Nurse midwives and licensed midwives provide similar services:

• Prenatal care
• Attending childbirth
• Postpartum care
• Newborn care
• Physical examinations
• Initial and ongoing comprehensive assessment, diagnosis, and treatment of conditions
• Referrals to physicians
• Administration of medications (limited for Licensed Midwives)
• Ordering and interpreting laboratory and diagnostic tests
• Perform procedures such as episiotomies, repair of lacerations, and amniotomies
• Use of medical devices
• Health promotion, disease prevention, and individualized wellness education and counseling

In addition, nurse midwives can:

• Prescribe medications, including controlled substances
• Order the use of medical devices
• Provide family planning services, including prescribing oral contraceptives and inserting IUDs
• Perform first-trimester abortion by medication and aspiration

Settings of care

Nurse midwives primarily practice in hospitals, but they also can practice in birth centers, offices, and homes.

Licensed midwives primarily practice in homes and birth centers, but also can practice in hospitals and offices.

Physician and organization oversight

Licensed Midwives in California have been allowed to practice without physician supervision since 2013, although some practice in collaboration with physicians and other health care professionals. LMs are authorized to care for normal pregnancies and births, and to provide prenatal, intrapartum, and postpartum care, including immediate care of the newborn. LMs must report their birth outcomes annually to the Medical Board.

Nurse Midwives in California have been allowed to practice without physician supervision since January, 2021. Nurse midwives may practice independently for low-risk pregnancies and births, prenatal, intrapartum, and postpartum care, family planning care, and immediate care of the newborn. They also may care for patients who have higher risks if they have formal written collaboration and procedures with a physician. Nurse midwives who practice in out-of-hospital settings must report data on their birth outcomes.

In 2011, the American College of Obstetricians and Gynecologists and the American College of Nurse-Midwives released a joint statement advocating for a health care system in which obstetrician/gynecologists (ob/gyns) and nurse-midwives collaborate to optimize women’s health care. The statement recognizes that nurse-midwives are “experts in their respective fields of practice and are educated, trained, and licensed independent clinicians.”