These rules will increase the regulatory burdens on certified nurse midwives, increase cost of care, and decrease access to care while providing no benefit to the public. 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. Virginia CNMs have been safely practicing for the last six years without supervision by other professions. With the new law and these regulations we are under a team leader physician, which is not collaborative practice. This leads to limitations in practice, difficulty in opening midwifery-owned and midwifery-run practices and restricts hospital admitting privileges. All the national Advanced Practice Nursing Organizations oppose practice agreements and promote independent practice. As a woman who has benefited from midwifery care in VA I personally wouldn't have it any other way. Also, as an aspiring midwife it saddens me to see all of the regulations that are being put on midwives who do the same thing if not more than OB's to care for women. We need to protect midwives and the patients right to choose with whom and where they deliver as well.