Section 1.

Enacts new Article 10B, the “Dr. Jannell Green Smith, DNP, CNM, Maternal Health Accountability Act,” to GS Chapter 90. Contains six findings related to maternal mortality and severe maternal morbidity, with disproportionate impact on Black, Indigenous, rural, and low-income communities and midwifery care. Declares the General Assembly’s intent to establish a comprehensive maternal health accountability framework that promotes safety, transparency, workforce sustainability, informed consent, and equitable access to care while honoring the legacy of Dr. Janell Green Smith, whose leadership advanced patient-centered maternity care and system accountability. Lists six core principles that govern North Carolina’s maternal health system, including accountability and the importance of midwives as maternal health providers. Defines six terms applicable to Article 10B. Requires hospitals providing maternal or emergency obstetric services to comply with six requirements relating to accountability and safe discharge of patients admitted in labor. Instructs hospitals and perinatal health care providers to submit annual reports on the eight specified matters, including maternal mortality, severe maternal morbidity, and types of labor deliveries, to the Department of Health and Human Services (DHHS). Requires that DHHS disaggregate the data by race, ethnicity, payer, geography and provider type, and to make the reports publicly available on its website. Establishes oversight requirements. Directs DHHS to submit an annual report containing the data discussed to the specified NCGA committee by October 1 of each year. Establishes a statewide maternal health reporting and navigation system in DHHS to provide the described assistance to hospital grievance processes under the State’s medical board or DHHS’s Division of Health Service Regulation as well as the listed referrals and trauma-informed and perinatal mental health services. Directs hospitals and perinatal health care providers to participate and collaborate in standardized transfer protocols that prioritize patient safety and continuity of care while preserving professional autonomy. Directs the State to support midwifery education and apprenticeship pathways, scholarships and stipends for perinatal health care providers, and continuing education and workforce development, through new Article 10B. Requires DHHS to provide any available funds to community based organizations to provide the described infrastructure support and the statewide maternal health reporting and navigation system detailed above.  Requires the State to support doulas as described.

Amends GS 58-3-170 so that a health benefit plan that provides coverage for any maternity care provided by a Certified Nurse Midwife licensed under Article 10A of GS Chapter 90 must reimburse at the same rate, subject to the same coverage terms, equivalent services provided by  a perinatal health care provider licensed under Article 10C and subject to Article 10B of GS Chapter 90. Applies to insurance contracts entered into, renewed, or amended on or after October 1, 2026. Tasks DHHS’s Division of Health Benefits to take all necessary actions to ensure parity of reimbursement for Medicaid maternity care services between midwives licensed under Articles 10A and 10C of GS Chapter 90. Effective October 1, 2026.

Section 2.

Enacts new Article 10C, Certified Professional Midwives and Certified 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 10C. 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), and (5) the rendering of childbirth assistance in emergency situations.

Includes definitions applicable to Article 10C. 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 Certified Professional 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, 2026, 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 9 responsibilities of a licensed CPM or CM, 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 10C 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 10C 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 10C. 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.

Section 3.

Effective October 1, 2026, except as otherwise provided.