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## § 54.1-2957.04 – Licensure as a licensed certified midwife; practice as a licensed certified midwife; independent practice as a licensed certified midwife; use of title; required disclosures

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A. It shall be unlawful for any person to practice or to hold himself out as practicing as a licensed certified midwife or use in connection with his name the words “Licensed Certified Midwife” unless he holds a license as such issued jointly by the Boards of Medicine and Nursing.

B. The Boards of Medicine and Nursing shall jointly adopt regulations for the licensure of licensed certified midwives, which shall include criteria for licensure and renewal of a license as a certified midwife that shall include a requirement that the applicant provide evidence satisfactory to the Boards of current certification as a certified midwife by the American Midwifery Certification Board and that shall be consistent with the requirements for certification as a certified midwife established by the American Midwifery Certification Board.

C. The Boards of Medicine and Nursing may issue a license by endorsement to an applicant to practice as a licensed certified midwife if the applicant has been licensed as a certified midwife under the laws of another state and, pursuant to regulations of the Boards, the applicant meets the qualifications for licensure as a licensed certified midwife in the Commonwealth.

D. A licensed certified midwife who has practiced fewer than 1,000 hours shall practice in consultation with a licensed physician or independent practice midwife in accordance with a practice agreement between the licensed certified midwife and the licensed physician or independent practice midwife. Such practice agreement shall address the availability of the physician or independent practice midwife for routine and urgent consultation on patient care. Evidence of a practice agreement shall be maintained by the licensed certified midwife and provided to the Board upon request. A licensed certified midwife who has completed 1,000 hours of practice as a licensed certified midwife may practice without a practice agreement upon receipt by the licensed certified midwife of an attestation from the licensed physician or independent practice midwife with whom the licensed certified midwife has entered into a practice agreement stating (i) that such licensed physician or independent practice midwife has provided consultation to the licensed certified midwife pursuant to a practice agreement meeting the requirements of this section and (ii) the period of time for which such licensed physician or independent practice midwife practiced in collaboration and consultation with the licensed certified midwife pursuant to the practice agreement. A licensed certified midwife authorized to practice without a practice agreement shall consult, collaborate with, and refer patients to other health care providers as may be appropriate for the care of the patient. The Board shall adopt regulations for the practice of licensed certified midwives, which shall be in accordance with regulations jointly adopted by the Boards of Medicine and Nursing, which shall be consistent with the Standards for the Practice of Midwifery set by the American College of Nurse-Midwives governing the practice of midwifery. For the purposes of this subsection, “independent practice midwife” means a licensed certified midwife who is authorized to practice without a practice agreement pursuant to this subsection and has practiced independently for two years or a certified nurse midwife who is authorized to practice without a practice agreement pursuant to subsection H of § 54.1-2957 and has practiced independently for two years.

E. Notwithstanding any provision of law or regulation to the contrary, a licensed certified midwife may prescribe Schedules II through VI controlled substances in accordance with regulations of the Boards of Medicine and Nursing.

F. A licensed certified midwife who provides health care services to a patient outside of a hospital or birthing center shall disclose to that patient, when appropriate, information on health risks associated with births outside of a hospital or birthing center, including but not limited to risks associated with vaginal births after a prior cesarean section, breech births, births by women experiencing high-risk pregnancies, and births involving multiple gestation. As used in this subsection, “birthing center” shall have the same meaning as in § 54.1-2957.03.

G. A licensed certified midwife who provides health care to a patient shall be liable for the midwife’s negligent, grossly negligent, or willful and wanton acts or omissions. Except as otherwise provided by law, any (i) doctor of medicine or osteopathy who did not collaborate or consult with the midwife regarding the patient and who has not previously treated the patient for this pregnancy, (ii) physician assistant, (iii) advanced practice registered nurse, (iv) prehospital emergency medical personnel, or (v) hospital as defined in § 32.1-123, or any employee of, person providing services pursuant to a contract with, or agent of such hospital, that provides screening and stabilization health care services to a patient as a result of a licensed certified midwife’s negligent, grossly negligent, or willful and wanton acts or omissions shall be immune from liability for acts or omissions constituting ordinary negligence.