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HB 838

Health Occupations - Licensed Direct-Entry Midwives - Revisions

2025 Regular Session Introduced by Tiffany Alston and 17 co-sponsors

Maryland expands licensed direct-entry midwife authority and regulations to increase access to out-of-hospital birth services while establishing clearer professional standards and oversight.

Approved by the Governor - Chapter 645
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Bill Summary · HB 838

Legislative bill overview

HB 838 revises Maryland's regulations for licensed direct-entry midwives (LDEMs), expanding their scope of practice and professional standing within the state's healthcare system. The bill modifies licensure requirements, practice protocols, and oversight mechanisms for midwives who attend out-of-hospital births. These changes aim to increase access to midwifery services while establishing clearer regulatory frameworks.

Why is this important

Direct-entry midwifery represents an alternative birth model that many families seek, particularly in underserved rural and low-income communities where obstetric services are limited. Clarifying and potentially expanding LDEM authority could improve maternal healthcare access and choice, though it also raises questions about safety standards and coordination with traditional medical oversight. This is significant because Maryland's approach may influence other states' midwifery regulations.

Potential points of contention

  • Scope of practice expansion: Determining which medical interventions LDEMs can independently perform versus situations requiring physician referral or transfer of care
  • Safety and liability standards: Balancing professional autonomy with requirements for emergency protocols, informed consent documentation, and malpractice accountability
  • Insurance and payment mechanisms: Clarifying whether expanded practice authority includes increased insurance coverage or reimbursement rates, affecting accessibility and provider sustainability

Compiled from official sources — confirm details with the bill’s official record.

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