Nurse-Midwifery in California

Certified Nurse-Midwives (CNMs) have been practicing in California since 1960.  The first CNM practice was established in Madera County in the San Jaquin Valley after a State Department of Health recommendation that nurse-midwives could be valuable additions for prenatal care and could reduce infant mortality.  California's CNMs practice in all settings including private hospitals, public health departments, HMOs, family planning clinics, homebirth practices, and universities.

Since the Nurse-Midwife Practice Act passed in 1974, California's population of CNMs has grown to one of the largest in the county.  Currently, there are more than 1,000 CNMs in the state.  There are 371 nurse-midwifery practice sites in California, according to the ACNM Directory of Nurse-Midwifery Practices.  In 2001, California's CNMs attended the births of 44,552 babies (8.4%), and provided care to nearly 10% of pregnant women in the state. [California DHHS statistics]

There are currently 44 accredited educations programs offering post-baccalaureate certificate and masters degree programs in nurse-midwifery and midwifery.  A number of these programs have distance learning educations options.  Three graduate programs in nurse-midwifery are in California: Charles R. Drew University of Medicine and Science, San Diego State University, and University of California, San Francisco/San Francisco General Hospital.

California Nurse-Midwife Practice and Reimbursement Issues:

• California grants limited prescriptive authority to nurse-midwives
• CNMs have been authorized to get DEA numbers for outpatient (ambulatory care settings) and for intrapartum prescribing
• Third-party reimbursement is mandated for CNMs in California.  They receive Medicaid reimbursement at 100% of physician fee levels

Q:  What is a Certified Nurse-Midwife?

A:  According to the American College of Nurse-Midwives, "a Certified Nurse-Midwife is an individual educated in the two disciplines of nursing and midwifery, who possesses evidence of certification according to the requirements of the American College of Nurse-Midwives."  Certified Nurse-Midwives are Registered Nurses, often with a background in maternity care, who decide to further their education with the intent of independently caring for women and their families.

Q:  What type of education do Certified Nurse-Midwives have?

A:  Certified Nurse-Midwives are graduates of accredited midwifery educational programs.  The midwifery program curriculum prepares them to care for essentially healthy women before, during, and after their pregnancies.  They are also educated  to provide gynecological care for women throughout their life span.  All midwifery programs in California are post-graduate (Masters Degree) programs.  Upon graduation, Certified Nurse-Midwives sit for a national certification exam.  Additionally, they must complete continuing education units in order to maintain their licenses.

[The above information is reported in part by the American College of Nurse-Midwives]