USED requirements. 

The goal of accreditation is to ensure that institutions of higher education meet acceptable levels of quality.  ACME creates and develops rigorous standards for the CM and the CNM educational programs in the US to ensure high-quality education for midwives. There is no difference in the accreditation standards for these credentialed professional maternal healthcare provider's education. In addition, both credentials take the same certification exam offered by the American Midwifery Certification Board (AMCB). The American Midwifery Certification Board (AMCB) is the national certifying body for candidates in nurse-midwifery and midwifery who have received their graduate-level education in programs accredited by the Accreditation Commission for Midwifery Education (ACME). 

In Virginia in 2021, 79.3% of infants were born to women receiving adequate/adequate plus prenatal care. More than 2.2 million women live in maternal healthcare deserts in our country. This is unacceptable in particular for a country that spends the most money on maternal healthcare and has dismal outcomes with high maternal mortality rates. 

Maternity care deserts are counties where access to maternity health care services is limited or absent, either through lack of services or barriers to a woman's ability to access that care within counties. A maternity care desert is any county in the United States without a hospital or birth center offering obstetric care and without any obstetric providers.

It is imperative to Virginians that we expand the number of maternal healthcare providers to ensure that pregnant people have access to high-quality, evidence-based maternal healthcare. Midwives play a vital role in promoting positive maternal and newborn health outcomes.

Licensed certified midwives (CMs) provide comprehensive, evidence-based care throughout the childbirth continuum, sexual and reproductive health, gynecologic and primary care throughout the lifespan focusing on preventive measures, health promotion, and personalized care. Exactly the same as the Certified Nurse Midwife (CNM). 

Licensed certified midwives are equipped with the same advanced practice midwifery skill-set and certification as Certified Nurse-Midwives who have successfully been licensed in the state for many years. Licensure of certified midwives is crucial to strengthening the healthcare workforce by diversifying and increasing the range of available healthcare practitioners. By recognizing the “CM credential”, we ensure that Virginians have access to a range of healthcare options that align with their preferences and values, promoting patient-centered care. 

I support the regulations as proposed for licensed, certified midwives (CMs) in Virginia.

I have been practicing as a CNM at the University of Virginia since 2013.  I'm writing in support of the approval of strongly support the Regulations Governing the Practice of Licensed Certified Midwives in Virginia. Virginia would benefit tremendously from the further integration of midwives into our maternal-child healthcare system. Increasing the number of midwives in the healthcare workforce is crucial for meeting the demand for maternity care, improving maternal and newborn outcomes, addressing disparities, promoting individualized care, reducing healthcare costs, and ensuring access to care in underserved areas. It requires strategic investments in midwifery education, training programs, and supportive policies to foster the growth and integration of midwives within the healthcare system. The approval of these regulations would allow existing practices in Virginia to hire more qualified midwives, which we desperately need. 

My name is Sarah Allen-Short, and I am a Virginia resident and former doula who has benefitted from midwifery care. 

I am writing to strongly support Regulations Governing the Practice of Licensed Certified Midwives in Virginia. 

I am in favor of regulations allowing certified midwives to practice in VA for the following reasons: 

Meeting the growing demand for maternity care: The demand for maternity care services is increasing due to factors such as population growth, aging populations, and improved access to healthcare. Midwives play a crucial role in providing comprehensive and personalized care to pregnant women, facilitating normal childbirth, and promoting maternal and newborn health. Increasing the number of midwives can help meet the rising demand for maternity care services and ensure access to quality care for all women.

Improving maternal and newborn outcomes: Midwifery care has been associated with positive maternal and newborn outcomes. Studies have shown that midwife-led care is associated with lower rates of interventions, such as cesarean sections, episiotomies, and inductions, while maintaining excellent safety and quality outcomes. By expanding the midwifery workforce, more women can benefit from midwifery-led care, leading to improved health outcomes for both mothers and babies.

