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View NCGA Bill Details2023-2024 Session
Senate Bill 474 (Public) Filed Monday, April 3, 2023
Intro. by Burgin.

Status: Ref To Com On Rules and Operations of the Senate (Senate action) (Apr 4 2023)

Bill History:

S 474

Bill Summaries:

  • Summary date: Apr 3 2023 - View Summary

    Enacts new Article 10B, Certified Professional Midwives, to GS Chapter 90. Prohibits any person from practicing or offering to practice midwifery without a Certified Professional Midwife or Certified Midwife license as provided in new Article 10B. Exempts the following circumstances from the licensure requirement: (1) an individual approved to practice midwifery under Article 10A (Midwifery Practice Act); (2) a physician licensed to practice medicine; (3) the performance of medical acts by a physician assistant or nurse practitioner as specified, (4) the practice of nursing by a registered nurse as allowed under Article 9A (Nursing Practice Act), (5) the rendering of childbirth assistance in emergency situations; (6) individuals present or assisting the certified professional midwife during the birth process as specified; and (7) traditional birth attendants practicing with families in distinct cultural or religious traditions that include their attendance, as described.

    Sets forth legislative findings and includes definitions applicable to Article 10B. Defines certified midwife (CM) as a person who has obtained national certification from the American Midwifery Certification Board (AMCB), and a certified professional midwife (CPM) as a person with national certification from the North American Registry of Midwives (NARM). Defines midwifery as the provision of primary health or maternity care to childbearing people and infants.

    Creates a seven-member North Carolina Council of Midwives (Council), with members appointed by the Secretary of Health and Human Services (Secretary; DHHS). Provides for initial members to be appointed on or before October 1, 2023, or within three months of the Article becoming law, whichever is later. Details Council member requirements and term limits and includes provisions for compensation, meeting procedures, and Council administration. Directs the Council to adopt rules within one year of the initial meeting to implement the Article. Enumerates 12 powers and duties of the Council, in consultation with the Division of Health Service Regulation (DHSR) of DHHS and with guidance from the National Association of Certified Professional Midwives Standards of Practice, including rulemaking, licensing, and disciplinary authority. 

    Lists five requirements for licensure as a midwife, including completion of an application and payment of required fees, and completion of all required educational and clinical training and earning the national midwifery certification credential awarding by an accredited midwifery certification agency.

    Lists 10 responsibilities of a licensed CPM, including the responsibility to provide care for the healthy client who is expected to have a normal pregnancy, labor, birth, and postpartal phase in the setting their choice; the responsibility to order routine antepartal or postpartal screening or lab analysis at a licensed lab or testing facility; and the responsibility to instruct the parents about newborn screening requirements. Directs a midwife licensed under Article 10B to display the license at all times in a conspicuous place where the midwife is practicing. Sets forth provisions for biennial license renewal, periods of lapsed licensure, and granting inactive status. Authorizes the Council to grant a license to a person residing in North Carolina licensed, certified, or registered to practice as a certified professional midwife in another jurisdiction if that jurisdiction's standards are substantially equivalent and the person submits an application and required fees. Directs the Council to establish a formulary of drugs and devices appropriate to midwifery care from which licensed midwifes are limited to dispensing from, subject to applicable state and federal laws and recordkeeping requirements. Directs the Council to set all fees under Article 10B and to pay all expenditures out of funds from the fees or other funds. Allows the Council to discipline applicants or licensees, after a hearing, under seven specified circumstances.

    Authorizes the Council to apply to superior court to enjoin violations of Article 10B. Provides that no health care provider will be liable for an injury to a woman or infant arising during childbirth and resulting from an act or omission by a licensed certified professional midwife.

    Effective October 1, 2023.