Please remove Certified Nurse Midwives from this regulation.  Certified Nurse Midwives have practiced independently without direct physician oversight everywhere for many years, including in Virginia.    There is good scientific evidence supporting the safety of independent Certified Nurse-Midwife care.  By requiring direct physician oversight of their practices, many Virginia CNMs would be unable to practice, and this would restrict access for Virginia mothers to the care provider of their choice.  In this way, this regulation would restrict Virginia mothers' reproductive choice.  Furthermore, this requirement would unecessarily burden the ability of CNMs to practice their profession without any increase in public safety.  Reducing access to trained and qualified birth attendants for Virginia mothers actually decreases public safety overall.