Addressing disparities in maternal health: Disparities in maternal health outcomes, particularly among marginalized and underserved populations, are a significant concern. Midwives are well positioned to address these disparities by providing culturally sensitive and equitable care. Increasing the number of midwives, particularly in areas with limited access to maternity care, can help ensure that all women, regardless of their background or socioeconomic status, receive comprehensive and respectful care throughout the childbirth continuum.

Promoting holistic and woman-centered care: Midwifery care is characterized by a holistic and woman-centered approach that emphasizes personalized care, shared decision-making, and continuity of care. Midwives focus on the physical, emotional, and social well-being of women, providing comprehensive care that extends beyond pregnancy and childbirth. The presence of more midwives in the workforce allows for greater availability of this model of care, empowering women to actively participate in their healthcare decisions and promoting a positive childbirth experience.

Reducing healthcare costs: Midwifery care has been associated with cost savings in healthcare systems. By providing care that is based on evidence, promoting normal physiological processes, and reducing unnecessary interventions, midwives can help lower healthcare costs associated with childbirth. Increased investment in midwifery services can contribute to cost-effective care models while maintaining high-quality outcomes.

Filling healthcare provider gaps in underserved areas: Many regions, particularly rural and remote areas, experience shortages of healthcare providers, including obstetricians and other maternity care specialists. Midwives can help fill these provider gaps by providing primary maternity care in these underserved areas. By expanding the midwifery workforce, access to maternity care services can be improved in these areas, reducing disparities and ensuring that women have access to essential care closer to their communities.

Thank you,

Sarah Allen-Short

My name is Kelly Sicoli, CNM, and I have been a practicing Certified Nurse-Midwife for the past 12 years in the community setting. I am writing to strongly support Regulations Governing the Practice of Licensed Certified Midwives in Virginia. 
Increasing the number of midwives in the healthcare workforce is crucial for meeting the demand for maternity care, improving maternal and newborn outcomes, addressing disparities, promoting woman-centered care, reducing healthcare costs, and ensuring access to care in underserved areas. It requires strategic investments in midwifery education, training programs, and supportive policies to foster the growth and integration of midwives within the healthcare system.

Promoting holistic and woman-centered care: Midwifery care is characterized by a holistic and woman-centered approach that emphasizes personalized care, shared decision-making, and continuity of care. Midwives focus on the physical, emotional, and social well-being of women, providing comprehensive care that extends beyond pregnancy and childbirth. The presence of more midwives in the workforce allows for greater availability of this model of care, empowering women to actively participate in their healthcare decisions and promoting a positive childbirth experience.

My name is Christina Owens and I have been a practicing Certified Professional Midwife at EVa Homebirth, LLC for the last 10 years and have served as a Community Midwife in many of Virginia's healthcare deserts over the years. I am writing to strongly support Regulations Governing the Practice of Licensed Certified Midwives in Virginia. 

Increasing the number of midwives in the healthcare workforce is crucial for meeting the demand for maternity care, improving maternal and newborn outcomes, addressing disparities, promoting woman-centered care, reducing healthcare costs, and ensuring access to care in underserved areas. WE NEED MORE MIDWIVES NOW MORE THAN EVER! It requires strategic investments in midwifery education, training programs, and supportive policies to foster the growth and integration of midwives within the healthcare system. The recent pandemic has brought more light to growing need of midwives in our health systems and communities!

I support these regulations as written!

I support these regulations as written.  Thank you for expanding access to midwifery care for the families of Virginia.  

I submit this comment in support of the Virginia Certified Midwife regulations. Virginia is setting a precedent by joining the growing list of states that recognize and license Certified Midwives. The U.S. has a major shortage of maternity care providers with nearly half of all U.S counties not having a single practicing obstetric provider (OBGYN, midwife, or Family medicine). Pregnant people in urban centers and rural areas have limited access to perinatal care and poor pregnancy outcomes continue to affect our communities. Increased access to highly trained Certified Midwives will help to bridge the care gap and is a big step in the right direction to show Virginia cares about pregnant people, maternal health, and the well-being of newborns. I support the regulations and look forward to partnering and collaborating with Certified Midwife colleagues in the near future. 

