Regulation of Certified Nurse‐Midwife Scope of Practice: Change in the Professional Practice Index, 2000 to 2015

Abstract

The CNMPPI can be used to document changes in practice authority of CNMs. The increase in state CNMPPI scores and decrease in variance across states can be interpreted as indicating growth of professional authority and increasing consensus regarding the CNM role. The scoring system needs to be updated to reflect the current health systems environment and to include certified midwives and other midwives meeting the International Confederation of Midwives definition of a midwife. Applications of the CNMPPI to future research are discussed.

Nature and scope of certified nurse‐midwifery practice: A workforce study

“…Since 2000, the professional practice environment of CNMs in the U.S.A has been regularly examined regarding legal status, reimbursement and prescriptive authority. Texas scores increased 21.3% from 2000–2015 with smallest gains made in legal status and prescriptive authority; greatest increase was in reimbursement (Beal et al., ) demonstrating but modest improvement in midwifery practice autonomy.…”

“…greatest increase was in reimbursement (Beal et al, 2015) demonstrating but modest improvement in midwifery practice autonomy.…”

“…The purpose of this research was to provide workforce data relevant to certified nurse‐midwives (CNMs) practicing in Texas—the largest conterminous state in the U.S.A with the second largest population, as well as to serve as a model for a national survey. Examination of the CNM workforce in Texas was particularly relevant as the state has been ranked in the lower 25% of U.S. states for scope of nurse‐midwifery practice (Beal, Batzli, & Hoyt, ), has large underserved rural areas and is known to have large areas with no nurse‐midwifery services ([ACNM] American College of Nurse Midwives, , [ACNM] American College of Nurse Midwives, ). Not unlike global trends, the U.S.A is experiencing a shortage in maternal health services (Ollove, ) with close to half of U.S. counties lacking a single obstetrician/gynaecologist and 56% without a single nurse‐midwife ([ACNM] American College of Nurse Midwives, , [ACNM] American College of Nurse Midwives, ).…”

“…To improve midwifery service access and coverage, midwives with skill in affecting legislation are urgently needed to influence health policy changes. HASTINGS-TOLSMA ET AL. | 4001 of nurse-midwifery practice (Beal, Batzli, & Hoyt, 2015), has large underserved rural areas and is known to have large areas with no nurse-midwifery services ( [ACNM] American College of Nurse Midwives, 2016a, [ACNM] American College of Nurse Midwives, 2016b). Not unlike global trends, the U.S.A is experiencing a shortage in maternal health services (Ollove, 2016) with close to half of U.S. counties lacking a single obstetrician/gynaecologist and 56% without a single nurse-midwife ( [ACNM] American College of Nurse Midwives, 2016a, [ACNM] American College of Nurse Midwives, 2016b).…”

Relationship Between Hospital‐Level Percentage of Midwife‐Attended Births and Obstetric Procedure Utilization

“…For example, previous research has found that autonomous practice for CNMs is associated with a greater supply of CNMs, and with a greater likelihood of births being attended by midwives . An examination of the nurse‐midwifery environment across all states in 2015 found that New York CNMs were second out of the 50 states and the District of Columbia in professional authority . Other states may consider whether their regulatory environments may influence access to and value derived from midwifery care.…”