Assemblywomen Autumn Burke’s (D- Inglewood) bill, AB 2682, which would ensure all Californian pregnant women are able to access prenatal care of their choice, has passed out of the Assembly Business and Professions Committee and has proceeded to the Assembly Appropriations Committee.

Currently, certified nurse midwives (CNM) can only practice under the supervision of a physician which can restrict the ability on where they could provide service. AB 2682 would untether a CNM from a doctor, in cases of normal childbirth, to provide care, including family planning, for the mother and the newborn.  The bill also provides strong safeguards.  If at any time during the pregnancy, an abnormal condition would arise, the CNM would be required to refer or transfer care to a physician and follow the physician’s treatment plan.

Although CNMs undergo more training than a licensed midwife, CNMs still have the requirement of being supervised by a doctor, while the Legislature removed physician supervision of licensed midwives in 2014.

California is one of only six states which places the physician requirement on CNMs, even though the doctor doesn’t oversee health care delivery, inspect or review of charts, co-sign prescriptions, perform direct care on the patient, or evaluate CNM patients at any point during pregnancy.

“I have experienced first-hand the expert care provided by certified nurse midwives,” Burke said. “I want all women in California to have the choice of selecting which kind of medical practitioner they would like to help them as they give birth to their children. Untethering CNMs from physician supervision requirements will increase access to health care services for thousands of women in both urban and rural areas.”

According to a national study published in February, areas within the U.S. where certified nurse midwives are used for maternity care, pregnant mothers experience higher rates of spontaneous vaginal delivery, vaginal birth after cesarean, and breastfeeding, and significantly lower rates of cesarean, preterm birth, low birth weight infants, and neonatal death.  Further, the use of midwives in collaboration with other health care professionals drastically reduces the cost associated with maternity care.