I support these regulations as written.

Midwifery care has been shown to improve outcomes and the birth experience for moms and babies. It is far past time to enact these regulations as written and begin issuing licenses. Further delays would hurt moms and babies by limiting their options and putting pressure on an overburdened maternity care system. 

I support these regulations as written. 

As a Virginian, a mother, a midwifery client and an advocate for personal autonomy, I encourage the state to pass the regulations as written. Midwifery training is a thorough, rigorous and well established credentialing pathway. Virginia women deserve to reap the benefits of all midwifery has to offer. In order for us to have access to midwives, those who would be midwives must be able to A) access the training programs required and B) use that credential once it has been earned. The professional, dedicated people who have worked so hard to establish the CM credential are making midwifery training better than ever. Now it's the job of the state to open the legal door to all midwifery has to offer us. Pass the regulation for a healthy, strong, self sufficient Virginia. 

I support the Virginia midwives. 

As a Certified Nurse-Midwife (CNM) with 20 years experience and the Director of Midwifery of a hospital-based midwifery practice in Salem, Virginia, I want to voice my support for the passage of the Regulations Governing the Practice of Licensed Certified Midwives in Virginia. The passage of the Certified Midwife (CM) regulations is a critical step forward to help increase access to qualified maternity care providers for Virginians. The need is great, especially in rural parts of the state. The graduate-level education CMs undertake and the board certification process they complete is identical to that which CNMs complete. CMs are well-prepared to stand with their midwifery and obstetrician colleagues, to care for some of the most vulnerable citizens in our state. Passage of these regulations will increase access to midwifery care and help to elevate maternal and newborn health outcomes in Virginia.

I have 5 children and after a traumatic experience in the hospital with my 1st, I opted for midwife care. I have never in my life felt more cared for, more respect, more informed then I do when working with midwives. We need them and everyone should have access to them and their skills.

As a Health Science Researcher, Lactation Consultant, and Childbirth educator working with parents in Virginia for over 20 years, I want to voice my support for passing the Regulations Governing the Practice of Licensed Certified Midwives in Virginia. The passage of the Certified Midwife (CM) regulations is a critical step forward to help increase access to qualified maternity care providers for Virginians. The need is significant in all parts of the state. The graduate-level education CMs receive and the board certification process they complete is identical to Certified Nurse Midwives complete. CMs are well-prepared to stand with their midwifery and OBGYN colleagues to care for vulnerable families in our state. The passage of these regulations will increase access to midwifery care and help elevate maternal and newborn health outcomes in Virginia. Let Virginians lead the effort to improve maternal/child health to bring the nation next on the list as the safest developed countries for maternity care.

These regulations are an example for the nation for the importance of licensing Certified Midwives to the full-scope of practice consistent with education and certification as Advanced Practice Midwives. Thrilled for VA to finally be moving forward with licensure 2 YEARS after the law was passed. Approve these regs, as written by CM and CNMs in partnership with the VDHP based on the law passed by the GA and approved by the Boards of Nursing and Medicine. 

I am a licensed midwife in Virginia, and I support these guidelines as written.  I believe we should have many choices of safe midwifery care in all settings.

I support this regulation as written. Virginia needs midwives 

I am writing to strongly support Regulations Governing the Practice of Licensed Certified Midwives in Virginia. 
Increasing the number of midwives in the healthcare workforce is crucial for meeting the demand for maternity care, improving maternal and newborn outcomes, addressing disparities, promoting woman-centered care, reducing healthcare costs, and ensuring access to care in underserved areas. It requires strategic investments in midwifery education, training programs, and supportive policies to foster the growth and integration of midwives within the healthcare system.

