I am currently a Certified Nurse Midwife in the state of Virginia and I left private practice approximately 13 years ago because of the lack of a midwifery friendly environment in the state of Virginia.  I went to work for the federal government as a Certified Nurse Midwife and was granted credentials as an independent  provider of care.  As such I am able to admit and discharge my patients, prescribe medications,  and  generally work well in a collaborative environment with my physician colleagues . 

After the law was changed and midwifery care was granted the privilege to practice with a collaborative/consultative relationship with physicians; I was contemplating going to one of the underserved area to establish a midwifery practice. 

With the change in law - that is no longer a feasible option for me.  I am asking that you remove this restriction for the nurse midwives in the state of Virginia.  With the safety of midwifery care well established; it keeps the state of Virginia from recruiting well qualified providers that could set up practices in the underserved areas and render quality women's health care to thousands of women. 

Midwives are trained to be independent providers of care and do not need a "physician team leader" in order to render competent, compassionate care to our population.  Collaborative/Consultative environments without all the paperwork - practice agreements - are more conducive to midwifery care.

Karen R. Brayboy, MSN, CNM