House Bill 495, the Accessing Midwives Act, would create a new licensing framework in Chapter 90 of the North Carolina General Statutes for Certified Professional Midwives and Certified Midwives practicing under the bill’s new Article 10B. It makes it unlawful to practice or hold oneself out as a licensed CPM or CM without a license, while carving out exemptions for physicians, nurse practitioners, physician assistants, registered nurses, emergency childbirth assistance, supervised assistants and students, and certain traditional birth attendants serving distinct cultural or religious communities.
The bill establishes the North Carolina Council of Midwives within the Division of Health Service Regulation to administer the new licensing system. The Council would be responsible for adopting rules, verifying credentials, issuing and disciplining licenses, setting fees, maintaining records, collecting annual practice reports, and educating the public and other providers about licensed midwifery. It also sets licensure, renewal, reciprocity, inactive status, and disciplinary standards, and requires licensed midwives to follow NACPM standards, maintain CPR and neonatal resuscitation certification, carry out informed consent and emergency transfer planning, and comply with newborn screening and birth certificate requirements.
The bill would also authorize the Council to establish a formulary of drugs and devices appropriate to midwifery care and permit licensed midwives to dispense only items on that formulary, subject to state and federal law. It includes enforcement tools such as license suspension or revocation, injunctions against unlawful practice, and a provision limiting liability for health care providers and medical facilities for injuries arising from a licensed midwife’s acts or omissions during childbirth, even when consultation or referral occurred.
The overall sentiment in the available record appears neutral to supportive, but there is little direct evidence from committee debate or votes because no transcripts or vote history were provided. The bill’s structure suggests an effort to formalize and expand access to community birth and midwifery services while also imposing regulatory oversight and safety standards. Any controversy would likely center on scope of practice, the creation of a new licensing board, and the liability protection language, but those issues are not documented in the supplied materials.
In practical terms, the bill would significantly affect midwives, pregnant patients seeking out-of-hospital birth care, physicians and other maternity-care providers, and the Department of Health and Human Services. It would create a new regulated profession within state law, define who may practice, and set statewide standards for education, supervision, reporting, and discipline.
H495 would amend Chapter 90 by adding a new Article 10B governing Certified Professional Midwives and Certified Midwives, thereby creating a state licensing and regulatory regime where none is described in the bill text. It would establish the North Carolina Council of Midwives, authorize rulemaking and enforcement, require licensure for practice, and set standards for renewal, reciprocity, fees, discipline, and practice requirements. The bill also interacts with public health and vital records law by requiring newborn screening instruction and birth certificate filing, and it affects liability and provider relationships by limiting vicarious liability for other health care providers and facilities in certain childbirth-related circumstances.
Based on the bill text alone and the absence of recorded debate or votes, the general sentiment appears to be favorable toward expanding access to licensed midwifery and community birth options, while pairing that access with formal regulation. The title, sponsor list, and detailed licensing structure suggest a policy goal of legitimizing and standardizing midwifery practice rather than restricting it. No committee testimony or vote record is available here to indicate organized opposition or support, so any assessment of sentiment is necessarily limited.
The most likely points of contention are the scope of practice for midwives, the creation of a new licensing council, and the bill’s liability protections for physicians and medical facilities. Some stakeholders may view the bill as improving access to maternity care and recognizing certified professional midwives, while others may question whether the training and oversight standards are sufficient, especially for out-of-hospital births and medication administration. The exemption for traditional birth attendants serving distinct cultural or religious groups may also draw attention, as could the provision insulating other providers and facilities from liability for a licensed midwife’s acts or omissions.