Licensed Midwives in Virginia are restricted from administering the medications that are within their scope of practice. Virginia is one of only two states that license midwives, yet restrict them from accessing these medications. Licensed Midwives should be able to work within their full scope of practice.
When I heard that Virginia Licensed Midwives can’t legally use medications, I was flabbergasted. I asked a Virginia LM, “You mean no Pitocin?” The midwife said, “No Pitocin. We can’t even use oxygen legally.” What kind of backward place is Virginia that it won’t let LMs use these medications that can save women’s lives? Why wouldn’t someone change this law and help the midwives help families have safer care? —Licensed Midwife in Washington State
The North American Registry of Midwives (NARM) is the organization that administers the Certified Professional Midwife (CPM) credential that Licensed Midwives are required to have. CPMs are authorized to practice in 37 states. Virginia has had licensure for CPMs since 2005. CPMs are uniquely qualified to practice in the community setting. CPMs work at freestanding birth centers and in patient’s homes. Their training includes the use of basic medications needed for safer practice in the community setting.
Scope of practice for CPMs is determined by the NARM Job Analysis. It becomes the blueprint for the board certification exam’s test specifications. The most recent NARM Job Analysis requires CPM candidates demonstrate knowledge of the benefits, risks, and appropriate administration of the following medications:
Local anesthetic for suturing
Medical oxygen
Antihemorrhagics
IV fluids
Antibiotics for GBS prophylaxis
RhoGAM
Newborn medications (vitamin K, erythromycin eye ointment)
Epinephrine for allergic reactions and for use in neonatal resuscitation
A Job Analysis is a list of tasks essential to the performance of a profession. The list defines the scope of practice for that profession, according to a consensus of the practitioners. The list of tasks is not meant to limit the job performed by those professionals, but to identify the core skills needed for entry into the profession. The purpose of the Job Analysis, for a certification program, is to determine the knowledge and skills that must be demonstrated by those seeking certification. —North American Registry of Midwives website
Virginia Licensed Midwives should be allowed to practice within their full scope of practice. Our outdated law needs to be changed to reflect the certification and training Licensed Midwives have.
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