Bill
HB 495
North Carolina would require CPMs and CMs to be licensed under a new state framework, creating the North Carolina Council of Midwives to regulate practice, standards, and disciplin
Status & timing
- Introduced: March 24, 2025 (Filed with the House Clerk).
- Committee referral: Referred to Rules (and related House procedures March 25, 2025).
- The bill would add a new Article 10B to Chapter 90 of the General Statutes establishing the Certified Professional Midwives (CPM) licensing framework. The bill sets an implementation milestone: initial Council members must be appointed on or before October 1, 2025, or within three months of the Article becoming law, whichever is later.
Purpose and intent
- To create a statutory licensing and regulatory structure for Certified Professional Midwives (CPMs) and Certified Midwives (CMs) in North Carolina, provide practice definitions, and establish the North Carolina Council of Midwives to oversee licensing, standards, and discipline. The act is captioned the "Accessing Midwives Act."
Key provisions
- New Article 10B (Certified Professional Midwives):
- Definitions: establishes terms used in the Article, including CPM (credentialed by the North American Registry of Midwives, NARM), CM (credentialed by the American Midwifery Certification Board, AMCB), CNM, “midwifery,” “collaboration,” and “consultation.”
- License requirement: makes it unlawful to practice or hold oneself out as a licensed CPM/CM unless currently licensed under the Article.
- Exemptions: the Article does not apply to (among others) CNMs practicing under Article 10A, licensed physicians, physician assistants and nurse practitioners acting under their boards’ rules, registered nurses performing nursing acts, emergency birth assistance, supervised students/assistants, and certain traditional birth attendants serving distinct cultural/religious groups.
- North Carolina Council of Midwives:
- Created as a subcommittee reporting to the Division of Health Service Regulation (DHHS).
- Composition: seven members appointed by the DHHS Secretary — four CPMs (staggered initial terms: 4, 3, 3, 2 years), one licensed physician knowledgeable in midwifery (4 years), one community birth consumer (2 years), and one CNM experienced in community birth (2 years). After initial terms, appointments are for four years; members limited to two consecutive terms.
- Governance: Council may remove members for neglect/incompetence/unprofessional conduct; members receive per diem and travel reimbursement per G.S. 93B‑5; officers elected, first meeting within 45 days of appointment.
- Scope: defines collaboration and consultation with physicians/CNMs and recognizes midwifery as primary maternity/childbearing care, including antepartal, intrapartal, and postpartal care.
- Licensing and discipline processes: the Article establishes the Council’s authority to license and conduct oversight (specific administrative rules, fees, education/competency requirements and disciplinary standards would be developed by the Council and Division).
Who is affected
- Primary: CPMs (NARM-certified) and CMs (AMCB-certified) seeking to practice in North Carolina — they would be subject to new licensing requirements and oversight.
- Other providers: CNMs, physicians, PAs, NPs and RNs (exemptions and collaboration/consultation provisions affect interprofessional relationships).
- Patients/consumers: people seeking community or out‑of‑hospital birth options; the statute establishes regulatory safeguards and a formal pathway for licensed CPM practice.
- State agencies: Department of Health and Human Services / Division of Health Service Regulation (administrative responsibility for Council oversight and licensing processes).
Potential impacts and considerations
- Access: formal licensure may increase integration of CPMs into regulated care pathways and clarify collaboration/consultation expectations.
- Regulation & oversight: creates a state regulatory body with appointment, meeting, discipline and rulemaking responsibilities; DHHS will have workload to appoint the Council and implement licensing processes.
- Administrative costs: initial and ongoing administrative costs for DHHS/Division to establish the Council, promulgate rules, process licenses, and support enforcement (not quantified in the bill text).
- Health system interactions: the statute frames collaboration and consultation but leaves operational details (protocols, referral standards, reimbursement, scope-of-practice specifics) to Council rules and interprofessional arrangements.
Procedural / next steps
- The bill establishes the Council appointment deadline (on or before Oct. 1, 2025 or within three months of enactment). Further details on licensure requirements, fees, and rulemaking will be developed through administrative rules once the Council is constituted.
Compiled from official sources — confirm details with the bill’s official record.
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