To amend sections 3701.351, 3702.30, 4723.01, 4723.02, 4723.03, 4723.06, 4723.07, 4723.08, 4723.271, 4723.28, 4723.282, 4723.33, 4723.34, 4723.341, 4723.35, 4723.41, 4723.43, 4723.431, 4723.432, 4723.481, 4723.483, 4723.487, 4723.488, 4723.4810, 4723.4811, 4723.50, 4723.91, 4723.99, 4731.22, and 4731.27 and to enact sections 5.2322, 4723.53, 4723.54, 4723.55, 4723.551, 4723.56, 4723.57, 4723.58, 4723.581, 4723.582, 4723.583, 4723.584, 4723.59, 4723.60, 4724.01, 4724.02, 4724.03, 4724.04, 4724.05, 4724.06, 4724.07, 4724.08, 4724.09, 4724.10, 4724.11, 4724.12, 4724.13, 4724.14, and 4724.99 of the Revised Code to regulate the practice of certified nurse-midwives, certified midwives, and licensed midwives and to designate May 5th as the "Day of the Midwife."
HB224 would create a comprehensive statutory framework for midwifery in Ohio by regulating three related professions: certified nurse-midwives, certified midwives, and licensed midwives. It also designates May 5 as the “Day of the Midwife.” The bill amends existing nursing and health-facility laws and adds new chapters and sections governing licensure, scope of practice, collaboration requirements, informed consent, discipline, reporting, and facility standards.
For certified nurse-midwives and certified midwives, the bill establishes licensure and renewal requirements through the Board of Nursing, defines their scope of practice, and sets rules for collaboration with physicians or podiatrists through standard care arrangements. It also creates specific provisions for prescribing authority, use of the drug database, expedited partner therapy, epinephrine and glucagon furnishing, home-birth consent, transfer-of-care planning, and reporting of adverse incidents. For licensed midwives, the bill creates a separate licensure system administered by the Department of Commerce, with education, certification, renewal, discipline, and practice rules tailored to out-of-hospital and home-birth settings.
The bill would also amend hospital and birthing-center laws to prohibit discrimination against qualified certified midwives and licensed midwives in clinical privileges and to recognize these practitioners in freestanding birthing centers. It adds reporting and oversight mechanisms, including mandatory adverse-incident reporting beginning in 2027 for births planned outside hospitals, annual reporting to state entities, and creation of a licensed midwifery advisory council to advise the Department of Commerce. The bill includes immunity provisions for certain emergency and transfer-of-care situations unless conduct amounts to willful or wanton misconduct.
The overall sentiment reflected by the bill text is supportive of expanding and formalizing midwifery practice, with an emphasis on access, professional recognition, and patient choice. Because the bill was only introduced and there are no committee transcripts or votes provided, there is no recorded public debate in the supplied materials. The structure of the proposal suggests an intent to balance expanded practice authority with regulatory oversight, safety standards, and reporting requirements.
The main points of contention likely to arise from this legislation are the scope of home-birth practice, especially for higher-risk situations such as VBACs, twins, and breech births, and the degree of physician collaboration required for midwives to practice and prescribe. The bill also draws a distinction between hospital-based and out-of-hospital care, which may prompt debate over patient safety, liability, and regulatory burden. In addition, the creation of a separate licensing system for licensed midwives and the delayed effective date for some provisions suggest the bill would require significant administrative implementation.
HB224 would substantially revise Ohio law governing nursing, midwifery, and certain health-care facilities. It would expand the Revised Code to expressly recognize certified midwives and licensed midwives, create new licensure and disciplinary provisions, amend hospital privilege rules, and establish new standards for birthing centers, informed consent, collaboration agreements, drug prescribing, and reporting. It would also shift some regulatory authority to the Department of Commerce for licensed midwives while keeping certified nurse-midwives and certified midwives under the Board of Nursing, thereby affecting practitioners, hospitals, birthing centers, physicians, and patients seeking maternity care, especially in home-birth and freestanding-birth-center settings.
The bill appears generally favorable toward midwifery and maternal-choice advocates, as it formalizes and broadens the legal status of midwives while adding a dedicated commemorative day. The absence of committee testimony or recorded votes means there is no documented opposition or support in the provided materials, but the bill’s detailed regulatory structure suggests an effort to reassure safety-focused stakeholders by pairing expanded practice rights with oversight, reporting, and discipline provisions.
Likely areas of contention include whether midwives should be allowed to attend higher-risk home births, how much physician collaboration should be required, and whether the bill gives midwives too much or too little autonomy. Hospitals and medical groups may focus on privilege standards, liability, and the requirement to accept qualified midwives without discrimination, while midwifery advocates may emphasize patient autonomy and access to out-of-hospital birth options. The new reporting requirements, advisory council oversight, and split regulatory scheme between the Board of Nursing and the Department of Commerce may also be debated as either necessary safeguards or burdensome regulation.