I strongly support the development and completion of the regulations for CPMs to carry the basic emergency medications for pregnancy and delivery in out of hospital settings.  CPMs are trained on these medications, the lack of which heavily influences hospital transfer.  This results in higher costs, delays in treatment and dissatisfaction on the part of the delivering families and healthcare providers at the receiving hospitals. Having the ability to start treatments for postpartum hemorrhage will improve the safety of out of hospital birth for Virginia's families without any detriment to in-hospital care or services.  

Thank you for your support of the women and families of Virginia - 

Erin M. Baird, DNP, MBA, MS, CNM

Executive Medical Director of Women’s & Children’s Services
Centra Medical Group Women’s Center
2007 Graves Mill Road, Forest, VA 24551
P 434.384.8948     M 434.420.0472

I support the passage of the regulations for CM practice.  These regulations are consistent with the national movement to increase access to midwives that are licensed to practice full-scope midwifery. Specifically, the House of Representatives reintroduced the Midwives for Maximizing Optimal Maternity Services Act (Midwives for MOMS) in the 118th session of Congress. This legislation is a bipartisan effort to increase access to maternal health care whose lack thereof disproportionately affects minority and indigenous populations. This Virginia CM regulation legislation will improve access to midwifery care by meeting the demand for more midwives that our federal legislation will create. 

Sincerely 

Juliana Fehr, CNM, PhD, VACNM, Professor Emeritus Shenandoah University, Winchester, VA.

I am the Community Engagement Coordinator for the National Black Midwives Alliance, and we are writing to express our support for licensure and regulation as proposed for licensed certified midwives in the state of Virginia. Midwives play a vital role in promoting positive maternal and newborn health outcomes. Licensed certified midwives provide comprehensive, evidenced-based care throughout the childbirth continuum, sexual and reproductive health, gynecologic and primary care throughout the lifespan focusing on preventive measures, health promotion, and personalized care. 

Licensed certified midwives are equipped with the same advanced practice midwifery skill-set and certification as Certified Nurse-Midwives who have successfully been licensed in the state for many years. Licensure of certified midwives is crucial to strengthening the healthcare workforce by diversifying and increasing the range of available healthcare practitioners. By recognizing the “CM credential”, we ensure that Virginians have access to a range of healthcare options that align with their preferences and values, promoting patient-centered care. 

Increasing access to Midwifery care in Virginia is an essential element to improving maternal outcomes in our state. I am mother of three young children, the last of whom was born at home under the care of a CPM. That pregnancy and birth experience was the best care I received, by far, out of my three pregnancies and births. The care I received was evidence based, individualized, compassionate, professional, and contributed to an incredible birth experience and smooth postpartum. 

I can’t not understate how important access to this kind of care is for the low risk pregnant families in our state. Midwifery care provides access to health care where there may not otherwise be good options, it provides a trauma informed, compassionate care option to those who need it, and it provides a model of care that approaches Birth as a process to be respected, not just managed. This is vital for the health and success of Virginia families, women, and birthing parents.

I will add that in order to perform their jobs the way they need and want to, and in order to keep their clients safe, midwives need the ability to provide clients with lifesaving drugs like pitocin and antibiotics, and they need a medical system that is available to them when collaborative care or hospital transfers are necessary.

 Thank you.

I am the mother of one (and another due any day now) and the manager of a pelvic health physical therapy clinic. 

I switched from an OB practice to a homebirth practice with Certified Nurse Midwives at 20 weeks gestation with my first and had a phenomenal care and birth experience. The focus on empathetic, unhurried, evidence-based care left me feeling so empowered and peaceful about my birth and perinatal care. I never felt nervous or fearful. 

As someone who works with women every single day through the pelvic health physical therapy clinic, I can unfortunately say that my experience was anomalous. I can ALSO say that those women who receive care from certified midwives have had much better outcomes than the majority. We regularly work with midwives for our patients anywhere from 14-100. They are so necessary for facilitating optimal women's health and I greatly support them. 

Yes, I support the proposed regulations for certified midwives. 

I support these regulations 

I support midwives 

Certified midwives have the potential to greatly increase access to perinatal care. This program decreases barriers to practice while upholding the same standards of practice that are already in place for CNMs. Please move forward with enacting these regulations so that the current and future CMs - of which many already reside in Virginia - can start practicing. 

As a mom of three, doula, aspiring midwife and Coast Guard veteran, I have seen time and again how midwifery care provides excellent options and outcomes for pregnant and birthing families. Approving the certified midwife regulations will allow additional midwives in Virginia to practice to the full scope of their education, training and certification. This can only benefit Virginia and Virginia families. 

I highly support midwives. They genuinely care for women and families.

Midwives provide high-quality family-centered care. 

Midwives go above and beyond caring for women's health. They focused on evidence based practices. 

The world health Organization did enough research to prove the efficacy of the midwives work around the word getting a great impact on good outcomes related to maternal-child mortality. The USA needs more midwives to improve outcomes. We, lovers need midwives!

Thanks for this opportunity.  I have been a practicing Licensed Midwife in Central Virginia since 2005.  The need for more midwives practicing in the Commonwealth has been overwhelmingly stated.  Families want and deserve midwifery care in all its many forms.  Those of us working struggle to keep up.  After two years of waiting, it is beyond time for these midwives to offer their skills and expertise to our communities.  The evidence is clear!  Families are waiting!  I (and many others) support the regulations governing the practice of Certified Midwives in Virginia as written.  Looking forward to joining forces on behalf of the families of our area!

Most sincerely,

Leslie M. Payne, CPM

Traditional Midwifery of Lynchburg, LLC

Trillium House LLC

Lynchburg, VA

I have been a Virginia Licensed Midwife (CPM/LM) since 2009 and have served as the former Chair of the Midwifery Advisory Board to the Virginia Board of Medicine. I am currently the Chair of the North American Registry of Midwives Board of Directors. I regularly work with midwives nationwide to support the licensure of midwives as autonomous maternity care providers. The United States has the worst maternal and newborn outcomes in the developed world. Despite spending more on maternity care than any other country, the United States is the only high-income country with rising maternal mortality rates. The solution to our maternal mortality crisis is not money or technology. The solution is midwives. Outcomes are best in countries where midwifery care is the norm. To reduce the shockingly high maternal mortality rate in the United States, we must remove structural barriers to midwifery care, increase access to midwives for all childbearing people, and strive toward a more integrated system of care where midwives of all credentials are empowered to provide the high-quality maternity care that is within their training and scope of practice. As a Licensed Midwife and a national midwifery leader, I have seen the positive impact midwifery licensure and regulation of autonomous midwifery practice have had on consumer access to midwifery. I fully support Certified Midwives and the passage of these regulations that encourage the safe and legal practice of midwifery in Virginia.

I am a Certified Nurse Midwife serving women and families in my own community.  We need more midwives in Virginia, such that all women have access to a midwife for obstetric and gynecologic care.  The Certified Midwife credential helps fill this need.  A midwife for all women will go a long way to reduce perinatal health disparities in The Commonwealth. 

I support the regulations for Certified Midwives in Virginia. 

We know that midwifery care improves outcomes for both women and babies. We also know that there are not enough midwives in our state. Creating more pathways for people to become midwives and serve the perinatal population in our state will lead to better health outcomes and care at a faster rate than we are currently experiencing. I wholeheartedly support the licensure and credentialing of CMs. 

I support the regulations to provide a pathway for Certified Midwives in Virginia. Having Certified Midwives would help increase access to care for birthing people in Virginia while meeting the same standards that Certified Nurse Midwives must meet. It's a win-win for Virginia. 

I support the regulations for certified midwives